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Subject:
From:
"Johnson, Martha (PHMG)" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 24 Jun 1999 11:51:05 -0700
Content-Type:
text/plain
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Dear Dianne and Lactnetters,
Try having this mom feed off only one breast for several feedings in a row.
She should definitely NOT be pumping, as this only exascerbates the problem.
Some of these moms with overactive let-down actually have a syndrome (I
forget the name of it) that is associated with extremely high levels of
oxytocin.  associated symptoms include very short painful labors, overactive
let-down reflex, and on the emotional front, a sort of hyper-vigilance state
that  can make the mom feel intensely concerned about her baby,
depressed/paranoid, and  have a hard time being alone for the first two
months.
          We had a mom with this syndrome in our practice,  she resolved the
breastfeeding difficulties by feeding for as long as 12 hours on one breast
only, before using the other one.  After the first feeding on one side, the
let-down reflex is diminished and the baby can tolerate it more easily.
This may also reduce the pain your client is experiencing.  After about
10-14 days, my client was able to go back to a more normal feeding pattern,
though she never did use both breasts at a feeding.--- Of course, you wd be
monitoring the baby's weight closely during this transition.
 When she got pregnant with her 2nd child, she found a doctor on the East
Coast who has researched this syndrome, and she has been able to avoid the
disabling emotional effects this time around by treating with (I believe)
Zoloft.
  Good luck with this case, overactive let-downcan be frustrating and
demoralizing for the mom.
Martha Johnson RN IBCLC
Eugene, Oregon
> -------
> From:         Dianne Veatch[SMTP:[log in to unmask]]
> Sent:         Wednesday, June 23, 1999 7:20 PM
> Subject:      Very Painful letdown
>
> Does anyone have any other suggestions for a Mom I have been working with
> with very painful letdowns(MER) and an enormous milk supply. The baby is 1
> month old and has been nursing well since birth. Mom describes her MER and
> uterine contracrtions as extremely painful right after the birth. (This
> was
> her second pregnancy.)She could barely stand to nurse unless she had pain
> medication first.
>
> She describes her pain as shooting into her shoulders and back. There is
> no
> signs or symptoms of yeast in her or the baby. Her baby does cough and
> sputter, with some spitting up, but usually handles the feeding fairly
> well. She has done all the positioning for overactive letdown, which helps
> the baby but doesn't releive her extreme pain. She wears cabbage much of
> the day and night, but it helps only for the time is has it on, uses ice
> packs frequently, but when she takes it off the fullness and tightness
> return. She pumps briefly a few times a day when she can't tolerate the
> discomfort and can easily get 20 ounces a pumping. She recently started
> taking parsley but has seen no difference.
>
> She has an unremarkable medical and hormonal history, not on birth control
> pills or any other medications. She was very full when she nursed her
> first
> baby who is age 2 but not this severe. Any suggestions?
>
> Dianne RN IBCLC from rainy, hot and humid Florida.
>

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