Full, but not uncomfortably full.

Whenever you are looking to down regulate your milk supply, the rule of thumb is to stay full, but not uncomfortably full.

Full: when it feels like it is time to feed or you are a few hours late for feeding. Your breasts will feel heavy, warmer than usual, maybe a little tender. Your body is sending you reminder signals that it is time to feed baby such as an intermittent throb, zing, or cramp. When your breasts feel full and you do not drain them by breastfeeding or pumping, it sends a message to your brain to slow milk production. This is a protective mechanism to your body so your boobs don’t explode. Just kidding. They won’t explode, but they will start to kick into an inflammatory response if they hit the uncomfortably full point.

Uncomfortably full: when it feels like your boobs are going to explode. You may remember this feeling from when your milk came in if you experienced any engorgement. You may know it from the first time your baby surprisingly slept a longer-than-usual stretch of sleep overnight. Uncomfortably full is when your body starts to get upset about how full your breasts are. Heavy turns to a feeling of boulders on your chest. Warmer than usual turns to really warm or even hot. Your skin may feel stretched and your breasts may be tender to the touch. Your body has mounted an inflammatory response against the stagnant milk in your breasts. If you sit too long in the uncomfortably full phase, you are at a higher risk for plugged ducts and mastitis. Uncomfortably full will down regulate your milk supply, but it isn’t the most pleasant way to go about doing it.

If you are looking to simply make a little less milk, follow the instructions for the over producer.
If you are looking to do away with your milk entirely, read on.

There are a few elements that all will help all weaners:

A well-fitting, non-underwire bra
Find a sport bra-like bra to help you through this process, but make sure it fits well. You don’t want any areas that feel uncomfortably tight or dig into your breasts. Keeping your breasts high and tight helps manage the discomfort of having big heavy milk-filled boobies hanging off your body. You may want to sleep in this bra as well.

Ice
Swelling is an inevitable part of the weaning process. Your body is not a fan of stagnant milk, so there is usually an attempt to mount an inflammatory response inside of your milk ducts, which causes more discomfort and an increased risk for mastitis. Pack your breasts with cool or cold compresses for 20 minutes on, then 20 minutes off to keep swelling at bay. Frozen diapers work really well for this since they are moldable and absorbent. They will catch any leaking milk! Simply open up a size one or size two diaper, wet it and lay it flat in the freezer. Be careful not to stack one on top of another or they will freeze together. (These are also great for a sore vagina, like you might have had after giving birth).

Cabbage leaves
Cabbage happens to be one of those old wives tales that has actual proven benefit. Keep a head of green cabbage in the fridge, peel off a leaf, wash it, and stick it in your bra–it is boob shaped! Once the cabbage wilts, remove it.

Parsley, sage, and peppermint
These three herbs are known to decrease supply if taken in high enough dose. If you are going to mess with herbs or tea, your best bet is to drink a preprepared tea with these ingredients or, better yet, order some No More Milk Tea which has all three.

Ibuprofen
This non steroidal anti-inflammatory will keep swelling at bay as well as control any pain you may be having.

Pseudophed
If you really want to dry up your milk fast, take a few doses of the real deal pseudophed. You know, the one you get behind the pharmacy counter and need to sign your name for. It dries your sinuses and your breastmilk up really quickly. Just take it as directed as if you were taking it for allergies.

The mastitis flush protocol without the part about breast drainage
Keep the plugged duct and mastitis flush protocol handy as you go through this weaning process. All weaners should boost up their fluids, Vitamin C, and rest. Remember, your body is not pleased it has to do this. If there is a glitch in your immune system, you are at an increased risk for mastitis.

Your OB or midwife’s on-call phone number
A low grade fever is sometimes seen during this process; however, if you spike a fever of 100.4 or higher during this process, call your OB or midwife. Let them know that you are weaning and ideally do not want to drain your breasts to remedy the mastitis. They will most likely offer you an antibiotic. That’s good. Now you can continue to wean and the infection will be well controlled.

A strategy:
Decreasing your milk requires you to keep your breasts full, but not uncomfortably full, and there are a few ways to go about this process. How you decide to proceed mostly depends on your unique circumstances. How quickly are you looking to wean? Is your baby still directly nursing? Are you weaning from pumping?

Whatever your weaning goals may be, you should be able to adapt them based upon the following two strategies:

  1. The Cold Turkey Wean: The fastest route. Do this only if absolutely necessary.

Ideally, don’t cold turkey wean like this. This method puts you at the highest risk for mastitis and frankly isn’t all that comfortable.

But, if you need or want to get rid of your milk as fast as possible, the safest and fastest way to do so is to keep them full, but not uncomfortably full. The concept here is that you maintain that full feeling, but when you start to approach the uncomfortable feeling you “take the edge off” by pumping. Oftentimes, this is best done by passively leaking into a cloth, massaging and leaking in the shower, hand expressing, or hand pumping. It is not the best idea to hook up to an electric pump because it is likely that you will take out too much milk too fast. Yes, it will feel like a relief, but it will slow down your weaning process because it will trigger your body to replace all that milk you took out. If you use heat to take the edge off, such as when taking a shower, be sure to cool down your breasts afterwards. This is a great time to grab some ice or cabbage.

  1. The Gradual but Deliberate Wean: Ideally, you wean gradually.

When you wean gradually, you still follow the principle of full but not uncomfortably full. During the gradual wean, you leave your breasts comfortably full not all the time, but just for longer than usual. You can do this in one of three ways:

  • Space breast drainage further apart. If you typically go three hours between breastfeeding or pumping, stretch it to four hours or however long you can go before feeling “uncomfortably full.” When you need to pump or feed, go ahead and proceed as normal. Breastfeed or pump as you usually would.
  • Keep the same schedule, but take out less milk each time your drain your breasts. For pumping, this may mean pumping for less time or expressing less volume. There isn’t an exact number here, just the point at which you get back to that magic place: comfortably full.
  • A combination of the two (fastest way to wean of the three): Space breast drainage further apart and express less volume or for less time.