Lactogenesis II Onset Following Prolonged Delay in a Mother With a Nonfunctioning Macroadenoma Treated With Cabergoline: A Case Study in Persistence

Abstract

IntroductionThis is a case of a 31-year-old woman who experienced headaches and visual changes in her 15th week of pregnancy and was diagnosed with a macroadenoma.TreatmentShe started a dopamine agonist, a prolactin inhibitor, at that time to treat these symptoms and continued it for 2 weeks after the birth, a total of 13 weeks.Goal and OutcomeThe mother's goal was to provide her own milk for her infant. She began to express milk the day of her infant's birth but obtained only drops for the first 2 months. Using a breast pump and, later, hand expression, this mother was able to finally express more than drops per day. She achieved a full milk supply, 750 mL per day, 21 weeks following delivery, when 2–3 weeks is the average. She continued expressing milk achieving over 900 mL per day when the infant was 24 weeks old.ConclusionIn this case where cabergoline was discontinued after the birth, persistent pumping and hand expression was enough to initiate milk production. This case study reports this mother's experience with continued expression despite no increasing volumes in the first 2 months. This confirms that with a diagnosis and treatment of this type, milk production is possible with persistent expression.