Thank you all for being my number one resource for lactation help.  I
have a clinical situation that I am hoping someone can help with.  The
mother has had a long standing history of hyperprolactemia with probable
associated benign pituitary tumor. No history of infertility. Denies
having taken bromocriptine.  Medical records are unavailable as to
source of hyperprolactemia and mother is unsure (perhaps afraid?) of
tumor.  At any rate she has documented elevated PL levels (198 at 36
weeks antepartum).  She is 2 days postpartum and so far production and
secretion seems normal.  However, with her first child several years ago
she had severe engorgement during the immediate postpartum and inability
to have a MER.  Baby lost 12% of birth weight and had
hyperbilirubinemia.  She was unable to hand express or pump despite
standard tricks of the trade including reverse pressure softening,
acupressure and reflexology.  Didn't have access to oxytocin nasal spray
(does anybody and does it work?).  Involuted and fed ABM.   So here are
my questions. Could lack of MER be due to oxytocin problem which could
be related to prolactin issues?  Any endocrinologists out there who can
help?  Is there any link between the 2 or is this just a coincidence?
Anyone seen this before?  What are the chances of a repeat situation.
Hoping there will be no trouble, but want to be proactive if possible.
thanks for all your help,
Mary Westra

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