553
Views
4
CrossRef citations to date
0
Altmetric
Review

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

ORCID Icon, ORCID Icon, &
Pages 159-170 | Published online: 09 Mar 2020
 

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Acknowledgments

We wish to thank Tania Gottschalk (University of Manitoba Health Sciences librarian) for her efforts in selecting the appropriate MeSH terms and guiding us through the study retrieval process.

Disclosure

Dr Isabelle Boucoiran reports personal fees from FRQS during the conduct of the study. The authors report no other conflicts of interest in this work.