Barbara writes: <Today a 24-hr postpartum patient told me> <Today we could not express a drop of colostrum. In addition, her baby could not latch onto her flat and retracting nipples.> Did she by chance have a long pitocin induction? Or augmentation? This is mighty soon for edema/nipple flattening etc. even if just 500-1000cc. or so of IV fluid (without pitocin) was infused possibly because of an epidural. I have no expertise in the matter of prolactinomas. But even though there's a "zebra" to be seen on the horizon, it might be wise to consider that the "hoofbeats" you hear might partly be coming from "iatrogenic horses" in the underbrush, to mix a metaphor or two. Oxytocin has some anti-diuretic qualities. It also shares a few chemical similarities with ADH, probably causing some competition for binding sites when exogenous pitocin gets administered. On top of that, even though those two hormones come from a different lobe than prolactin, still, if there's already a problem with the pituitary, sudden discontinuation of medication that had been keeping one pituitary secretion in check, might theoretically have some sort of rebound effect on other secretions (????) I think Reverse Pressure Softening is a good bet to teach this mother. Denise Fisher has been kind enough to put the RPS intervention up on http://www.BreastEd.com.au Jean *********** K. Jean Cotterman RNC, IBCLC Dayton, Ohio USA *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html