Topic
Lactation suppression
About: Lactation suppression is a research topic. Over the lifetime, 49 publications have been published within this topic receiving 511 citations. The topic is also known as: suppressed lactation & suppressed lactation - delivered.
Papers
TL;DR: There is weak evidence that some pharmacologic treatments are better than no treatment for suppressing lactation symptoms in the first postpartum week and large randomised trials are needed to compare the effectiveness of pharmacologic and non-pharmacologic methods with no treatment.
Abstract: Background
Various pharmacologic and non-pharmacologic interventions have been used to suppress lactation after childbirth and relieve associated symptoms. Despite the large volume of literature on the subject, there is currently no universal guideline on the most appropriate approach for suppressing lactation in postpartum women.
Objectives
To evaluate the effectiveness and safety of interventions used for suppression of lactation in postpartum women (who have not breastfed or expressed breastmilk) to determine which approach has the greatest comparative benefits with least risk.
Search methods
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2012).
Selection criteria
Randomised trials evaluating the effectiveness of treatments used for suppression of postpartum lactation.
Data collection and analysis
Two review authors independently assessed trial quality and extracted data.
Main results
We included 62 trials (6428 women). Twenty-two trials did not contribute data to the meta-analyses. The trials were generally small and of limited quality. Three trials (107 women) indicated that bromocriptine significantly reduced the proportion of women lactating compared with no treatment at or within seven days postpartum (three trials, 107 women; risk ratio (RR) 0.36, 95% confidence interval (CI) 0.24 to 0.54). Seven trials involving oestrogen preparations (diethylstilbestrol, quinestrol, chlorotrianisene, hexestrol) suggested that they significantly reduced the proportion of lactating women compared with no treatment at or within seven days postpartum (RR 0.40, 95% CI 0.29 to 0.56). We found no trials comparing non-pharmacologic methods with no treatment. Trials comparing bromocriptine with other pharmacologic agents such as methergoline, prostaglandins, pyridoxine, carbegoline, diethylstilbestrol and cyclofenil suggested similarity in their effectiveness. Side effects were poorly reported in the trials and no case of thromboembolism was recorded in the four trials that reported it as an outcome.
Authors' conclusions
There is weak evidence that some pharmacologic treatments (most of which are currently unavailable to the public) are better than no treatment for suppressing lactation symptoms in the first postpartum week. No evidence currently exists to indicate whether non-pharmacologic approaches are more effective than no treatment. Presently, there is insufficient evidence to address the side effects of methods employed for suppressing lactation. When women desire treatment, bromocriptine may be considered where it is registered for lactation suppression in those without predisposition to its major side effects of public concerns. Many trials did not contribute data that could be included in analyses. Large randomised trials are needed to compare the effectiveness of pharmacologic (especially bromocriptine) and non-pharmacologic methods with no treatment. Such trials should consider the acceptability of the intervention and lactation symptoms of concern to women and be large enough to detect clinically important differences in major side effects between comparison groups.
57 citations
TL;DR: It is suggested that lactation suppression is due mainly to the estrogen content.
51 citations
Book•
1 Mar 1994
TL;DR: This manual consists of concise discussions about the management of 102 common obstetric and gynaecologic problems, followed by a list of annotated references for further study.
Abstract: This manual consists of concise discussions about the management of 102 common obstetric and gynaecologic problems, followed by a list of annotated references for further study. Each chapter includes basic information on pathophysiology, diagnosis and management. New to this edition are chapters on surgery and trauma in the pregnant patient; lactation and lactation suppression; antepartum assessment of foetal well-being; papillomavirus; AIDS; hyperprolactinemia; androgen insensitivity; benign breast disorders; and malignant breast disease.
35 citations
TL;DR: It has been suggested that D2 receptor agonists commonly used postpartum for the physiological suppression of lactation, such as bromocriptine and cabergoline, may increase the risk of illness onset or relapse in women where there is a predisposition for or history of schizophrenia, bipolar disorder or post partum psychosis.
Abstract: Background: It has been suggested that D2 receptor agonists commonly used postpartum for the physiological suppression of lactation, such as bromocriptine and cabergoline, may increase the risk of illness onset or relapse in women where there is a predisposition for or history of schizophrenia, bipolar disorder or postpartum psychosis. This is based on two lines of reasoning: current models of psychosis assume episodes are triggered by dysregulation of brain dopaminergic activity and treated by medications that universally have D2 receptor antagonist properties; and limited research suggesting these agents may be associated with psychotic episodes in vulnerable individuals outside of the postpartum period. Aim: The aim of this study was to examine whether D2 agonists trigger psychosis in previously well mothers, or psychotic relapse or exacerbation of symptoms in mothers with known psychotic illnesses, when used to suppress lactation during the early postpartum period. Materials and Methods: A systematic review of the literature was undertaken of electronic databases, including: MEDLINE, EMBASE and PsychINFO from 1950 to 2015 using keywords. Results: Eight case reports, three case series and a pharmacovigilance survey were identified. Conclusion: Whilst D2 receptor agonists appear to increase the risk of triggering psychosis in previously well mothers and those previously diagnosed with schizophrenia, bipolar disorder and postpartum psychosis, bromocriptine appears to pose a much greater risk than cabergoline. When considering the use of pharmacological agents to suppress lactation, physicians should carefully screen patients for a history of psychosis and consider alternatives to moderate this risk.
32 citations
TL;DR: Bromocriptine (Parlodel®) has attracted widespread controversy for its use for postpartum lactation suppression because of recent reports of cerebral and cardiovascular complications, so its use with caution is suggested, especially in patients with identifiable risk factors of coronary artery disease or arteriovascular disease.
Abstract: Bromocriptine (Parlodel) has attracted widespread controversy for its use for postpartum lactation suppression because of recent reports of cerebral and cardiovascular complications. This case describes a maternal death in which bromocriptine therapy may have triggered myocardial infarction in a patient with asymptomatic coronary artery disease. We suggest its use with caution, especially in patients with identifiable risk factors of coronary artery disease or arteriovascular disease.
28 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2020 | 2 |
| 2019 | 1 |
| 2017 | 1 |
| 2016 | 2 |
| 2014 | 1 |
| 2013 | 1 |