Some dopamine agonists such as bromocriptine have been offered to inhibit lactation. However, they expose women to severe adverse effects, sometimes from the start of treatment: hypertension, myocardial infarction, stroke, hallucinations, convulsions. That is why, in the USA for example, no dopamine agonists are authorised as lactation inhibitors.

A Toulouse team has carried out a study involving 61 women who remained in hospital after giving birth and who did not wish to breastfeed. They were informed, either by midwives, or by a patient leaflet explaining both the benefits and the harms of bromocriptine and listing alternative drugs to relieve the pain and discomfort associated with puerperal lactation.

Ultimately, only 11% of the women decided to use bromocriptine. Nearly all the women took an analgesic treatment during puerperal lactation.

Most of the patients (87%) were satisfied with the treatment they received. The reasons given by patients opting for bromocriptine were that they had taken it after a previous birth or had been advised to do so by their doctor.

This study shows that providing patients with balanced information explaining the harms and benefits of bromocriptine to inhibit lactation enables women to avoid being exposed to the drug’s adverse effects, and that there is a high level of patient satisfaction with alternative treatments.

©Prescrire 1 February 2015

"Choosing not to take bromocriptine" Prescrire Int 2015; 24 (157): 45. (Pdf, subscribers only).