I have  permission to post a situation with one of our nurses who works in a local OB's office. She is currently pregnant with her second baby. Her first is about 1 year old. She was found to be hyperprolactenemic prior to her first pregnancy and had difficulty becoming pregnant. She was treated for this at that time in order to become pregnant. Her pregnancy and vaginal delivery were basically uneventful. Breastfeeding was managed very well with the baby feeding appropriately the first few days. Problems began when mom experienced no breast fullness at all postpartum.  Baby was getting jaundiced, scant urine/BM output etc. Mom began pumping faithfully after  feeds with a good rented breast pump, but never got more than a few drops of milk. Started taking fenugreek and did all the appropriate things to stimulate milk production. (with the exception of Reglan due to pituitary problems).  She continued to breastfeed this baby for several months but was never able to express more than a few drops of milk and eventually switched from the SNS at breast to a bottle. She has never had diagnosis of adenoma because decided not to have "definitive tests" (CT scan?). I spoke with her very knowledgeable OB, ( also my GYN and really knows his stuff) He felt this is somehow hormone related but not sure what is going on. Possible polycystic ovaries but not diagnosed. 

This mom's question is this: Now that she is pregnant again. Is there anything that can be checked hormonally and how would anything like that be treated? Her prolactin levels tested close to normal after the first pregnancy. (Probably why she got pregnant so easily this time.) Her estrogen levels are somewhat low according to her.  She really wants to give breastfeeding another go. Her twin sister has had a baby also and no problem making "tons of milk"! 

Any suggestions?



Holly McSpadden IBCLC
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