Pam, Just a question. Did your client have any treatment for this tumor?
Say, like parlodel? I've had 2 clients in the past 5-6 years with the
same history. Both treated with parlodel. Both stopped during pregnancy.
But both had trouble, especially initially, with milk supply.

Cheryl Muller RNC IBCLC







Date:    Fri, 17 Sep 2004 11:27:36 -0500
From:    Price Pamela B <[log in to unmask]>
Subject: <No subject given>

I have a client who delivered on the September 14th.  She had a meconium
delivery and baby was vigorously suctioned. Baby had the usual oral
aversion that one would expect, and before discharge from the hospital
the baby was latching to the breast and nursing with the use of a nipple
shield.

Mom has a history of a benign pituitary tumor. She said that she had
leaked lots of milk and that is I guess how they found the tumor.  She
did not get any treatment for that and they had thought that she might
have difficulty getting pregnant since she was leaking milk but she had
no trouble at all. Problem is, it almost appears as though she really
has barely any milk.  I have not actually come out and said this to her
because I do not want to set anything up and I thought it may be too
early to tell. Even though the shield is place well and infant latches
deep to breast with the shield ( and no he absolutely will not latch
without it) there is only scant amount of milk on shield if he comes off
prior to being done and it almost looks dry when he is finished.  We did
begin supplementing under the shield during feedings with ABM (started
with just a little glucose water the first few times just to get him to
start sucking because he would just latch and suck once and sit there)
Not much audible swallowing heard and draw/pause is poor. Mom has been
pumping after feedings and gets only the tiniest of droplets.

I am seeing them this afternoon for a 24 hour follow-up from discharge.
Any suggestions or ideas.  I thought since she had a benign tumor and
she had leaked milk that this would not be an issue although I told her
from the start that we would want to monitor closely until feedings are
well established.  She did get increase in breast size during her
pregnancy, but they just do not really feel like "post partum" breasts
to me.

Pam Price IBCLC, CBE
Lactation Services Coordinator
Women's Health
Trident Health System
9330 Medical Plaza Drive
Charleston, S.C. 29406
(843) 824-5013 office
(843) 728-9640 pager


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