Lawrence&Lawrence reports of cases of severe anaphylaxis occurring just
after the birth, probably made more severe by the use of nonsteroidal
antiinflammatories, and that resolved in a few days. They were usually
treated with steroids and antihistamines.
The article I read (cited by L&L) reports that a skin test for oxitocin was
performed in one case and resulted negative - prolactine skin test was not
performed. These cases were probably not related to let down in the same
way as the case you describe seems to be, a phenomenon that
Lawrence&Lawrence mentions without much details.

I have known a couple of mothers who had hives when breastfeeding, with
different intensities, at each let down. I searched the medical literature
and Lactnet archives, but apart from some personal experiences, I could not
find much.

MER seems to be quite a strong and systemic event that for a number of
women involves significant physical reactions, different for different
women. Besides hives and D-MER, there are also reports about nausea
(mentioned in Lawrence) and headache (about which Virginia Thorley had
published the few infos available). I have heard also about shivers and
dizziness (which however could be related to thirst) and recently I noticed
that violent bowel movement (and also diarrhea) closely related in time to
the MER seems to be not so uncommon.

Ideally, we need systematic and good quality research about all this. I try
to take systematic note of these phenomena in my mental archive. My guess
is that D-MER is by far the most relevant of all these phenomena,
especially for the strong disincentive that can be for breastfeeding and
for the amazing relief many D-MER women experience when their condition is
revealed to them. But I think worthwhile that LCs have knowledge of the
possibility of the other less relevant phenomena. Mothers take always
comfort knowing that they are not alone in something. And we LCs gain
professional standing showing that we are "on top of issues" with respect
to other professional figures who don't have a clue about them :-)

Micaela
Italy



I think that D-MER could be an example of a phenomenon that does occur and
is related to let down about which little is known. Besides hives and
D-MER, there are also reports about headache (about which "our" Virginia
Thorley had published the few infos available), I have heard about about
shivers and dizziness (which however could be related to thirst) and
recently I found that violent bowel movement (or diarrhea) closely related
to the MER which seems not to be so isolated as I first thought.

Ideally, we need good quality information about all this. Collecting,
remembering and putting together all these pieces of information about odd
phenomena is only a first step, but I think it is a necessary one.

Micaela
Italy




On Wed, Feb 5, 2014 at 2:03 PM, Leslie Cree <[log in to unmask]> wrote:

> Hello all,
>
> Patient and her physician have given me permission to post this. Mother
> delivered her third baby on 1/11/14 at 37 2/7 weeks. This is her first time
> breastfeeding, and up until a few days ago everything was ""going great"
>  Mom had begun to notice hives on her abdomen and down one leg when she
> breastfed . She attempted pumping, and the breast turned "very red" and got
> hives "all over it". She discontinued pumping and has been breastfeeding
> only. The hives seem to appear with every let down. She has had relief from
> the itching with Benadryl, but the hives remain. A search of Lawrence's
> Breastfeeding Guide for the Medical Profession suggested a daily Claritin
> antihistamine, but did not have a long description of the condition. The
> only other unusual occurance in mother's history is a blood patch on
> 1/14/14 for headache. Infant is growing and gaining well. Mom is using the
> Medela Symphony pump. She has made no changes is detergent, diet, or body
> care products. Your wisdom and insight are much appreciated!
>
> Kindly,
> Leslie Cree, IBCLC
> Kate Lupo, MD
>
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