Dear Laurie,
If in fact the pituitary gland necrosed, there is not much that I am aware of doing except to keep loving and supporting her through this difficult time. I have read that the pituitary can become partially necrotic but have not seen this as evidenced by no milk production. The moms I've seen Sheehan's in, had history's like the mother you describe. They had successful past experiences nursing other children and following postpartum hemorrhages, had no milk. Following these moms closely following delivery for weeks, no breast changes and no milk production ( in spite of pumping, careful management etc) were observed. It can be devastating to the mother and challenging for us. I would offer realistic options of SNS, donor milk, pumping for awhile but not an extended period and take the moms lead on it. Support, support and just really try and accentuate the positive ie: she and baby are alive. Thankfully, Sheehan's is not common.
Colleen McKeown RN, MSN, IBCLC
--- On Sat, 9/25/10, Laurie Shornick <[log in to unmask]> wrote:
From: Laurie Shornick <[log in to unmask]>
Subject: Possible Sheehan's Syndrome
To: [log in to unmask]
Date: Saturday, September 25, 2010, 11:21 AM
Dear Lactnetters,
I am posting for a colleague who is dealing with a mom with possible Sheehan's Syndrome. We have permission to post.
This is mom's 2nd baby - she nursed her first child for 18 months, never any milk supply issues even following a C/S. This time around, she Vbac'ed, had a traumatic forcep delivery that resulted in post-partum hemorrhage. She needed two units of blood, and had severe hypotension. Her son is one week and two days old, was hospitalized for dehydration because she had no idea from his vigorous, frequent, nursing that he wasn't getting anything. She is pumping (with a Symphony every 3 hours) but can't produce anything more than drops of colostrum. She has had an ultrasound, and there is no evidence of retained placenta. She also had a high fever about 5 days post-partum, but WBC counts were normal. She is visiting OB today to have prolactin levels checked and she will inquire about sulpride and nasal oxytocin spray. She is currently giving baby donor milk.
We read the Lactnet archives, and it looked like the most recent discussion about Sheehan's was from 2007. Is there anything new since then? Are we missing anything that would be helpful to this mom?
Thank you in advance for your thoughts and insights.
Warm regards,
Laurie Shornick, PhD, IBCLC, LLL
St. Louis, MO
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