I have a 40 yr old client who took bromocriptine to drop her high prolactin
level enough to allow for pregnancy. Takes thyroid medication. Pregnancy
was normal, except for ongoing thyroid medication. C-section; large, soft
breasts; broad, flat nipples; baby does not latch well, even w/ SNS, and
won't sustain a latch w/o it. Initially, pumping produced drops only. On
Day 9, drops suddenly increased to about 2 droppersful. Thyroid tests (w/
medication) are normal. She's just finished 3 days of "intensive" (8x/day)
pumping, which yielded 24 hr totals of 1 oz, 3/4 oz, 3/4 oz of what looks
like mature milk. She's now 16 days postpartum.
Our current plan: 2 more days of "intensive" pumping, which she finds
difficult, then drop back to whatever will continue about the same output
(I'm guessing 4 or fewer, since there isn't much back pressure!), hang in
there to the 3 week mark (at which time a client long ago suddenly and
mysteriously produced a full supply). Further efforts w/ the SNS don't
interest her, but she'll continue to use breast as a "snuggly place". I
don't know, but I suspect my long-ago client was not producing mature milk
before her sudden burgeoning. This woman is. Despite my congenital rose
colored glasses, I'll be amazed if anything more happens.
Thoughts?
Diane Wiessinger, MS, IBCLC, LLLL Ithaca, NY USA
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