Ruth, I have only dealt with one client that I knew had a prolactinoma that was
managed with bromocriptine when not pregnant or lactating.  She breastfed
without difficulty and was NOT a problematic over-producer (have seen plenty of
those).  She had an ample supply, but no problems.  Her experience seems
consistent with what is reported in Riordan & Auerbach's book.

Your second mom who is having copious leaking at 7 mo. gestation sounds like a
real problem.  Wearing shells is probably the last thing she should do, since
they encourage leaking.  I have not a lot of experience with the leakage
inhibitors, but they have been helpful for a few of my moms who were still
leaking copiously 4-8 weeks after delivery.  After using for a week or two the
leaking lessened and they were able to quit using them (some suppression of milk
supply or coincidence?).  I can't see how there'd be a problem with thrush or
ulcers since there is a cotton pad between the nipple and device, mastitis would
be a minor risk IMO, and labor stimulation I'd want to ask a physician about.
Seems to me that the constant pressure provided by the device would not be all
that different than that from a tight bra pressing on nipples, but I'd want some
confirmation on that one.  After delivery I'd expect to try one-breast nursing,
cabbage, sage tea, and B6 if all else fails.

Becky Krumwiede, RN, IBCLC, Appleton, WI
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