On 17/9/02 11:06 AM, "Automatic digest processor"
<[log in to unmask]> wrote:

> Well, I learned that the mom is on bromocriptine and that dr does not
> want her to breastfeed because the whole reason she's on the med is to
> lower the prolactin level so the tumor does not grow.  My next question
> is, say the bromocriptine lowers her level to about that of the average
> lactating woman, would breastfeeding raise her level higher, or would
> breastfeeding have little or not effect on her prolactin level? I
> apologize if this is not clear.  It's just that I'm confused and
> obviously showing just how far over my head this technical stuff
> is........Thanks to anyone who can clear this up for me.  Mary

Mary I'm by no means "well informed" in this area however I did care for a
mother with a prolactinoma who was taking  bromocriptine and was
breastfeeding successfully, also - in Hale (I only have the 99 ed) - he
reports one breastfeeding patient who received 5mg/day and continued
lactation with no untoward effects on the infant. I also know of another
woman who came off her bromocriptine just to get pregnant and breastfeed
each of her three children (don¹t know for how long) and then went back on
it again (have no other details - 2nd hand story). There appears to be no
hard and fast rules here but I would think it would depend on the degree of
the hyperprolactinaemia (and associated side effects) the patient is
experiencing. Certainly breastfeeding does stimulate an increase in
prolactin levels 45 minutes after breast stimulation - but the half life of
prolactin produced in this case is around 60mins as the levels quickly
return to previous baseline levels following the feed.

I would think there should be room to let the mother breastfeed and monitor
the effects it may (or may not) have on her basal levels and then treat
accordingly.

There are usually lots of sites on the web that may have patient histories
that could shed more light on the issue.

Cathy Fetherston
Perth, Western Australia

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