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Episode 54     Lori talks about Drying up your milk supply

Weaning – by definition means to gradually take away, to detach. My personal and professional preference would be for moms who want to wean do so, Gradually and with love. This would be an optimal way to go about the weaning process. There are times when this is not possible and moms need to dry up their supply as quickly as possible. Today’s show is all about the “not possible.” About drying up quickly, which is why I did not title this show Weaning and titled it: drying up your supply. And yet, you will hear me use the term drying up and weaning interchangeably because it just seems to be the most accepted and understood way of talking about this topic. And I refuse to have to stay the course always using the exact right technical term with moms. Lots of times they don’t care about our terminology, they just want help and if they “hear” me best when using a term they are familiar with and connect to, I will do so to best meet them where they are at.

As a lactation consultant, the assumption is that I only help mothers who want to breastfeed their baby. Of course, this is one of the important things I do each and every day. Educate through classes, blogs, and private consults and now with podcasting. I also help moms with the weaning process. I recognize that there are many reasons why some mothers who have been breastfeeding and or pumping want to or need to stop producing milk. Since this is a choice and not an urgent matter, she can do so gradually. While there are few reasons why a mom would need to stop producing milk abruptly, these circumstances do arise. Usually it becomes a necessity because she has a medical problem or needs to take medication that there are no other options and this is not compatible with breastfeeding. Sometimes a mom has had a breast abscess and can continue breastfeeding and other times for medical reasons can no longer breastfeed from one side and she needs to dry up that side. Good thing our breasts are autonomous .What we do with one side does not mean we have to do the same with the other side.

I am going to go backward for just a minute before I move forward. I did want to mention that I will be doing another show on the topic of weaning. There are many reasons and circumstances that gradually weaning happens. Perhaps the mom decides she no longer wants to continue the process of breastfeeding or pumping. Babies or children also self wean by gradually spending less and less time at the breast. Sometimes moms decide to purposefully night wean, some do daytime weaning and the baby or child only nurses first thing in the morning or the last thing at night. There are lots more to talk about the subject of weaning and we will definitely do that on another show.

When a mom tells me she has to wean abruptly, I spend some time finding out why she has to stop producing milk. The fact is, that there are a lot of times when moms are told they need to stop breastfeeding, and they really did not need to. There is a lot of breastfeeding mismanagement in the field of lactation and I just want to be sure mom is making a fully informed decision. Talking this through is very important to me because by not talking about the process with an expert, some moms go it alone or get poor advise and cause problems in the process. I want every mother who needs to dry up, to accomplish this in the safest way possible. For their heart, their breasts, their baby and their brain. As in many things related to breastfeeding, advising on the drying up and the weaning process is not a standard textbook one size fits all. Trouble happens when this is the approach.

My hope with initiating the conversation is that this will make it easier for them to talk about what may be weighing heavy in their heart and on their minds. This gives me the opportunity to answer e questions and ensure that she is not following this course of action because of circumstances someone told her and she has been given wrong or outdated information. This gives me the opportunity to suggest to her that if there is a medical reason for doing so, and I suspect this is not truly the case, that I am able to share with her the wisdom of getting a second opinion from an objective and knowledgeable healthcare provider. I am not pushy nor do I try to bring in what might be my own personal bias or agenda. I also avoid giving a very specific care plan because it can be somewhat risky as the advice may fit one person to a “T” and be quite negligent info to the next mom and baby pairs needs. I am going to do my best to narrow down the process of weaning and then describe the most common ways of weaning.

1. Weaning from breastfeeding only.
2. Weaning from breastfeeding and pumping.
3. Weaning from exclusive pumping.

Additional variations come in when we need to think about how long mom has been breastfeeding, how frequently she has been removing the milk, and how much milk she is making.

For instance, if she has been breastfeeding 1 week and making about 2 oz every 2-3 hours, her weaning process will more than likely be quicker, than a mom who has been removing the milk for 6 months with baby/and or pump 8 times a day and removing 4-5 oz. The weaning process is going to take her longer and perhaps need to be creative with how to go about it and accept the fact that she cannot be done overnight.

As a lactation consultant, I am there for the moms I work with, no matter what. It does make it easier for me, if this is something mom really wants to do and is ready for this process. It breaks my heart and I have to do my best, to try and be as professional as I can be, when she needs to wean quickly for a health issue or perhaps her baby passed away at a very young age. I do my best to remain professional, but sometimes I just cry along with her.. and I have also learned that this is okay. I am a professional, and I am also a human being and a mother and walk alongside mothers with the empathy and kindness and compassion. It is the way I would want to be treated if I were in her position.

While I do not want to give a one size fits all template to this process, I do want to address the risk factor of abrupt weaning.

Mothers may experience breast pain and moderate to severe engorgement, which can lead to plugged ducts, breast inflammation can lead to a breast infection where her breasts will become very red, hard, sore, warm to hot and if this continues may very well lead to a breast abscess., which is incredibly painful and a major health issue, which can sometimes be managed during an office visit and other times requires hospitalization for an incision to be made and drainage to occur. Breast abscess while certainly not common with breastfeeding moms, is a risk factor when abruptly weaning.
Abrupt weaning cause major stress to the mother and lead to depression as the hormones levels are more likely to take a drastic plunge which tends to cause anxiety, depression, and severe mood swings.

Abrupt weaning (may also have heard it called “going cold turkey” leaves a baby susceptible to an increased risk of infection, overnight losing the comfort and closeness that breastfeeding provides. Some babies don’t take to a bottle or a cup easily and this causes stress for mom and baby. Particularly if the weaning is abrupt and there is no stored breastmilk for the baby, switching to formula can cause tummy issues for the baby. Finding the right formula can take weeks and during this time period, the baby is very unhappy.

I want to take this opportunity to talk about the what “not to do’s”, which I still, unfortunately see happening. These ways of weaning are typically old information and we know better now how to help moms wean safely.

• Don’t bind your breasts. This is an old fashioned idea which is no longer recommended because it can make you very uncomfortable, and may cause plugged ducts and mastitis. Wear a supportive sport bra instead.
• Using drugs to “dry up” the milk is also not recommended because they are not very effective, and may cause serious side effects.
• Wear a supportive (but not tight) bra for support. Choose clothing that is less likely to show wet spots if you leak, and wear nursing pads to absorb leaking milk.

So, how can you safely wean? You can take some pain medication to help with the uncomfortableness and also with the drying up. When it comes to medication, you always want to discuss this with your physician first before taking anything.

1.Decongestants, such as Sudafed under the care of your physician, can be quite helpful when looking to abruptly wean. Just as this medication helps to dry up other areas of secretion in the body, it also dries up your milk.

2. Herbs such as Sage to help reduce supply quickly.

3. Wrapping your breast tissue with cold cabbage leaves ( being careful not to cover your nipples), and changing the leaves frequently can help to quickly dry up.

4. Reducing the amount of times you remove the milk and reducing the volume of milk you remove each time, combined with any or all of the above methods, will help you dry your milk up as quickly as possible. Since I see this as being quite risky to the mother’s health, I urge you to seek the help of an IBCLC in combination with a breastfeeding knowledgeable healthcare provider to advise you on a very specific care plan designed just for you. You will be asked specific questions regarding allergies to medications or herbs, how much milk you are currently producing, how frequently you are removing the milk, and my greatest wish is that your emotional health as well as any need to know info about your baby, will also be addressed.

I am hoping that by my laying out the details, you can begin to understand the need to not go this alone.

There is good reason to work with an expert for abrupt weaning, as you will hear cabbage suggested, just like I did. But what I don’t have the ability to explore with the individual mom is the specific nuances for every situation. For instance, cabbage works great, but you do not want to use it if you have an allergy to sulfa. You may be told certain herbs, such as Sage and Peppermint will be helpful, but how you use it can be in direct proportion to how useful it is to you.

Abrupt or quick weaning, is our least favorite way to dry up you milk supply, However, if it needs to happen, I strongly encourage you to never go cold turkey, meaning, just stop removing the milk period, as this can put you at a very high risk factor for breast infection and mastitis. Worse yet is to listen to outdated advise to just stop removing the milk and bind your breasts. Particularly if you have been breastfeeding for several weeks or more and producing 3-4 o z every few hours, this is a huge set up for a breast infection and mastitis. I urge you to not take this course.

1BI788IIf you are weaning abruptly, please discuss with your loved ones what you are doing and have them rally around them for support. Because of the abrupt changes in hormone levels, specifically oxytocin and prolactin levels, you are at risk for emotional difficulties that may cause you to feel loss or leave you with feelings of deep deep sadness, and may lead to feelings of anxiety and depression. This may happen whether you were emotionally ready to wean or not. You will want your loved ones help and compassion during this process..

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