This is the first time I have posted, but I have been reading Lactnet
and learning from all your expertise for several months.  I am one of
two full time LCs at the University of Michigan. We have about 3200
births a year, and have a 37 bed NICU along with covering Mott
Children's Hospital.

My question is about a 24 y/o woman I saw today who was admitted on May
2 for premature onset of labor.
She is  G4 P2 L2 and 27 5/7 weeks, and has been treated with
Betamethasone and Indocin, and Macrobid for a UTI.  She is dilated to 2
cm, and is no longer contracting

Her youngest is 4 years old and she nursed her for 6 months.
She tells me that Monday evening her breasts started feeling full, and
have been getting fuller since. The only leakage she has had is when she
is in the shower.
On exam the breasts are very full and hard, and very warm to touch, no
redness.

I have looked in Lawrence, and Riordan and Auerbach, but have been
unable to find an explanation for why her breasts are starting to fill
so early. I haven't searched the archives because I still have many
other patients waiting to see me, and they want to discharge her today
if possible.

I have told her I thought she could apply cold compresses and/or
cabbage leaves to try and make herself more comfortable, but to use the
cabbage sparingly, as I'm not sure how it may affect her long term milk
supply. Has anyone seen this before and what was the outcome when the
mother delivered?  Could this be an endocrine problem???

One of the OB nurses said she saw this one other time and the mother
continued to leak a lot the last two months of the pregnancy, and then
had a copious milk supply.
Any help or answers would be appreciated. Please respond privately, as
I won't have time to read the Lactnet postings today.
Thanks!


Patricia Awood, RN, IBCLC
Lactation Consultant
University of Michigan Health System
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