Management of hyperlactation using pseudoephedrine - a case report.

Abstract

Hyperlactation refers to excessive breastmilk production over and above the infant's needs. It may cause a range of distressing and uncomfortable symptoms for mother and infant, potentially affecting breastfeeding duration. The majority of cases will resolve through common, supportive management strategies that aim to reduce breastmilk supply through the negative feedback mechanism of milk production. Some herbal and pharmaceutical agents are considered to reduce breastmilk production and may be used to manage hyperlactation. One of these medications, pseudoephedrine, has been reported anecdotally to reduce breastmilk production, but there is a lack of evidence to support its use in this context. This case report details the use of pseudoephedrine as a 'last resort' treatment for a mother experiencing hyperlactation which had not responded to the usual management strategies. By titrating the dose according to her milk production, the mother was able to effectively self-manage hyperlactation and maintain an adequate breastmilk supply without any apparent adverse effects to herself or her baby. This suggests that pseudoephedrine has potential for use in the management of severe hyperlactation. However, pseudoephedrine should be used with caution and in conjunction with professional lactation support and supervision.