Had a follow up yesterday with the mother that was taking lecithin for plugged ducts with her last two babies and both were FTT. I presented her information about lecithin and she also felt that it may be what was causing the FTT. Lecithin is a fat emulsifier. It seems to have been affecting the fat content in milk. She was able to pump a significant volume of milk, but the baby was never satisfied and lost weight rapidly. She never had plugged ducts while on the lecithin, but I'm suspicious that what this baby was getting was mostly foremilk. On day 4 the baby went from 7#6oz to 5#12 with 3 voids and no stools. 

I believe she has damage to her right breast due to a previous severe breast infection which probably caused scarring in one of her ducts. Now she has constant plugged ducts in her right breast. We discussed the possibly of slowly stopping lactation in the right breast and developing a full supply only on the left breast. But it seems I was more concerned about the plugged ducts than she was. She seemed to prefer to stop the lecithin and just deal with the plugs as they come along with more frequent nursing, massage, pumping, etc. I'm just concerned about her developing mastitis again.

I think part of the problem was the length of time that she was taking the lecithin and the dosage. Her MD told her that you can't take too much lecithin, but I think that may not be true. She was taking 2 to 3 times the recommended dose. Also, most women will take this temporarily during a plug, but she began taking in pregnancy and was taking large doses daily throughout lactation. 

Possible Side Effects 

In high doses, lecithin and choline may cause sweating, nausea, vomiting, bloating, and diarrhea. Taking very high dosages of choline (10 grams a day) may produce a fishy body odor or a heart rhythm disorder. 

CAUTIONS

People with bipolar disorder and depression - should not use lecithin as it can worse then depressive stage of the illness 
People with any psychiatric condition - should get medical advice before taking lecithin.



The client told me that she had been feeling like her heart was racing and she had some difficult sleeping. I though maybe hyperthyroid at first, and so she was tested, but thyroid was normal. Then when I told her this, she said that she has had terrible problems with profuse sweating while she was taking lecithin, but she never associated it with the lecithin. So now she has stopped the lecithin, and is pumping and giving her milk and supplemental formula in an SNS. I will let you all know later how it all works out for her. 

Thanks for all your help with this one,

Tricia Shamblin, RN, IBCLC

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