Dear beloved fountains of breastfeeding information;

I saw a patient yesterday at 4 days post partum with sore nipples and
concerns over latch on and milk supply.  I observed the feeding, etc. and
provided a few suggestions regarding latch on technique but basically think
everything is going well.

During the course of the visit, the mom told me that she "never got any
milk" with her last baby 6 years ago, had a horrible experience (pumping,
doctor's appointments, infant weight loss, etc.), was unable to
breastfeed... About five months later when her period did not return, she
was discovered to have a pituitary tumor.  She has been seeing a "maternal
endocrinologist" since then and been on varying doses of bromocriptine
(Parlodel) to regulate her prolactin level.  She was taken off the
bromocriptine about three weeks into this pregnancy.

She tells me that she will possibly be placed back on the bromocriptine as
her prolactin levels are monitored and visual fields tested.  I have found
very little information on this in my sources and have not paid attention
when/if this has been discussed on Lactnet.  I would appreciate any
information from those of you who have experience with this.  From what I
read, it sounds as though lactation can proceed without problems.  But
should she be seen periodically for weight checks, etc?  What is the
expected postpartum course in this condition with breastfeeding.

I am especially hopeful in working with this family.  She is extremely happy
to have some help as she got none with her first experience in another
state.  Her husband is the Health and Safety Director at a major employer
(self insured) in our town which has just started a wonderful employee
benefits program that includes two postpartum/newborn home visits but is a
little vague about coverage of lactation visits.  I think the husband can
have an influence on the corporate bosses with a personal experience on the
value of lactation visits and the importance of insurance coverage.

Please pass along any information that may be helpful in working with this
family.

Thanks,


Esther Oppliger, ARNP, IBCLC
Garden City, Kansas