Dear Deena,

Here is a responce to your post on oxytocin and unilateral nursing.  I sent
this letter to the editor of the ILCA Globe this summer regarding the
availability of intranasal oxytocin.

Oxytocin nasal spray is still available through the Professional Compounding
Centers of America.  This is an organization, available through membership,
to pharmacists.  It carries ingredients and formulation directions needed
for the preparation of discontinued pharmaceutical products.  If a
pharmacist is a member, he or she can obtain the oxytocin powder from the
organization and then prepare it in a spray form.

If you want to contact the organization and see if a pharmacist in your area
is associated their address is:
Professional Compounding Centers of America
10925 Kinghurst
Suite 520
Houston, TX USA 77099
Ph 1-800-331-2498 (USA or Canada)

Regarding the patient with unilateral surgery, please encourage her to
breastfeed.   If she does develop unilateral engorgement, she can use ice or
cold or cabbage leaves.  The engorgement should be temporary and she will go
on to involute quite naturally on the non nursing side.  The clinical
correlates would be to a mother whose baby refuses one side or the mother
with axillary gland tissue.  Both of these types usually do well.  I also
think that there is a theoretical risk of mastitis but I have not found this
to be clinically significant.

A friend of mine was a northern nurse (really northern Canada) and her baby
would only nurse on one side.  She described herself as having a snowball
and a beaver tail.  You see, beaver tails are quite flat and snowballs are
quite round.............oh never mind!

From the Great (soon to be white and cold) North,
Shirley Gross M.D.,C.M.