< I have a mom who keeps threatening preterm labor>   She's now
describing a case of engorgement.> < On mag sulfate and terbutaline,
with beta methasone, for baby> <Would the medications result in
engorgement>


Pat  - I have seen this twice. I am a hospital based LC at a university
medical center.  As a level three hospital, we see a lot of preterm
labor. One mom had engorgement and one had engorgement and some leaking.
In the last case, Mag sulfate, terbutaline was successful in terminating
contractions and the mom maintained the pregnancy another several weeks.
She went on to successfully initiate pumping.
  I don't think its the medications per se. When Mag is used for
pre-eclampsia in fact you may see delayed milk secretion. I think i's
more physiologic, than pharmacologic, in both cases. Since we know that
delivery of the placental removes the prolactin inhibitory hormones
allowing increasing milk secretion; we have speculated that in these
preterm labors there may be a decreasing level of hormones to support
the pregnancy and hence allowing some increasing secretion of milk
leading to engorgement. That plus all the IV fluids sometimes used to
give Mag sulfate etc. And the fact that moms are on bedrest - in the
hospital and worrying about every tiny symptom and their babies! We did
nothing other than tell moms to use warm compresses for discomfort.

Martha Roseen BSN, IBCLC