I have a new client today with a problem that i have never had to assist with before: 2 days ago she had an emercency C-section for worsening toxemia and during the surgery, also had an unexpected bilateral oophorectomy because the surgeon found dermoid cysts on both ovaries. She was gravely ill postop and, although she had indicated that she wanted to breastfeed this child - her first, her obstetrician prescribed Prempro daily as HRT. Two doses were given before I was called in because the mom was comcerned that her milk hadn't come in yet in spite of the baby's frequent nursing. needles to say, the HRT has been stopped, but many questions remain. My research leads me to believe that, altho delayed, her milk should come in with frequent stimulation. However, how should this mom be maintained once lactation is well under way? I think that early and exclusive lactation has some similarities with peri-menopause as far as a hormonal "climate" goes anyway, but once six weeks has passed, will she need some form of estrogen to keep other menopausal symptoms at bay? When is the safest time to resume HRT (if it becomes necessary) without compromising her milk supply and endangering the infant to high extrinsic estrogen exposure? Do estrogen and progesterone play any role in maintenance of lactation after 6 weeks? What will happen to her bone density if she does not resume HRT until after weaning (whenever that may be)? I realize this forum may not be the place where all of these questions can be answered, but would appreciate input from any consultants who have encountered similar problems. There must be plenty of women out there who have required some kinds of hormone therapy to initiate and maintain a pregnancy and plenty of them must have breastfed. How do women with non- functioning ovaries manage?. Thanks in advance. Vee Peterson, RNC, IBCLC *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html