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| Date: | Thu, 9 Nov 2000 15:50:53 +0800 |
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I have received a request from a psychiatrist, whose patient has what
appears to be breastfeeding induced narcolepsy, to post the details of this
case in the hope that there may be other observed cases elsewhere.
This woman delivered of a term baby 8 days ago and was described to me as
desperately wanting to breastfeed. This is her third baby. The first was pre
term and second was either a neonatal death or a death in utero (Dr couldnąt
remember which). The mother was alcohol dependant and didnąt breastfeed the
first baby. There is a history of rape and assault.
After birth the nurses commented on the plentiful supply of colostrum and
milk coming in early. When the narcolepsy was first observed is not known by
the Dr. However, a minute or so after commencing breastfeeding (time
correlates with normal time for initiation of let down) the mother falls
into a deep sleep. The baby falls from the breast (in fact the nurses found
her once fast asleep on the bed and the baby on the floor). She sleeps
heavily (snoring observed) for 10-20 minutes and can't be woken. She was
incontinent during one episode (although has a history of stress
incontinence).
The Dr wishes in retrospect that they had got her to an EEG lab but she has
now given up breastfeeding due to fear of the consequences.
At the time of delivery she was on citalopram 60mg daily and oxazapam 60 mg
daily. When this began to occur the oxazapam was reduced to 30mg and then to
15 mg daily.
The psychiatrist doesnąt feel that this is a dissociative state as there was
never any anxiety apparent regarding breastfeeding, only a genuine desire to
be able to breastfeed this baby. It would appear that oxytocin may have some
role to play although how or what is anyone's guess.
Has anyone out there heard of or seen any similar cases? Please feel free
to reply directly to me if necessary.
Regards
Cathy Fetherston CM MSC IBCLC
Perth Western Australia
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