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Subject:
From:
"Foley, Mary" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sun, 30 Mar 2014 18:14:19 +0000
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PTP:
First time mom w/ history of hyperprolactemia prior to pregnancy.  She was treated with Bromocriptine - then became pregnant and the Bromocriptine was discontinued.   During her 6th month of pregnancy she experienced breast engorgement and "shooting, stabbing" breast pain bilaterally.   She had an ultrasound with "benign findings."  She also saw an endocrinologist who told her that there was nothing she could do for her during the pregnancy.   Baby was born at 38 weeks.  Mom began breastfeeding but states it was "super painful," describing breast pain.   Because it was so painful for her to breastfeed - breasts now even more engorged - she decided to hand express/pump.  Initial colostrum looked black.  Over the next day she was pumping increasing amounts but milk was very dark brown/mahogany colored.  Day 2 she pumped 3 ounces of this brown milk. Mom did not want to give that to her baby so she began formula feeding and went home on day 2 following birth, with instructions to pump every 3 hours until milk became clear enough for her to feel comfortable giving it to baby. 

A few days later she called describing symptoms of mastitis including difficulty draining L breast.   She was prescribed an antibiotic, and Sudafed was suggested once per day.  Following day she called MD to report diarrhea - both the antibiotic and Sudafed were discontinued.  Day 13 following birth she went to ED reporting mastitis sx again - this time on R.   She has been pumping throughout, milk has cleared to creamy white w/ hint of pink.  She has been unable to directly breastfeed - still with painful shooting pains in breast.   New endocrinologist.  MRI ordered (next week).   Another US ordered - again, benign findings.   

As you can imagine, mom is very discouraged, and not sure what to do about breastfeeding.  I'm not sure that even if mom went through the normal weaning process if her breasts would respond?  It's possible if she agrees to wean - there may be a chance she could go on the bromocriptine again.  For now she is back on antibiotics and pumping q 3 hours.   Cool compresses between pumpings.  Baby is getting pumped milk and formula via bottle.   I'm wondering if anyone has dealt with anything like this - looking for any suggestions.

Thank you,
Mary Foley RN IBCLC
Woburn, MA
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