Hi Paula,
As regards your Lactnet post: For more information, my Independent Learning Module (ISM) on Headaches and Lactation is on the ILCA web site at www.ilca.org
Is the mother newly delivered? Postpartum headaches are the ones on which I get the most queries from health professionals, by email, as the assumption is often incorrectly made that these transitory headaches are the lactational headaches first identified by by Scandinavian neruologists, Askmark et al, some years ago. Early postpartum headaches usually disappear after a few days.
If the headaches in your client have occurred later than this, there are a lot of questions to be asked, to eliminate other causes. Some headaches seem to have a combination of causes. You are sensible, thinking of food-related triggers, e.g. low blood sugar or allergy. Other causes may include a warning sign of a fever (mastitis, or other). Or there may be a severe headache in the occasional woman associated with overfulness, that is relieved by breastfeeding or pumping to give a good let-down (MER). A case history of mine was published in JHL in 1997 - details below. (That's the opposite from the classic lactational headaches described by Askmark et al, where the let-down triggers the severe head pain.) If the baby is older, and getting heavy, I wonder if the mother has a history of neck trauma, such as whiplash, and is carrying her baby on her hip - a postural issue, affecting the old neck injury. (I reported a case where this was a factor in Breastfeeding Review in 1997. It is also discussed in the 2001 ISM.)
If it's not any of those, I wonder if the mother has a history of migraines, the menstrually-related type? Breastfeeding intensively, by delaying fertility, may hold off these headaches for a time for some, and they can then hit when the menstrual cycles resume. A few unlucky women may have acute headaches return in the early weeks after delivery, anyway.
Does the headache hit right on the let-down? Does it build up during the feed, progressively? Is it a morning headache (which can be associated wiht poor ventilation and carbon monoxide build-up, from household heating)?
Sometimes no cause can be found, or no single cause. Both pharmaceutical and non-pharmaceutical treatment has been described in a number of studies. (See Hale for pharmaceutical information.) Non-pharmaceutical treatment that has been used includes biofeedback taught by a physiotherapist (looks promising), mild aerobic exercise, massage by a physiotherapist (but not deep massage).
This isn't a comprehensive coverage, but to give you a few ideas. Some references are below. I'll send more references separately.
Virginia
in Brisbane
Thorley V: Lactation and headaches (letter) South Dakota J Med 1997; 50(2):57.
Thorley V: Lactational headaches: a lactation consultant's diary. J Hum Lact 1997; 13(1):51-53.
Thorley V: Lactational headaches. Breastfeeding Rev 1997; 5:23-25.
Thorley V: Lactation and headaches. Proceedings of International Conference, Breastfeeding - the Natural Advantage, Sydney, 23-25 October 1997.
Thorley V: Headaches and lactation (Independent Study Module). Raleigh, NC: International Lactation Consultant Association, revised 2001 [Available from ILCA www.ilca.org ]
Thorley V: Headaches in breastfeeding women. Birth Issues 2000;9(3):85-88.
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