Suppression of puerperal lactation using jasmine flowers (Jasminum sambac).

EDITORIAL COMMENT: It is unlikely that the use of jasmine flowers for suppression of lactation will become the rage but we thought that readers would be interested in this safe and simple method. We respectfully disagree that it would be unethical to have included a placebo treated control group in the study (read on for reason). Twenty years ago (2), when the association between oestrogen therapy and venous thromboembolism was reported (1), our management of suppression of lactation changed abruptly from stilboestrol 5 mg tds for 5 days, to avoidance of breast stimulation, the use of a good supporting brassiere, and aspirin for pain if engorgement occurred — we were surprised to see how little difference there was and how few patients required analgesic drugs. Provoked by this paper, discussion with 12 charge sisters of postnatal wards disclosed that about 20% of patients who elect to suppress lactation are prescribed bromocriptine — in most cases prophylactically rather than as treatment of severe engorgement. This miniaudit revealed that the nursing staff were not in favour of bromocriptine therapy except when engorgement was severe, because of nausea and rebound lactation (often after the patient had gone home) — interestingly in one postnatal ward in Melbourne, the charge sister used cabbage leaves to treat engorged breasts and claimed that the method was successful! Routine therapy can become a crutch you can afford to throw away. Summary: The efficacy of jasmine flowers (Jasminum Sambac) applied to the breasts to suppress puerperal lactation was compared that of Bromocriptine. Effectiveness of both regimens was monitored by serum prolactin levels, clinical evaluation of the degree of breast engorgement and milk production and the analgesic intake. While both bromocriptine and jasmine flowers brought about a significant reduction in serum prolactin, the decrease was significantly greater with bromocriptine. However, clinical parameters such as breast engorgement, milk production and analgesic intake showed the 2 modes of therapy to be equally effective. The failure rates of the 2 regimens to suppress lactation were similar; however, rebound lactation occurred in a small proportion of women treated with bromocriptine. Jasmine flowers seem to be an effective and inexpensive method of suppressing puerperal lactation and can be used as an alternative in situations where cost and nonavailability restrict the use of bromocriptine.