Hello, wise ones.  I hope there is someone on this list who has the time to
wade into this challenging scenario and teach me a few things.

 

Permission to post.

 

Client is expecting first child and has just shared that she has a benign
tumor on her pituitary.  It grows larger in response to increased levels of
prolactin.  The tumor was discovered in 1995 because she started lactating
spontaneously.  She was always aware of how high her prolactin levels were
based on how much milk she was producing.  She never expressed the milk, but
she did leak.  

 

I am unclear of what came first, the prolactin or the tumor, but I think it
was the elevated levels of prolactin that caused the tumor to occur.

 

Prolactin levels had been stabilized via dostinex, but she ceased taking
that when she became pregnant.

 

She is currently on increasing dosages of synthroid, but is concerned about
how this might affect her baby via breastmilk.  Anyone know?

 

Her vision is the main concern with this tumor.  Again, it is benign and
there are no current symptoms, but her hcp's are concerned about her vision
once she starts breastfeeding.  She has always known when the tumor is
growing because her peripheral vision starts to decrease followed by her
central vision, depending on how big the tumor is.

 

She has been advised that it is expected to grow during lactation, and her
hcp's have told her that if lactation increases the tumor, they will only
'allow' her to breastfeed for one month.  I personally think this is a
matter of weighing one risk against another (that of maternal reduced vision
and it's health and lifestyle effects vs. short and long term health
benefits for the breastfed baby).  She is willing to look at all angles,
however, our question is this:

 

If her tumor grows in response to the elevated levels of prolactin caused by
lactation, and she decides to keep breastfeeding even though she has reduced
vision, will her vision return to normal at any stage once she weans and is
no longer lactating?

 

I will appreciate all responses!

 

Blessings.

 

Karyn-grace Clarke, IBCLC, LLLL

Gulf Islands, BC, Canada


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