Spontaneous Flow of Milk

Etiology

There are several possible causes of spontaneous flow of milk:

• Long labor, constitutional weakness: The strain of a long labor can lead to a deficiency of Qi after childbirth, which can be more pronounced in women who have a pre-existing Qi deficiency. This can cause the breast milk to trickle out spontaneously.
• Emotional upset: Ongoing emotional problems, such as anger, frustration, or resentment, or a sudden emotional upset, can cause Liver-Qi stagnation and Liver-Fire. Since the Liver controls the nipples, Liver-Fire can "heat" the breast milk, causing it to be forced out of the breasts.

Pathology

The pathology of spontaneous flow of milk is similar to that of flooding and trickling. In either case, either Qi fails to hold fluids and breast milk flows uninterrupted, or Liver-Fire agitates the breast milk and, since the Liver channel controls the nipples, milk is pushed out of the breasts. The specific organs involved vary depending on the underlying condition:

• In the case of Spleen- and Stomach-Qi deficiency, a deficiency of these organs is responsible for the trickling. The breast milk will be watery and dilute.
• In the case of Liver-Fire, the breast milk will be dense and yellow.

Identification of Patterns and Treatment

The treatment principles for spontaneous flow of milk vary depending on the underlying condition:

• In the case of Spleen- and Stomach-Qi deficiency, the treatment principle consists of tonifying Spleen- and Stomach-Qi to hold fluids.
• In the case of Liver-Fire, the treatment principle consists of pacifying the Liver, moving Qi, and clearing Heat.

Spleen- and Stomach-Qi deficiency

The clinical manifestations of Spleen- and Stomach-Qi deficiency include:

• Spontaneous flow of milk a few days after childbirth
• Scanty but constant flow of dilute, watery milk
• Soft, non-distended breasts
• Pale complexion
• Tiredness
• Poor appetite

Tongue: Pale

Pulse: Weak

The treatment principle for this pattern is to tonify Qi, nourish Blood, and firm fluids.

Liver-Fire

The clinical manifestations of Liver-Fire include:

• Spontaneous trickling of milk after childbirth
• Dense milk
• Distension of breasts
• Hypochondrial distension
• Irritability
• Insomnia
• Headache
• Thirst
• Bitter taste
• Constipation

Tongue: Red, redder on the sides, yellow coating

Pulse: Wiry and Rapid

The treatment principle for this pattern is to pacify the Liver, drain Fire.

Prognosis and Prevention

Both acupuncture and herbal medicine can be effective in stopping spontaneous trickling from the breast. Herbs are typically more effective for the pattern of Liver-Fire. In most cases, trickling of milk should stop after a few days. There is no Western view on this condition.