I have a third time mom with the following history: 1st baby 9 years ago,
normal pregnancy and delivery. Breastfed in the DR baby latched well,
continued to latch and suck well. Mom became worried early on that something
was wrong, baby became sleepy, decreased output. Sought Pedi advice,
reassured mom, she continued to breastfeed. Baby became severly dehydrated,
in hospital for a period of time. Mom continued to try to nurse, used SNS.
Had prolactin level checked (not sure at what point) and found to be 13.5.
Mom gave up on the breastfeeding after 4 months. Baby #2, normal pregnancy
and birth, mom decided not to attempt breastfeeding. This was 6 years ago.
Mom delivered baby #3 Sunday, again normal pregnancy and birth. Baby latched
in DR and was exclusively breastfed until this morning at 8am. Mom found uric
acid crystals in diaper, scared her as she remembered first baby and she
decided to formula feed. Prolactin level checked yesterday 14! Baby appears
well latched at breast, nursed every 2-3 hours, we even tried a little
pumping with the electric pump, nothing pumped or visualized. Supported mom
with her decision to formula feed. Our CNM talked with her about this and
questioned whether Reglan would help increase the level of Prolactin. Mom
decided to try it. Our current plan is attempt to nurse baby as often as he
wants and supplement after the breastfeeding or at breast with SNS. Also a
little pumping to increase the stimulation. We will keep in close contact
with her over the next week and she will come in for Prolactin level about a
week into the course of Reglan. Interestingly she has never had any further
work up suggested, but one of the fellows wrote a paper on her. She was never
given the conclusions but was told they only found one other person in the
literature like this. Thoughts and suggestions would be greatly appreciated.
Sorry for the length. BTW, all babies easily conceived, vaginal deliveries,
no excessive bleeding, no retained placenta.
Lisa Enger RN BSN IBCLC
Boston, MA
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