Weak evidence for effectiveness of some pharmacologic treatments for suppression of lactation

Clinical question: 
How effective are interventions used for suppression of lactation in postpartum women?
Bottom line: 
There is weak evidence that some pharmacologic treatments are better than no treatment for suppressing the symptoms of lactation in the first week postpartum. Drugs tested included bromocriptine, oestrogens, and combined oestrogen and testosterone. There is currently no evidence to show that nonpharmacologic approaches (such as binding the breasts, fluid and diet restrictions, icepacks) are more effective than no treatment. There is insufficient evidence at present to address the issue of side effects of the pharmacologic, and nonpharmacologic, methods that are employed for suppressing lactation. When women desire treatment for suppressing lactation, consideration may be given to bromocriptine where it is still registered for such use in healthy mothers with no predisposition to major side effects of public concern (thromboembolism, myocardial infarction and maternal death).
Caveat: 
Most of the drugs tested are currently not available or registered for suppressing lactation. No trials compared nonpharmacologic approaches to no treatment, and none of the included trials provided reliable data on women's satisfaction with the treatment.
Context: 
Various pharmacologic and nonpharmacologic interventions have been used to suppress lactation after childbirth and relieve associated symptoms. Despite the large volume of literature on the subject, there is currently no universal guideline on the most appropriate approach for suppressing lactation in postpartum women.
Review CD#: 
CD005937
PEARLS No: 
168
Date: 
June, 2009
Authored by: 
Brian R McAvoy