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A Case Study of Early Postpartum Excessive Breast Engorgement: Is it Related to Feedback Inhibition of Lactation?
J Hum Lact. 2021 May; 37(2):414-418.JH

Abstract

INTRODUCTION

There is limited information about problems of feedback inhibition of lactation which should be considered as a rare cause of breast engorgement. We report the management of excessive breast engorgement in a mother with a presumptive diagnosis of a defect in the feedback inhibition of lactation.

MAIN ISSUE

The participant, who had been discharged on postpartum Day 2 while breastfeeding her infant, was readmitted to the hospital the next day with engorgement of the breasts and cessation of milk flow. Pumping and application of cold dressings alone did not work effectively. The severity of the symptoms decreased only after the addition of an anti-inflammatory drug and a prolactin inhibitor.

MANAGEMENT

The participant received breastfeeding counseling, family-centered care, and support for pumping equipment. An anti-inflammatory drug was started and a low dose prolactin inhibitor was given. The difficulty was the management of extensive and painful breast engorgement and the re-establishment of milk flow. At postpartum Day 14, the participant and her infant were discharged with effective breastfeeding status.

CONCLUSIONS

The recognition of a problem in the feedback inhibition of lactation as a cause of breast engorgement is important because it may be unresponsive to classical treatment methods resulting in cessation of milk flow. With the cautious use of low-dose cabergoline, in addition to other treatment strategies, milk flow can be reduced in a controlled manner while ensuring the continuity of milk production. An early diagnosis, interdisciplinary approach, and a close follow-up of the mother-infant pair are essential for preserving lactation.

Authors+Show Affiliations

37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey. 37516 Istanbul University, Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey.221265 Bezmialem Vakıf University, Faculty of Health Sciences, Nursing, Istanbul, Turkey.37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey.37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey.37516 Istanbul University, Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey.37516 Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey. 37516 Istanbul University, Institute of Child Health, Department of Social Pediatrics, Istanbul, Turkey.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33030995

Citation

Coban, Asuman, et al. "A Case Study of Early Postpartum Excessive Breast Engorgement: Is It Related to Feedback Inhibition of Lactation?" Journal of Human Lactation : Official Journal of International Lactation Consultant Association, vol. 37, no. 2, 2021, pp. 414-418.
Coban A, Bayraktar S, Yıldız N, et al. A Case Study of Early Postpartum Excessive Breast Engorgement: Is it Related to Feedback Inhibition of Lactation? J Hum Lact. 2021;37(2):414-418.
Coban, A., Bayraktar, S., Yıldız, N., Tunçel, D., Gökçay, G., & Ince, Z. (2021). A Case Study of Early Postpartum Excessive Breast Engorgement: Is it Related to Feedback Inhibition of Lactation? Journal of Human Lactation : Official Journal of International Lactation Consultant Association, 37(2), 414-418. https://doi.org/10.1177/0890334420962073
Coban A, et al. A Case Study of Early Postpartum Excessive Breast Engorgement: Is It Related to Feedback Inhibition of Lactation. J Hum Lact. 2021;37(2):414-418. PubMed PMID: 33030995.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A Case Study of Early Postpartum Excessive Breast Engorgement: Is it Related to Feedback Inhibition of Lactation? AU - Coban,Asuman, AU - Bayraktar,Sema, AU - Yıldız,Nevin, AU - Tunçel,Duygu, AU - Gökçay,Gülbin, AU - Ince,Zeynep, Y1 - 2020/10/08/ PY - 2020/10/9/pubmed PY - 2021/11/26/medline PY - 2020/10/8/entrez KW - breast engorgement KW - breastfeeding KW - breastfeeding support KW - lactation SP - 414 EP - 418 JF - Journal of human lactation : official journal of International Lactation Consultant Association JO - J Hum Lact VL - 37 IS - 2 N2 - INTRODUCTION: There is limited information about problems of feedback inhibition of lactation which should be considered as a rare cause of breast engorgement. We report the management of excessive breast engorgement in a mother with a presumptive diagnosis of a defect in the feedback inhibition of lactation. MAIN ISSUE: The participant, who had been discharged on postpartum Day 2 while breastfeeding her infant, was readmitted to the hospital the next day with engorgement of the breasts and cessation of milk flow. Pumping and application of cold dressings alone did not work effectively. The severity of the symptoms decreased only after the addition of an anti-inflammatory drug and a prolactin inhibitor. MANAGEMENT: The participant received breastfeeding counseling, family-centered care, and support for pumping equipment. An anti-inflammatory drug was started and a low dose prolactin inhibitor was given. The difficulty was the management of extensive and painful breast engorgement and the re-establishment of milk flow. At postpartum Day 14, the participant and her infant were discharged with effective breastfeeding status. CONCLUSIONS: The recognition of a problem in the feedback inhibition of lactation as a cause of breast engorgement is important because it may be unresponsive to classical treatment methods resulting in cessation of milk flow. With the cautious use of low-dose cabergoline, in addition to other treatment strategies, milk flow can be reduced in a controlled manner while ensuring the continuity of milk production. An early diagnosis, interdisciplinary approach, and a close follow-up of the mother-infant pair are essential for preserving lactation. SN - 1552-5732 UR - https://www.unboundmedicine.com/medline/citation/33030995/A_Case_Study_of_Early_Postpartum_Excessive_Breast_Engorgement:_Is_it_Related_to_Feedback_Inhibition_of_Lactation DB - PRIME DP - Unbound Medicine ER -