Postpartum Milk Production: When to Seek Medical Advice

Doctor, may I ask you a question?

Hello Doctor,
I am 32 years old and it has been three years and two months since I gave birth to my second child.
However, if I manually squeeze my nipples, I can still express milk; if I do not intentionally squeeze, no milk appears.
I have visited different hospitals and doctors, and I have had blood tests for prolactin levels, thyroid issues, and breast ultrasounds, all of which came back normal.
The last doctor I saw advised me not to worry about it.
I have taken medication to suppress lactation, which stopped the milk production, but I am not sure if after my menstrual period, I took a herbal remedy (as it is known to increase milk production).
Out of curiosity, I squeezed my breasts while showering, and milk reappeared.
Since all my tests have been normal, I am unsure if my frequent squeezing of my breasts while bathing after giving birth has caused this continued milk production.
Could this continuous stimulation prevent me from completely stopping lactation? Or should I still seek further evaluation at a hospital? I am very concerned that this could be related to a brain issue.
Which specialist should I consult?
Thank you,
A concerned individual

yang, 30~39 year old female. Ask Date: 2002/06/04

Dr. Li Guanghan reply Obstetrics and Gynecology

The tests for prolactin, thyroid function, and breast ultrasound are all normal, indicating that you are in good health.
Residual breast milk may sometimes be secreted in conjunction with your menstrual cycle or after consuming hormone-rich foods.
If the amount is not significant, there is no need for concern; however, if it is excessive, you may want to consult a gynecologist or neurologist.

Reply Date: 2002/06/04

More Info

Postpartum milk production can be a complex issue, especially for mothers who have experienced changes in their breastfeeding journey. In your case, it seems that you are experiencing the ability to express milk from your breasts even three years after giving birth, which raises some questions about the underlying physiological mechanisms at play.

Firstly, it is important to understand that the production of breast milk is primarily regulated by the hormone prolactin, which is secreted by the pituitary gland. Prolactin levels can remain elevated in some women for an extended period after childbirth, especially if there has been any stimulation of the breast, such as through breastfeeding or manual expression. This stimulation can lead to the continued production of milk, even if the breastfeeding has ceased.

The fact that you have undergone multiple tests, including blood tests for prolactin levels, thyroid function, and breast ultrasound, and all results have come back normal is reassuring. It suggests that there is no underlying pathology related to your pituitary gland or thyroid that would typically cause abnormal milk production. However, the continued ability to express milk may be linked to the stimulation of the breast tissue, which can be a normal physiological response.

Your concern about whether this could indicate a problem with your brain or hormonal regulation is understandable. If you are still worried, it might be beneficial to consult with an endocrinologist, a specialist in hormone-related issues. They can provide a more detailed evaluation of your hormonal levels and any potential issues related to the hypothalamus or pituitary gland, which are critical in regulating prolactin production.

Additionally, if you are experiencing any unusual symptoms, such as changes in your menstrual cycle, headaches, or vision changes, it would be prudent to mention these to your healthcare provider. These could be signs of an underlying condition that may require further investigation.

In terms of your question about whether the manual stimulation of your breasts is contributing to the continued milk production, it is indeed possible. Regular stimulation can signal your body to produce more milk, even if you are not actively breastfeeding. If you wish to stop any residual milk production, it may be helpful to avoid stimulating your breasts altogether.

Lastly, if you are considering any herbal supplements or remedies, such as the "生化湯" you mentioned, it is essential to consult with a healthcare provider before proceeding. Some herbal products can have varying effects on hormonal balance and may inadvertently stimulate milk production.

In summary, while your situation may seem concerning, the normal test results suggest that there is likely no significant underlying issue. If you continue to have concerns, especially about hormonal balance or potential neurological issues, seeking advice from an endocrinologist would be a wise next step. They can help clarify any remaining uncertainties and provide guidance tailored to your specific situation.

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