I have a client who delivered on the September 14th.  She had a meconium
delivery and baby was vigorously suctioned. Baby had the usual oral aversion
that one would expect, and before discharge from the hospital the baby was
latching to the breast and nursing with the use of a nipple shield.

Mom has a history of a benign pituitary tumor. She said that she had leaked
lots of milk and that is I guess how they found the tumor.  She did not get
any treatment for that and they had thought that she might have difficulty
getting pregnant since she was leaking milk but she had no trouble at all.
Problem is, it almost appears as though she really has barely any milk.  I
have not actually come out and said this to her because I do not want to set
anything up and I thought it may be too early to tell. Even though the
shield is place well and infant latches deep to breast with the shield ( and
no he absolutely will not latch without it) there is only scant amount of
milk on shield if he comes off prior to being done and it almost looks dry
when he is finished.  We did begin supplementing under the shield during
feedings with ABM (started with just a little glucose water the first few
times just to get him to start sucking because he would just latch and suck
once and sit there)  Not much audible swallowing heard and draw/pause is
poor. Mom has been pumping after feedings and gets only the tiniest of
droplets.

I am seeing them this afternoon for a 24 hour follow-up from discharge.  Any
suggestions or ideas.  I thought since she had a benign tumor and she had
leaked milk that this would not be an issue although I told her from the
start that we would want to monitor closely until feedings are well
established.  She did get increase in breast size during her pregnancy, but
they just do not really feel like "post partum" breasts to me.

Pam Price IBCLC, CBE
Lactation Services Coordinator
Women's Health
Trident Health System
9330 Medical Plaza Drive
Charleston, S.C. 29406
(843) 824-5013 office
(843) 728-9640 pager

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