Phyllis
What the mother describes sounds like a pretty frequent occurrence -
milk "coming in" in a baby following birth - with the consequence
that the baby's breast has become engorged and maybe even
infected. The white material that the surgeon found could be milk
(often called "witch's milk") or pus, as a consequence of infection
(like breast abscess in a mother). The baby's breast tissue has
merely reacted normally to withdrawal of placental hormones as a
consequence of birth - not to not to estrogen (!!) in the mother's
milk, as a so-called consequence of breastfeeding, as the surgeon is
suggesting. Poor little guy! If this was my client, I'd recommend
continuing to breastfeed the baby, while the mother obtains a second
opinion from a doctor more up to date with normal neonatal
endocrinology/physiology - he would need the protective properties of
mothers' milk to guard against further infection of the breast tissue.
The old Neville/Niefert book "Lactation: physiology nutrition and
breastfeeding" has this to say about the phenomenon:
"fetal tissue acquires the ability to respond to systemic
hormones. In the third trimester high fetal prolactin levels bring
about terminal differentiation of the ductile cells in the fetal
mammary gland so that, at birth, they resemble cels in the maternal
lactating gland, often secreting milk. After birth, these cells
revert to the undifferentiated state...... the neonate also
experiences postnatal decline in prolactin and placental steriods,
leading quite often to the appearance of "witch's milk" with the same
timing as lactogenesis in the mother."
My Lawrence, Breastfeeding: a guide for the medical profession, 5th
edition, adds:
"The newborn may have swelling of the breasts for the first few days
of life, whether male or female; this is unrelated to being
breastfed. If the breast is squeezed, milk can be obtained. This
has been called witch's milk." There follows more info on the
components of the milk, and a caution that if secretion persists for
many weeks it can be a marker for neonatal hyperthyroidism.
I have a dim recollection of also reading somewhere that in
_breastfed_ babies this breast tissue never becomes "infected", but
that infection is a risk in bottle-fed babies. However, I can't find
the info in my notes - can anyone confirm??
Meanwhile, I hope the quoted info above helps.
Pamela Morrison IBCLC
Rustington, England
------------------------------------------------
Date: Sat, 21 Nov 2009 23:33:33 -0500
From: Phyllis Adamson IBCLC <[log in to unmask]>
Subject: clogged duck in baby boy - rqst from former Lactnetter
I'm forwarding a request for information from a private practice
colleague in my town. She is a former Lactnet subscriber and is
seeking help for a client. Hope someone can give this mom some "ammunition".
Phyllis
---
Hi Phyllis:
Would you be willing to post this to Lactnet. I would love some
feedback from some wise woman and perhaps some of the IBCLC/docs on
the list. While I would never tell this mom what to do, it seems to
me that baby has had a clogged milk duct and this is not a reason to
quit breastfeeding. If you are willing to do so, thanks in advance.
Lori
---
Hi Lori -
First I wanted to let you know that he is doing great... we've had no
problems latching on quickly since we met yesterday. I've been using
the cream and hydrogel pads each time and hopefully in the next
couple of days, the pain will subside. (It's definitely better
though, now that he is getting a better latch).
I'm not sure if you noticed (or if we talked about) how the breast
tissue on his left side was swollen and red yesterday. He had "nubs"
on his chest when he was born that the pediatrician said were normal
and would go away in the next few weeks. The night before last one
side seemed to swell up a little more and turn red. We asked the
pediatrician about it yesterday at his appointment and she was
actually concerned that it was an infection. Fortunately he didn't
have a fever and didn't seem bothered by it, but the doctor felt like
it was urgent enough to send us to a surgeon at the Hospital to have
it drained. We saw the surgeon yesterday afternoon and he did a
procedure where he put a small cut in the tissue and drained
it. (I'm not sure if this was more traumatic for me or my baby, but
fortunately he is doing great now, and other than being pretty
sleepy, did fine yesterday afterwards). Anyway... the surgeon
actually said that he didn't think it was an infection, but he did
think that the tissue was full of milk. He said that this could be
due to estrogen stimulation from my breast milk and if that was the
case, I would probably have to "curtail the breastfeeding". I'm
curious if you have heard of this, and if so, what are your
thoughts? I've looked on the internet but haven't found anything
that really explains this. I'm so worried that they are going to
tell me I can't breastfeed him anymore, especially now that I feel
like we finally have the hang of it! I plan to talk to the
pediatrician about this on Monday at his follow up appointment, but I
was also curious what you thought. The surgeon did say that I should
continue to breastfeed until we know for sure what's going on which
will probably be early to mid week.
I would really appreciate any input you may have. Hope you are
having a good weekend!
Thanks again for everything.
Lori J. Isenstadt, IBCLC
http://www.aabreastfeeding.com
Welcome to my blog:
http://aabreastfeedinghotmail.blogspot.com/
--
Phyllis Adamson, BA, IBCLC
Glendale, AZ.
[log in to unmask]
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