Cabergoline and lactation

In this article, we want to address several serious issues related to the so-called “Cabergoline crisis,” which is widespread among mothers. This is especially relevant in situations involving the cessation of breastfeeding. We have repeatedly observed women taking this medication on their own, as well as thoughtlessly recommending it to others—and, most concerningly, sharing such advice widely on the internet.

The use of cabergoline (brand name Dostinex) can provoke very intense and traumatic experiences for both the breastfeeding mother and the child, particularly for the child, as it is associated with abrupt weaning. Milk production stops suddenly, the infant is unprepared for these changes, and in such circumstances, trauma is inevitable. Depriving a child of the breast—as both a physical and emotional “tool” for contact with the mother—suddenly, without assessment and without monitoring the child’s readiness for weaning, cannot be considered a prudent approach.

First of all, it is necessary to provide information about the medication itself. Its main component—cabergoline—acts directly on dopamine, or more precisely, suppresses it. Dopamine is vital for the brain, functioning both as a neurotransmitter and as a hormone. Imagine that cabergoline-based medications are used in the treatment of Parkinson’s disease. The list of side effects includes numerous problems and disorders.

Primarily, these are gastrointestinal disturbances, which, according to studies, occur in 53% of those taking the medication. Psychiatric complications are another noted side effect, impacting approximately 51% of patients. Additionally, about 30% of those taking cabergoline may experience cardiovascular disorders. However, this medication primarily affects the liver.

This alarming picture of cabergoline’s effects is compounded by the fact that the medication, which begins to act approximately three hours after ingestion, can persist for 7, 14, or 21 days, and according to some sources, up to 28 days. This further complicates the process of stopping breastfeeding.

After this brief overview of cabergoline, several questions arise:

• Is it acceptable to take such a medication independently?
• Is it appropriate to use it in the absence of a real and urgent need for immediate cessation of breastfeeding?
• Is it correct to use this medication when gentle, non-pharmacological, and natural methods of weaning exist that do not cause trauma to anyone?
• How reasonable is the use of cabergoline in situations where neither the mother nor the child has made a final decision regarding the cessation of breastfeeding?

In cases of weaning, this medication should be prescribed by a therapist, endocrinologist, or neurologist, since these specialists are, at the very least, able to anticipate potential complications in advance. Sometimes even gynecologists incorrectly determine the dosage, prescribing either an excessively high or too low a dose.

The recommendation to use cabergoline is appropriate only in very rare and extremely urgent situations where immediate cessation of breastfeeding is necessary. This medication can be particularly important, for example, for mothers who have experienced the loss of a child, as well as for women with serious health conditions requiring urgent surgery that necessitates the cessation of breastfeeding.

In all other cases, the cessation of breastfeeding should be gradual and gentle so as not to harm the mother or traumatize the child. If you have decided to wean your child, we recommend exploring the articles available on our website.

Do not forget to share your weaning experiences with us: which methods you used when stopping breastfeeding, which were effective, and which, on the contrary, caused complications for you or your child. We look forward to reading your stories.

Author: Saltanat Zulfugarova
Breastfeeding Consultant