I've begun working with a multip (G10 P 6) who was diagnosed with a
prolactinoma 8 yrs. ago.  When not pregnant or lactating, she is on Parlodel
to control its growth.  Mom has breastfeed all previous children for at least
one year without difficulty.  She delivered a 32 week gestation infant, birth
wt 4 lbs. 15 oz.  I saw the dyad at 3 1/2 weeks postpartum, with the infant
weighing 4 lbs. 7 oz.  Mom has enough milk for the entire
neighborhood...infant has very good breastfeeding skills and will actively
nurse X 20 mins. per breast every 2 hrs.  However, the infant is not gaining
weight; stools only once per 2-3 days but has 8+ wet diapers per 24 hrs.  The
physician wants to begin supplements with Human Milk Fortifier and expressed
breast milk, which is a better choice than ABM.

My theory at this point is that mom is making so much milk that infant is
getting primarily foremilk, and I have contemplated having her use the
electric pump she already has for 5-10 mins. prior to breastfeeding to
increase the amount of hindmilk the infant receives.  Any thoughts on this
dyad?  Other experiences with prolactinomas that could be helpful?  TIA

Kathy Parkes, RN, IBCLC
San Antonio, TX