Breast Care For The Non-breast Feeding Woman

What happens to a woman’s breasts during and after pregnancy?

During pregnancy, a woman’s breasts prepare for lactation. At as early as 16 weeks of pregnancy, breasts are producing milk. Milk usually comes in 3 to 4 days after the pregnancy ends, but this may happen later for some women. You may have a wide range of emotions (feelings) when your milk comes in. This is normal. Lactation (the production of breast milk) depends on the glands in a woman's body and on the hormones that the glands produce. Hormones are chemicals that help different parts of your body know how they should work. Prolactin is the hormone that makes your body able to breastfeed. Lactation will begin if you had a baby vaginally (through the vagina) or if you had a cesarean section (C-section).

What are some reasons why I may not be able to breastfeed?

There are many reasons why breastfeeding does not happen after a pregnancy. Breastfeeding may not occur because of personal choice, illness of the mother, adoption, or the baby dies. If your newborn has a disease called galactosemia, he cannot be fed breast milk. If you have a disease called tuberculosis and have an active infection that has not been treated, you will not be able to breastfeed. Women who are positive for human immunodeficiency virus (HIV) may avoid breastfeeding to decrease the risk of passing the virus to the baby through her breast milk. If you have a disease called herpes and you have sores on your breasts, you may not be able to breastfeed. If you use illegal (street) drugs, also called drugs of abuse, you may not be able to breastfeed. These include heroin, cocaine, methamphetamine, and others. If you have questions about reasons not to breastfeed, or you do not know if you should breastfeed, ask your caregiver.

What can happen to my breasts when I do not breastfeed?

When a woman does not breastfeed, production of breast milk will stop by itself over time. Before this happens, women may have one or more of the following signs and symptoms:

• Leaking milk. Your breasts may leak a medium to large amount of milk. Drops of milk may come from your breasts for weeks after your pregnancy.
  
  
• Breast engorgement. Your breasts may feel very hard to the touch. You may see swelling and feel pressure, discomfort, or pain for up to ten days after your pregnancy ends. Breast inflammation (swelling) can cause you to get a fever (higher than normal body temperature) and have muscle aches. Although engorgement can be uncomfortable, it helps your body decrease breast milk production.
  
  
• Cramping. You may have cramps (cramping of your uterus) as you make less milk over time.
  
  
• Vaginal bleeding. As your milk production decreases, you may bleed from your vagina (birth canal).

How do I care for my breasts if I am not breastfeeding?

Caring for your breasts after pregnancy if you are not breastfeeding includes stopping lactation and decreasing the signs and symptoms that can occur. Even when using treatments to help stop lactation, you may still have signs and symptoms, such as breast pain. Signs and symptoms may occur for a week or longer after your pregnancy ends. Talk to your caregiver. He may suggest any of the following:

• Wear a bra that fits you correctly and that provides firm support. A well-fitting bra that is not too tight may decrease breast pain and the amount of milk leakage from your breasts. A supportive bra can also decrease the symptoms of engorgement. Your caregiver also may tell you not to stimulate your nipples.
  
  
• Placing ice packs or bags of frozen peas covered with a cloth on your breasts may decrease breast swelling and pain. Move the ice packs or frozen vegetable bags every ten minutes, or as directed by your caregiver. Ice packs also may be placed inside your bra to decrease breast pain and swelling.
  
  
• The symptoms of breast pressure and discomfort may decrease if you release a small amount of milk from your breasts. To do this, place your nipples (not your whole breasts) in a sink full of warm water.
  
  
• Your caregiver may suggest that you take warm showers to decrease feelings of pressure in your breasts. Warm showers can cause some milk to leak from your breasts. Ask caregivers if you should stand with your back toward the water to decrease the flow of milk when taking a warm shower.
  
  
• Talk to your caregiver about using your hands or a breast pump to remove a small amount of milk from your breasts. If you use a breast pump, remove just enough milk to decrease pain and discomfort. Each time you pump, do it for a shorter time period. Allow more time to pass between pumping sessions. Doing this may slowly decrease the amount of milk that you make. It may decrease the pain and swelling that can come with stopping lactation. If you pump, using cold or hot compresses and doing gentle breast massage also may decrease symptoms, such as pain. Hot compresses may cause some milk to leak from your breasts.
  
  
• Your caregiver may order medicine, such as analgesics (pain medicine), to decrease your breast pain or discomfort. He may also suggest nonprescription (over-the-counter) medicine, such as ibuprofen or acetaminophen. These medicines can decrease pain and swelling. Your caregiver may suggest other medicine that can help stop your breasts from producing milk.
  
  
• Ask your caregiver about using cabbage leaves and jasmine flowers. Cabbage leaves may be used to decrease breast pain caused by stopping lactation. Placing the leaves on your breasts and massaging your breasts may help decrease pain. Cold cabbage leaves may also be placed inside your bra. Jasmine flowers placed on your breasts also may relieve breast discomfort.

What else can I do to cope with not breastfeeding after a pregnancy?

• Drinking liquids: Adults should drink about 9 to 13 cups of liquid each day. One cup is 8 ounces. Good choices of liquids for most people include water, juice, and milk. Coffee, soup, and fruit may be counted in your daily liquid amount. Ask your caregiver how much liquid you should drink each day.
  
  
• Eat healthy foods: Choose healthy foods from all the food groups every day. Include whole-grain bread, cereal, rice, and pasta. Eat a variety of fruits and vegetables, including dark green and orange vegetables. Include dairy products such as low-fat milk, yogurt, and cheese. Choose protein sources, such as lean beef and chicken, fish, beans, eggs, and nuts. Ask how many servings of fats, oils, and sweets you should have each day, and if you need to be on a special diet.

When should I have follow-up appointments?

You may need to see your caregiver 3 to 5 days after the end of your pregnancy, or your caregiver will call you on the phone. Tell your caregiver about your symptoms. Talk to him about your feelings and any questions that you have. Your caregiver may suggest breast self-exams and mammograms. Ask your caregiver for more information, as well as when and how often to have these exams and tests.

Where can I find support?

Being unable to breastfeed when you want to can make you feel sad. If your baby has died, or you cannot breastfeed, talk to your caregiver. Ask for contact information of support groups or other resources that can help you as you cope after pregnancy.

When should I call my caregiver?

Call your caregiver if:

• You have very painful breasts.
  
  
• You have a fever and muscle aches that last longer than one day.
  
  
• You cannot breastfeed, and you feel alone and scared.
  
  
• You feel or see a lump on your breast.

When should I seek immediate help?

Call 911 or seek care immediately if:

• You have symptoms of breast inflammation, such as swelling, that are getting worse over time, even with treatment.
  
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.