Hello Lactnetters
I have been on and off and now back on the list again, and I truly enjoy
reading the posts.  I'd probably just read and not write, but now I have
two questions I'm hoping someone may have some answers for.
First an introduction.  My name is Willow Ward -- a couple of you know me
-- and I'm an RN and IBCLC working in a large pediatric private practice
near Detroit, Michigan USA.  My duties there range from ... well, suffice
it to say I do *everything* that needs to be done.  Sometimes I see several
consults a week, other weeks not a one.  Virtually every day, though,
involves at least a few phone consults.
Now for my topics of concern today:
1.  Is anyone out there knowledgeable about a condition called mammary duct
ectasia?  I understand it to be benign, but potentially quite uncomfortable
during a flare-up.  Any idea of what factors encourage an exacerbation?
What treatments may help during a flare-up?  What the long-term prognosis
is (does this just go on and off forever?)  Would the good old cabbage
treatment be of use (I have heard that *warm* compresses are recommended)?
Is there any relationship between this condition and lactation history?  I
look forward to any replies, either on the listserve of by private e-mail.
2.   I am also currently working with a mom who had all but 18" of her
small bowel removed several years ago for weight loss.  She tells me that
she has chronic watery diarrhea, has difficulty maintaining nutrition
status, "absorbs 25% of" what she eats (but which nutrients tend to be lost
in greatest proportion, I don't know), and she is followed by a
nutritionist.  She has lost three pregnancies, and after fertility
treatment delivered an apparently healthy full-term boy just over a week
ago.  He was breastfed exclusively for a couple of days, then developed
jaundice and was supplemented.  Currently gets 1 to 2 oz ABM after every
breastfeed; weight is just a titch under BW.  There didn't seem to be much
milk production going on here (no swallow, few stools, little or no breast
change during pregnancy, no fullness...) although the little guy is more
than happy to "nurse" vigorously.  I got mom going with a double L******
pump, but after 2 days she had never gotten more than 1/2 tsp from either
breast.  She is game to give it a little bit longer, and to nurse for
whatever they are getting out of it (closeness, comfort) as long as babe is
willing.  Any suggestions?  Does this seem likely to be related to hormonal
problems (pregnancy loss, fertility drugs needed) or to the nutritional
problems?  Perhaps the aftermath of the bowel bypass actually *created* the
fertility problems?  Anyone seen this syndrome?
TIA for any input on these matters.
Willow
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