Does your colleague with expertise in eating disorders have a reference
for an association between binging and purging and increased letdown? It
is interesting to me that a postpartum nursing mother would binge and
purge, and hope the mother is getting both psychological and medical
help. This is my first response to a LactNet posting, having just signed
on a couple of days ago. I trained for 2 years in family medicine before
switching to preventive medicine. I am board certified in preventive
medicine, have an MPH in maternal and child health, and am IBCLC. My
particular interest is the physician's role in breastfeeding management
and how to coordinate that role with the that of other breastfeeding care
providers. I am cofounder and chair of the board of directors of the
Academy of Breastfeeding Medicine.
Elizabeth (Beth) Williams
Stanford Univ School of Medicine



On Wed, 5 Apr 1995, Catherine W Genna wrote:

> I had a mom several years ago with severe leaking that started a few months
> postpartum after finally getting through a very trying initiation phase:  sore
> nipples, mastitis, thrush, overactive MER, sucking difficulties.  This mom would
> spontaneously let down and leak several times a day to the extent that milk
> would spray across the room if she were not wearing clothing.  The only
> significant change during this time period was that this mom had begun binging
> and purging (vomiting).  A colleague knowledgeable about bulemia found it to be
> associated with forceful milk ejection.  Moms are not always candid about this
> type of problem, but you could ask her if she is vomiting a lot.
>         I have not heard of leaking with a new pregnancy, often milk supply
> declines slowly by mid-pregnancy.  Thyroid disorders seem to be common in
> postpartum women, hyperthyroidism could cause a huge increase in milk supply.
> You could refer the mom to her MD for blood tests for prolactin, T3, T4 and TSH
> levels.  Is it possible that the baby is taking less milk suddenly due to
> development (walking and being too busy to nurse?) or an increase in solid
> intake?  If this is the case, the leaking should stop pretty quickly as mom
> adjusts to the lower demand.  Could the mother possibly be eating a lot of
> licorice or taking a drug or herb that affects smooth muscle tone?  This could
> conceivably relax the circular muscles that keep milk in the breasts...
> Keep me posted,  Cathy
>