She needs to drink about 3 liters of water a day, take salt tablets, and
either Flourinef or Midodrine. I would suggest Flourinef. Did she have an
epidural? If yes, does she have headaches? If no, does she have headaches,
lol?

Elisabeth Coble, MSN, RN, IBCLC

On Thu, Sep 6, 2018 at 12:47 PM Amy Slotten, RN, IBCLC <
[log in to unmask]> wrote:

> I am working with a client and need some guidance.
> PTP:
> Baby is about 10 weeks old. Second baby and breastfed first baby with
> large oversupply which she managed to decrease somewhat.
> Has had a complicated postpartum time with readmission and abx for
> endometritis and mastitis. Somewhere around the mastitis time at 4 weeks
> postpartum she started developing symptoms of dizziness, light headedness,
> SOB (shortness of breath), increased heart rate and decreased BP. She has
> been dx with POTS (Postural Orthostatic Tachycardia Syndrome) and started
> on Paxil which she thought helped the SOB but not the dizziness and HR/BP
> issues. Maybe somewhat complicated by her massive oversupply with this baby
> as well. She is exclusively breastfeeding and then pumping 30-40oz/day
> which has decreased from where it was a couple of weeks ago. Naturally, the
> cardiologist recommends to stop breastfeeding so she can try a different
> med which doesn't have any info r/t lactation. Doc also assumes that
> lactation is contributing to dehydration which can worsen the symptoms.
> This mom is doing a great job of staying hydrated and replacing
> electrolytes.
>
> Has anyone worked with someone with POTS and oversupply while
> breastfeeding. Mom is looking for specific suggestions, including dietary,
> that have worked for others.
>
> I also have questions trying to understand if the same mechanisms can be
> at work here contributing to oversupply. If she has the hyperadrenergic
> form of POTS, couldn't that also impact the transport of dopamine which
> could be impacting supply? It's also mixed up in the hypothalamus/pituitary
> system and my lack of more endocrinology understanding is getting in my way.
>
> Thanks
> Amy Slotten, RN, IBCLC
> Ann Arbor, MI
>
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