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Subject:
From:
"Norma Ritter, LLL Leader" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 17 Apr 1996 19:16:04 EDT
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I have a real puzzler here and would be grateful for any input.

        Last November, "Doris" finished weaning her 10 m/o baby. On March 13th, she underwent a complete
hysterectomy and was started on the Estraderm patch. On April 4th, she awoke to find her breasts painfully
engorged and the sheets soaked with her milk. Four days later, still engorged, she called me. I suggested
using cabbage leaves in her bra and expressing just enough milk to relieve the pressure as necessary. Today,
April 17th, she called again. Her breasts were no longer engorged, but she is leaking milk in a pattern of
2-3 days of leaking followed by 2-3 days of no milk. In addition, she now has constant deep breast pain from
her chest wall to her nipples. There is no sign of nipple yeast - she knows what to look for and how it feels
from a bout with it last year - but I suggested that she have her milk tested to see if there were signs of
ductal yeast. She called back later to say that the test  was performed in the Dr.'s office this afternoon
and came back negative. (I thought that it took at least 24hrs to culture yeast and had not heard of a
quicker method. Anyone?) The baby has yeast on her bottom, but Doris says she always uses rubber gloves when
she changes her diapers and practices scrupulous hygiene.
        Doris says that she gets a little relief from the pain when she expresses some milk, but not enough
to make a significant difference. Her doctor has suggested testing her prolactin levels, but has not said
why. Since she is producing milk, I would assume that they would be higher than in a non-lactating woman.
Apart from the possibility of a disfunction of her pituitary gland, possibly caused by a tumor, what could be
causing this problem? The Dr. says that he has seen temporary galactorrhea following hysterectomy, but never
for so long, and nobody has been able to explain the breast pain.

Any ideas?


Norma Ritter, IBCLC, LLLL
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