Stopping Breastfeeding
If you have decided to stop breastfeeding the best way to do it to avoid engorgement, blocked ducts and mastitis is to do it gradually. However, this might not be an option and you may need to suddenly stop. This page provides some advice on reducing and stopping breastfeeding.
We are not medical experts and advise you to consult with your oncologist around any changes you are making that might affect your treatment.
If you’ve been advised by your medical team to stop breastfeeding, it is absolutely okay to question this if you don’t understand the reasoning. Health care choices should be reached in partnership with your health care professional and you should feel part of the decision process. Sometimes breastfeeding mothers are advised to stop feeding because the health care professionals are not in possession of all of the facts, and the safest option is to advise stopping breastfeeding. Working in partnership with your medical team alongside infant feeding specialists may help create a feeding plan for you and your baby you are comfortable with whilst going through treatment.
Stopping urgently
You might be advised to stop breastfeeding immediately for medical reasons. This is very challenging if you have a good supply. Stopping breastfeeding quickly is likely to cause discomfort and possibly pain. Taking regular pain relief and anti-inflammatories if able will help with the discomfort. There are some herbal remedies that some people claim reduce milk supply, such as sage, jasmine and peppermint, but the evidence is very weak.
Your doctor should be able to prescribe you a medication to stop milk production. The most commonly used in the UK is carbergoline but, as it carries some risks for people with certain known conditions it won’t be suitable for everyone. In addition, carbergoline has some grim side effects such as dizziness, shortness of breath, headache and nausea. Discussing your options with your oncologist will be important before embarking on medical treatment for stopping lactation.
What to avoid
Ideally you want to avoid anything that is going to stimulate milk production. Going back to the physiology of breastfeeding, we know that regular suckling and emptying of the breast stimulates milk production. Engorgement stops milk production. So whilst engorged breasts are painful, they are sending the right signals to tell your body to stop making milk. Easing engorgement with hot showers and hand expressing can help with symptoms but the draw back is, it stimulates supply. Some people say cabbage leaves help, but again, the evidence is very weak.
Another note of caution is some medications stimulate supply. If you need to take an anti-sickness tablet as part of your treatment, then avoid domperidone as this is known to increase milk production.
Look out for blocked ducts & mastitis
If you need to stop abruptly, then you will be at risk of developing blocked milk ducts and potentially mastitis. Mastitis is caused when a blocked duct becomes infected with bacteria. It can result in local symptoms in the breast such as pain, swelling and redness, and also systemic symptoms such as a high temperature, vomiting and generally feeling very unwell.
Nipping a blocked duct in the bud early is the best thing to do. If you have been advised to stop breastfeeding, you might still be able to use a breast pump to try and draw out the milk to unblock the duct. It will be really sore. If the breast pump is too much or not an option, then run yourself a bath, or hop in the shower and take a flannel and a comb. Imagine the breast is like a clock face, each number is a duct that drains into the centre point. Using the comb and flannel to massage each number on the face from the outside towards the centre, the nipple. Some women use their knuckles. Any area of redness needs the most attention. As well as milk, sometimes you might see a thicker cheesier substance draining from the breast; this can be a reassuring sign you are unblocking the duct.
If things don’t get better, and you start to become unwell, it is likely the blocked duct has become infected. In this case you will need to be assessed and it is likely you will be prescribed antibiotics. Keep massaging the breast to break up the blockage and let the antibiotics help rid the infection.
Remember - set a reminder on your phone for every 4-6 hours - to take pain killers the antibiotics. It is easy to forget when you are juggling everything.
Replacing breast milk
Breast milk or formula milk provides the main nutritional input for the first 12 months of a babies life. Solids are introduced around 6 months, but they don’t substitute milk, and indeed, most babies won’t take to 3 square meals a day until they’re a little older. So, if you are dropping breastfeeds and your baby is less than a year old, you will need to increase alternative foods to replace the breastmilk your baby is no longer drinking.
If your baby is not yet eating solid foods, you can substitute in your own stored breastmilk, donor milk, or formula milk.
If your baby refuses a bottle
‘What happens if my baby drops a breastfeed but they don’t pick up a bottle feed?’ we hear you cry (and probably hear you cry). Unfortunately, if this happens you are officially in Bottle Refusal Hell. This struggle is real. Trust us, we’ve been there, done that and got the t-shirt to prove it.
Luckily, there are some things you can do that may help:
Get advice from your health visitor or lactation consultant. They will be able to give you support and point you in the right direction if needed.
Try different bottles. If your baby has refused one bottle, try another. Get advice what bottles have worked for others; teats matter! If they really are hating the bottle then, depending on their age and head control, you could try a cup or spoon feeding.
Try different temperatures. Some babies like warm milk (never heat over body temperature), some like cooler milk, and some like cold milk.
Try different milks. If they are over 12 months then you can mix it up with cow’s milk, oat milk, any milk! Under 12 months you are restricted to infant formula milk, but different brands will taste differently. The ready made taste different to the powdered. A babies taste buds develop around 6 months, so they might start to show preference around then. All first infant formula milks are nutritionally equivalent, so there is no harm in switching brands, as they all are highly regulated and provide nutrition your baby needs. If you are a pumping mum, try mixing breastmilk with formula milk in decreasing volumes until they are eventually on a full formula feed.
Try different times. Try when they are hungry, try when they are full, try when they are sleepy and when they are wide awake.
Try different people. It might be sending your baby crazy to smell you and not be given the boob. So get partners, grandparents, friends - anyone who is willing - involved in offering a bottle. Make sure you leave the room. Not only may it help your baby to settle, but it will be much less stressful for you too.
Try different environments and positions. Some babies like to be still, others to be rocked. Some like noise and familiarity, others like quiet, unstimulating environments.
Mix formula into EVERYTHING. If they are already on solids mix formula with food. It will become really sloppy and disgusting looking, but it will allow them to get used to the taste. Mix it with breakfast, lunch, dinner and snacks.
Things you have tried once before, revisit them.
Finally, and most importantly, try and relax. This is going to be the hardest one of all to do. It can be a very stressful time stopping breastfeeding but don’t panic, they will eat when they want to. As long as they are hydrated (producing wet and dirty nappies) and getting plenty of cuddles they will be doing just fine.