Hi All,

 

Ok - update and I need more help as I am way out of my league here.  Oh, and
I have instructed parents to talk to the endocrinologist.

 

Mom had her Thyroid and prolactin levels tested on Day 10 post-partum.  TSH
3rd Generation High Sensitivity levels were 2.11 

Her prolactin level was 84.5.  Since Prolactin should be peaking between 200
and 400 on Day 10 (per Lawrence) I assume this is part of the issue.  

 

My questions are:  Is it safe to take domperidone under her circumstances?  

 

A few bits of other background:  mom is unwilling to do most of what she
needs to do which I believe is contributing to the issue.  She refuses to
pump more often than every 4 hours.  She refuses to do SNS at breast or
5-french tube a'la Jack Newman at breast.  Babies are nursing at breast
using a nipple shield but are getting NO measurable milk transfer at all.
It may be that her nipples being so large are being tightly compressed in
the nipple shield so milk is unable to get out.She has NOT been pumping at
all the past 48 hours because babies are on the breast. Babies cannot latch
onto nipples alone - they are too large - so knowing this I doubt they could
even reach the amount of areola they need to get to the milk even if they
would latch without the shield (which they won't).   Pumping has been
sporadic at best since birth - pumping in the hospital and at home as
painful until I switched her to 36mm flanges.  She had terrible mastitis in
the right breast - that is now gone.  

 

What else?  I am assuming that the milk supply has been compromised by all
of the above.it wouldn't surprise me if the prolactin levels were low due to
lack of 'enough and appropriate' stimulation.  The husband is a real trooper
- he is supporting his wife while being frustrated that she says she
desperately wants to BF and provide breastmilk but refuses to do all that
she needs to - it is really hit or miss with her.  He had to take 3 days to
talk her into getting the blood-work done even tho she knew how important it
was to have that information to figure out why she has virtually no milk
(she is lucky to pump 5mls from each breast.).

 

Thoughts?

 

 

 


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