For working mothers breastfeeding can be a dilemma – and a painful one at that. We all know nursing is good for our babies. Many working mothers try to breastfeed as long as possible before returning to work, often 3 to 6 months. But what then? Breast engorgement is the natural consequence of discontinuing breastfeeding. The glands that produce milk don’t stop producing milk overnight just because you decide to stop nursing. It’s like filling up a water balloon tighter and tighter. You can imagine that would hurt.
The best way to stop breast feeding without pain is the natural way: a gradual taper. As a young toddler begins to eat other foods he will naturally need less milk. Lengthening the interval between feeds will little by little decline the milk supply in most women.
Of course, if you need to discontinue nursing before your child is old enough to switch to regular foods, you will either have to pump your breasts or supplement with infant formula. Breast pumping often works because pumping empties the breast less efficiently than does nursing. It’s almost as if a child is nevertheless nursing, but less so. The milk supply will decrease if you pump your breasts enough to relieve the discomfort of engorgement but not enough to completely empty the breast.
If you don’t want to pump your breasts, another option is allowing some of the milk to leak out by deliberately triggering the let-down reflex. A hot shower is often quite effective. A little milk leaks out, but only enough to relieve the pressure and discomfort.
There is little scientific evidence to advise the use of other treatments. Breast binding may cause additional leakage and pain. Though some women use cabbage leaves in the bra to suppress lactation, medical studies have not confirmed a assistance of this practice. Ultrasound has been studied but was not found to be useful.
Why does milk production stop anyway? Unrelieved breast engorgement leads to an increase in the chemical FIL (feedback inhibitor of lactation) in the breast, which inhibits milk production. However, engorgement does not need to be painful for this to occur. Allowing enough milk to leak out to relieve the pressure nevertheless allows FIL to build up and do its job.
One more information on painful breasts. Nursing mothers may suffer from inflammation or infection of the breast (mastitis). If your breast is tender, especially in a localized area, or if it turns red or seems feverish, you may be experiencing from mastitis. Consult your doctor to determine whether you need to take an antibiotic.
Copyright 2010 Cynthia J. Koelker, M.D.