Is Cabergoline Safe and Effective for Postpartum Lactation Inhibition? A Systematic Review

Despite its benefits, there are some situations where breastfeeding is impossible or not recommended. Breast milk secretion and engorgement can be distressing to these non-breastfeeding women. There is currently no universal guideline on the most appropriate management for these women. Our objective...

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Bibliographic Details
Published in:International journal of women's health 2020-01, Vol.12, p.159-170
Main Authors: Yang, Yang, Boucoiran, Isabelle, Tulloch, Karen J, Poliquin, Vanessa
Format: Article
Language:English
Subjects:
Breast feeding
Bromocriptine
Cabergoline
dostinex
Headache
Health maintenance organizations
lactation inhibition
lactation suppression
Narratives
Nausea
Online searching
Phenols (Class of compounds)
postpartum
Retirement benefits
Review
Time
Women
Women's health
Women's studies
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Summary:Despite its benefits, there are some situations where breastfeeding is impossible or not recommended. Breast milk secretion and engorgement can be distressing to these non-breastfeeding women. There is currently no universal guideline on the most appropriate management for these women. Our objective is to evaluate the effectiveness and safety of cabergoline, a dopamine agonist, in lactation inhibition in postpartum women. Studies were identified through electronic database searching (Cochrane library, EMBASE, Medline, IPA and Scopus) to identify all relevant studies that evaluated the use of cabergoline as a lactation inhibitor in postpartum women. Citations were screened and a narrative synthesis was undertaken given the heterogeneity of study designs. A total of six randomized trials met the inclusion criteria. Majority of the studies recruited healthy postpartum women electing for lactation inhibition for personal reasons. A range of 0.4 mg to 1 mg of cabergoline was given within 0 to 50 hrs of delivery. Dose-response relationship is established, and the highest rate of complete success was achieved with 1 mg of cabergoline, with time to cessation between 0 and 1 day. Cabergoline is non-inferior to bromocriptine for lactation inhibition while also associated with fewer rebound symptoms and adverse effects. Commonly reported adverse effects of cabergoline (eg, dizziness, headache and nausea) are self-limited. Cabergoline is simple, effective and generally safe when given to postpartum women either wishing or needing to suppress lactation. Further research is needed to improve postpartum care of these women.
ISSN:1179-1411
1179-1411
DOI:10.2147/IJWH.S232693