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What options are there for lactation-suppression if one does not want to breast-feed?
There are two alternatives if one wants to suppress lactation. One is to use non-pharmacological means (i.e. no drugs). The other is to use drugs.
General measures where no drugs are involved include breast support, simple analgesics and meticulous fluid restriction. Milk expression should be avoided, as this encourages production of more milk and will prolong the period of suppression.
Drugs used for lactation suppression are taken daily for a period of two weeks. Lactation may start again after completing the course, which will necessitate recommencing the medication.
There is really no evidence that using drugs is more effective than using general measures.
Joints and Mobility issues after delivery
What are the pelvic joint complications of pregnancy and/or delivery?
Joints in the pelvis - mostly at the front, known as the symphysis pubis - may become lax or the bones may actually separate. This uncommon event tends to occur in late pregnancy or after delivery. There is pain, which is aggravated by movement, especially climbing stairs or rolling from side to side.
This can be quite severe and incapacitating. A wide support belt (brace) is available to try to stabilize the joints and prevent joint movement, which is the cause of the pain. In addition, measures such as rest and avoiding lifting are helpful. The condition almost always clears up entirely.
This may take a few days but may also continue for several weeks after delivery.
Are there any other joint complications?
Occasionally, during delivery, a fracture of the coccyx - which is the lowermost and smallest bone on the spine - may occur. This will cause pain on sitting down.
Treatment includes local infiltration with a local anaesthetic (temporary relief), heat therapy and rest.
A simple but ingenious device is a ring cushion for sitting in. This effectively takes the pressure off the affected area.
Fracture of the coccyx is rare.
What is a "foot-drop"?
Sometimes for a variety of reasons, there could be neurological damage which may show in the form of foot-drop.
This, as the name suggests, is the inability to flex the foot upwards at the ankle joint. Consequently, the affected person walks with a limp and with the toes dragging or barely clearing the floor. There may be pain in the rest of the limb or numbness of the ankle and foot.
The cause is severe or prolonged pressure on the nerve, either at the level of the spine or lower down in the leg.
The problem clears up completely with time. In the meantime, splinting to relieve the foot-drop may be used. Passive physiotherapy, to keep the joint supple, is strongly recommended. In the few cases where the foot-drop is caused by protrusion of a disc in the spine, surgery may be required.