Insufficient lactation

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Textbook Prescriptions Gynaecology

Essentials of Chinese Acupuncture (Beijing, Shanghai and Nanjing Colleges of Traditional Chinese Medicine, 1980) — the standard prescriptions of the Chinese colleges.

Points

ST18 Rugen bilateral

Stomach point below the breast; local point that warms and moves qi and blood

Moxibustion; or needle horizontally towards the breast to spread sensation locally.
- ⚠ Pneumothorax
CV17 Tanzhong midline

Influential point of qi on the sternum; moves qi in the chest

Moxibustion; or needle horizontally towards the breasts to spread sensation locally.
SI1 Shaoze bilateral

Jing-Well of the Small Intestine; empirical point for bringing in milk

Needling Safety

Cited hazards for these points. Tick what applies to the patient to see the cautions that follow from it.

ST18 Rugen
- ⚠ Pneumothorax risk: too deep an insertion can puncture the pleura. World Health Organization 1999, Section II §5.2 (Lung and pleura), p. 25

Treatment Principle

Promote milk flow, reinforcing with moxa for the deficiency type and reducing for the excess type.

Indications

scanty or absent milk after childbirth, or supply falling steadily while nursingdeficiency type: palpitation, tiredness and thin milkexcess type: fullness in the chest, poor appetite, milk retained in the breast, hypochondriac pain

Method

Deficiency type: reinforce and combine with moxibustion. Excess type: reduce; moxibustion may also be used.

⚠ Cautions

ST18 and the add-on LV14 lie over the chest wall: needle horizontally, never deeply, to avoid pneumothorax. A hot, painful, red breast with fever suggests mastitis or abscess and needs medical assessment.

About

The book's base prescription for insufficient lactation, whether from weak qi and blood, heavy blood loss at delivery, or liver constraint.

Rationale

ST18 is the local stomach-channel point below the breast and CV17 the influential point of qi; the book warms both with moxa to set qi and blood moving, or threads them towards the breast. SI1 is the long-standing empirical point for bringing in the milk.

Clinical Notes

Add BL20 and ST36 for the deficiency type to strengthen the spleen and stomach that produce blood and milk. Add LV14, the liver Front-Mu point, and PC6 for the excess type, to ease the hypochondrium and open the chest so milk can flow.

Sources

Beijing College of Traditional Chinese Medicine, et al. Essentials of Chinese Acupuncture. Beijing: Foreign Languages Press, 1980. Chapter III, Lactation Insufficiency, p. 379–380.

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