I received a call from a physician of a mother as well as the mother herself who has been diagnosed with diabetes insipidus. I know that prolactin secretion is affected by a number of hormones including oxytocin and vasopressin (the antidiuretic hormone). Diabetes insipidus results from a deficiency in the secretion of vasopressin from the posterior pituitary or the inability of the kidney to respond to the hormone. The mother talked of excessive urine output and I am wondering if this large disturbance in water and electrolyte regulation is going to adversely impact sucking-induced prolactin release and ultimately this mother's milk production. What should we be recommending in the way of breastfeeding management guidelines. Are there medications that this mother will be placed on that are of concern? I have not seen this condition for awhile and am looking for current treatment guidelines and any of your collective experiences with this.

Marsha Walker, RN, IBCLC
Weston, MA




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