Weaning
Breast engorgement or mastitis occur frequently after weaning. The pregnancy/lactation related hormones usually return to normal levels shortly after weaning but for some women it can take several months and there is an increased risk of rebound lactation and mastitis before hormone levels settle. Avoiding stress is important because the same hormones are also stress hormones. Even after hormone levels settle it takes some time for the breast gland to rebuild to its nonlactating state and it may be particularly prone to mastitis during this time.
Most cases of post weaning mastitis or breast engorgement resolve with relatively little treatment. Recurrent post weaning mastitis on the other hand can be an indication of a developing hyperprolactinemia or thyroid disorders and endocrinological examination must be considered.
Cold compresses, lactation inhibiting herbs or medication can be used.
Salvia officinalis is commonly used for weaning (Veldhuizen-Staas C. 2007), but no peer reviewed literature is known on this subject. Chasteberry extract can improve prolactin levels which may reduce risk of recurrence but no data is available for use in mastitis.
Prolactin lowering medication has been frequently used for weaning in the past but is much less used since Parlodel (bromocriptine) approval for weaning has been withdrawn in the US over safety concerns. While the question of bromocriptin safety for weaning purposes was never completely resolved it became apparent that it was not very effective in the prescribed dose and did rarely justify the unpleasant side effects.
Other prolactin lowering medications (cabergoline, lisuride) are effective and appear safe but are not widely used for weaning.
Granulomatous (non-puerperal) mastitis is known to occur on average 2 years and almost exclusively up to 6 years after pregnancy. It is an extremely rare condition and believed to be in many cases related to an autoimmune reaction to milk proteins following incomplete inhibition of milk secretion and hyperprolactinemia.
Distinction between puerperal (but post-weaning) and nonpuerperal mastitis is somewhat arbitrary.
Read more about this topic: Puerperal Mastitis