Michelle

Regarding your query about the mom who is suffering headaches when she
nurses, I see that there have been a few responses mentioning the
possibility of epidural (anaesthetic) as a cause.

I just wanted to add my 0.2ml that I doubt that this is the cause in this
case.  In my experience, an Epidural Headache, when it happens, comes on as
a consequence of an epidural anaesthetic - it happens quickly, is
continuous, caused by post dural puncture, and is not helped by any amount
of pain-killers.  The advice is for the mother to lie absolutely flat to
reduce the pain, which makes either nursing or pumping or caring the the
baby just about impossible.  If the OB can be persuaded to do a "patch" in
the theatre, the relief felt by the mother is miraculous!  A patch involves
taking some of the mother's own blood and injecting it into or near the
hole in the dura, the blood clots to stop the leak of spinal fluid, allows
the pressure around the brain to increase and stop the headache.  I used to
find that speed was of the essence (ie this cannot wait over a weekend, or
even til this afternoon!) and some advocacy was useful to explain to the OB
the importance of fixing the pain so that the baby could be breastfed!

It sounds like the cause of headache, which is only intermittent and only
comes on with nursing, is not due to leaking spinal fluid, but to something
else (letdown/oxytocin release/possible DMER?).

Hope this helps the diagnosis of exclusion.

Pamela Morrison IBCLC
Rustington, England



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