by Anne Eglash MD, IBCLC, FABM
What medications and supplements are known to reduce the milk supply? There are several ways that substances can reduce the milk supply. Some medications increase dopamine, a neurotransmitter in the brain. Dopamine is known to reduce the prolactin level, so increasing dopamine can lead to a decrease this ‘work horse’ hormone for breastmilk production. Some medications decrease oxytocin, the ‘letdown’ hormone, and a few medications might decrease growth hormone, which also plays an important role in milk production. Some hormones have been found to block prolactin receptors, such that prolactin cannot be as effective at the breast. Several herbs have been found to decrease milk supply, but their mechanisms of action are not known.
What medications do you think have been found to decrease milk supply? Choose 1 or more:
- Epinephrine
- Labetolol
- High dose steroids (such as Solumedrol)
- Strong antihistamines such as diphenhydramine (Benadryl)
- Testosterone
- Estrogen
- Methylergonovine (Methergine)
- Pseudoephedrine (Sudafed)
- Aripiprazole (Abilify)
See the Answer
The answer is all except B, Labetolol
References:
1. Anderson PO Drugs that Suppress Lactation, Part 2. Breastfeeding Med 2017 May:12: 199-201
2. Toxnet- Lactmed
Milk Mob Comment by Anne Eglash MD, IBCLC, FABM
Occasionally women are given medications that can interfere with their milk supply. A common clinical scenario is a woman who has an overwhelming allergic reaction to something, such as an antibiotic given to her for mastitis. Women who receive shots of high dose steroids, epinephrine, and strong antihistamines to manage an allergic reaction have a strong likelihood of experiencing a noticeable drop in their milk supply. From my experience, the supply will rebound over the next 7-10 days.
Another not-uncommon scenario is the woman given an estrogen-containing birth control pill at 6 weeks postpartum or later. Estrogen commonly drops the milk supply, and in fact I use estrogen medicinally to drop the milk supply for women who are over-producers. The rebound in milk supply after hormonal treatment is more challenging, from my experience.
Providers who care for breastfeeding women need to be aware of what medications can effect the milk supply. In a situation such as an allergic reaction, when the use of anti-lactation medications is unavoidable, the mother needs to be counseled on how to maximize her milk supply, and how to identify whether she needs to supplement her infant until her milk supply rebounds.