Hi, everyone: I've got permission from this mother to share her very
unusual story with Lactnet, to try to gain some insight/hear other related
cases/get any wisdom or suggestions about her case.
This mother of two who nursed her first child for 21 months and currently
nursing her second 15-month-old, had been receiving regular allergy
desensitization shots throughout both pregnancies and lactations,
uneventfully. About 3 weeks ago, she was inadvertently given 10 times
her usual dose. She was given a shot of steroids and told not to nurse
for 24 hours (I know, I know.....) but when she tried to resume nursing,
the baby broke out in hives (baby had never done this before). She tried
pumping and kept trying to nurse as the days passed, but with each
attempt, the hives reappeared. By the fifth day, she was barely able to
pump 1/2 and ounce (she had been pretty engorged due to the abrupt
weaning, and the pump just wasn't doing a great job -- don't know how
often she was pumping but she was using the same pump which had worked
well in the past), but it took another 4 days before she was able to nurse
the baby without seeing any trace of hives. It then took her another
couple of weeks to re-establish her milk supply with frequent nursing, but
she persevered through the child's frustration and her resulting sore
nipples and they are a happy nursing couple once more.
For background, both mother and father have significant allergies. The
shots were for inhaled allergens such as trees, dust and molds. There is
no history of food allergies. Mother ate a lot of dairy both during the
pregnancy and early postpartum (mom has never had a problem with dairy).
Baby was (to the best I could establish) breastfed exclusively for the
first 3 months, having a brief spell of "colic" at about 2 weeks of age,
which did not seem to respond to dairy-free diet or elimination of a few
other common allergens from mom's diet, but just resolved within a few
weeks even though most foods had been reintroduced into mom's diet. At 3
months, baby had a couple of bottles of soy formula (mother had not built
up enough of a store of ebm and believed that soy would be a safe
alternative to cow's milk formula) and tolerated those well, but continued
otherwise to be exclusively breast/breastmilk-fed. Mother stayed off dairy
for 4 months but noted no symptoms in the baby when she restarted dairy.
Solids introduced at about 6 months, very slowly, all tolerated well.
Currently, child eats a variety of foods, including dairy, with no
symptoms.
Besides questions about why her milk supply went away so quickly and took
so long to recover (which I dealt with) and venting about how upsetting it
was that most hcp's minimized her sense of loss of the breastfeeding
relationship (so what else is new?), this mom has a few questions about
the actual incident and the hives in her child.
First of all, what was the mechanism of the reaction? What actually
caused it? Secondly, what are the implications of this on her child's
future allergies/immune function? Thirdly, has anyone ever experienced
anything similar?
I couldn't find any literature on this and I have a few theories about
what might have caused it. Also, the overdose in this particular
case is probably (hopefully) a very rare occurrence. Still, I would love
to hear from anyone who has worked with any mother on allergy
desensitization shots whose nursling had any sort of adverse reaction,
even if there was no overdose of the serum. TIA, Alicia Dermer, MD,
IBCLC.
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