Dear Lactnetters,  I hope someone has some wisdom on this one:  1st time
mom delivered a full-term infant vaginally 7 days ago and came back for
engorgement at 3 days in tears.  Baby had been initially sleepy, but was
up to q 2 1/2 hr. feedings by then & mom was in pain.  I used piston-pump
on low suction to express twelve oz. of transitional milk + baby nursed
during consult.  I sent her home to apply ice, cabbage, breastfeed q  2
hrs. (one breast per feeding), & pump only to comfort when necessary.  She
found it necessary to express to relieve discomfort about every 6 - 8
hrs., avg. 4 - 6 oz. each time.  She came back today for follow-up
consult, breasts still very large, very full & still uncomfortable (and
she is a very compliant healthcare professional).  She has already
accumulated 60 oz. in the freezer & baby has gained 12 oz. from birth
weight!  She reports no underlying medical conditions (except past history
of migraines), and only takes vitamins when asked about meds.  BUT, that
got her thinking & she called back to ask if the Reglan she had taken
during the last 3 weeks of her pregnancy might have had any effect.  She
took 10 mg. 4X/day for the 3 weeks before delivery (along with Zantac) for
reflux.  Her last 2 doses were just before & during labor.  She hasn't
taken any since.  Would that cause an initial overproduction that was
difficult to control??  Should we do prolactin levels now to figure out
how to proceed?  Would anyone give medication to suppress prolactin if it
is found to be abnormally high?  Obviously, I have more questions than
answers.  TIA for any thoughts.
                Regards, Katie Winchell, BS, IBCLC