The use of medication to stop breast milk supply can generate questions. So here are the most frequently asked questions on this subject, which usually come up when weaning a baby from the breast:

1. What is cabergoline, and what does it do?

Dostinex® (cabergoline) is a medication that causes a drop in prolactin in the blood, which can result in a drop in breast milk supply. It is especially effective if the mother takes it immediately after giving birth.

However, if it is given after the mature breast milk has come in or when the mother has been breastfeeding for days or months, it is not effective.

Although this medication is referred to as drying up the breast milk supply, it is important to keep in mind that it does not make the breast milk disappear; it does not just “dry up breast milk.” Therefore, many women who stop breastfeeding with this treatment suffer from breast engorgement and a lot of pain, as they are often told not to remove any breast milk and leave their breasts.

2. Does it have side effects?

After childbirth, the doses of cabergoline must be indicated by a physician. In order to avoid the onset of lactation, usually, a dose of 1 mg (2 tablets of 0.5 mg) is administered as a single dose and is taken to prevent the onset of milk supply.

Side effects can range from dizziness, vomiting, and fatigue to low blood pressure and depression, among others.

3. In which cases are these pills effective in stopping breast milk supply?

Cabergoline only seems to have some effect if the mother takes it right after giving birth. In that case, it prevents the increase of prolactin in the mother’s blood, which may result in less or not-so-obvious breast milk coming in.
In spite of having taken the medication, it is very common that, once at home, the mother feels her breastmilk coming in anyway. The fact is that the stimuli of having her baby close, touching her, smelling her, and so on can activate the production of prolactin and oxytocin again.
When the mother has already had her breastmilk coming in, this medication has no effect. For this reason, it should not be recommended to have when the mother has already started breastfeeding. In the case of wanting to stop breastfeeding and wean, the only way to go is to remove some breast milk when necessary, and each time a little less so the breasts don’t feel uncomfortable.

4. I have taken these pills, but my breastmilk has come in. What can I do?

This happens very often, and, as mentioned before, breast milk supply is not so simple to eliminate. And even though you take this medication, your breastmilk can still come in days after leaving the hospital.
If your breasts feel engorged, hard, warm, and uncomfortable, remove some breast milk manually or with a pump. Breast engorgement is your body’s way to lower milk supply, but it is so traumatic and painful that no mother should have to go through it.
It is much better to remove some breast milk whenever necessary, in small amounts, to decrease milk supply gradually.

5. I have taken medication to stop breastfeeding, and I regret it

If you have taken medication to dry up your milk supply and now you have changed your mind and want to breastfeed again (relactation), you can do so. Although this medication decreases milk supply because it lowers prolactin levels, prolactin levels can rise again if you stimulate your breasts, for example, with your baby’s suckling. Then, the medication can have a minimal effect on your breast milk supply. The stimulation of directly breastfeeding your baby and pumping will allow you to fully recover from your breastfeeding journey.

6. Is relactation safe and compatible with breastfeeding if I have taken cabergoline (Dostinex®)?

On the website about medication in breastfeeding by the pediatrics association APILAM, www.e-lactancia.org, cabergoline appears as high risk, which is because taking this drug can compromise breast milk supply and, therefore, breastfeeding.
However, they also state that the ingestion of the tablets by the mother does not pose any problem for the baby, who can breastfeed safely without any precaution.

7. Are there any natural alternatives to this medication?

Many mothers, when they want to stop breastfeeding, they don’t want to take medication and prefer to opt for more natural methods. Although there is no evidence of the effectiveness of these methods, many mothers use them, and we can find a variety of these natural remedies from around the world. Of all of them, we highlight the following:

• Sage herbal tea: the recommendation is 1 cup of this herbal tea three times a day. You will have the same effect of this herbal remedy if you take 2 whole droppers of sage essence. The decrease in milk supply is said to be noticeable within 24 to 48 hours after drinking the tea or essence.
• Vitamin B6: High doses of vitamin B6 supplements have been reported to reduce breast milk supply. IBCLC Anne Smith, suggests taking 200 mg of vitamin B-6 a day for five days.
• Jasmine Oil: Applying jasmine oil is believed to be effective in reducing milk supply, and likewise, many mothers wear a jasmine flower necklace around their neck to reduce milk supply.

There are many more, but again, we point out that there is no evidence for their effectiveness in being used to decrease breast milk supply.

8. How can I make my breast milk dry up?

The first thing to remember is that breast milk does not dry up. The milk supply may decrease, but it will take years for breast milk to completely disappear. What you want to achieve when you stop breastfeeding is that breast milk does not accumulate in your breasts anymore and doesn’t create pain or mastitis.

When you want to stop breastfeeding, the best and only approach is to reduce the amount of breast milk you make, there is no other way, no matter how old your baby or child is, you have to take it step by step.

9. How can I reduce milk supply?

Breastfeeding works by supply and demand. The more milk you remove, the more milk you make. If there is some breast milk left inside your breasts, your body regulates itself thanks to an enzyme called FIL (Feedback Inhibitor of Lactation), which is in charge of managing the supply. The more of this hormone that comes out with your breast milk when your baby nurses or when you pump with a breast pump, the more milk is produced. And on the other hand, the more FIL that stays inside, the less milk the mammary gland will produce.

As we said before, the idea is to remove less and less milk from your breasts gradually. When your breasts (or one of them) bothers you, remove a little bit of breast milk to feel comfortable, but always leave a little bit inside. You have to remove or pump the minimum amount that will help you not to have pain, but that at the same time allows the mammary gland to understand that it must reduce production. It is a fairly intuitive process, and each mother finds out for herself how much milk she needs to remove to feel good while continuing to decrease production. There will be a time when it will become apparent that your breasts no longer need this continuous emptying, and it will be time to stop. Within a few days, it is likely that your breasts will no longer bother you, and you will no longer need to do this.

There are other outdated options to reduce or eliminate breast milk that are not as effective and can be dangerous or even traumatic. Only in certain cases can cabergoline tablets (Dostinex®) be somewhat effective.

10. How long does it take to stop producing breast milk?

Breast milk production does not stop right away. In fact, it is possible that after several months, even years, if you express your nipple, you might see that some droplets are still there.

If your breasts are ok, you don’t have pain, hard areas on your breast, or redness, then the milk will gradually become less evident.

Even so, if your breast milk has disappeared completely and reappears, talk to your healthcare professional or gynecologist.