Complete lactational failure in four consecutive deliveries: a case report

Abstract

Although the ever-breastfeeding rate in Nigeria is over 98%, there are some women who may not be able to lactate despite the desire and motivation to do so. Some of the reasons for this failure include lack of skilled support and inherent failure to lactate. We report .the case of a 29-year old graduate, who, despite adequate breast development, motivation to breastfeed and frequent suckling of the newborns, failed to lactate in four consecutive deliveries. Her last postpartum prolactin level was 260µ Units/L. She refused all methods of contraception and consequently delivered four term babies in a period from 1998¬ - 2004 [a period of 6 years] with inter-delivery intervals of 16.5, 36 and 18 months respectively and a mean of 23.5 months. Lactational failure, although uncommon in Nigeria, constitutes a medical indication for the use of breast milk from a wet nurse or breast milk substitute. In view of the high re-lactation rate by affected women when offered skilled assistance, there is need to identify and refer early affected mother-baby pairs to prevent total and consecutive failure to lactate. In event of failure to relactate, safe birth spacing methods should be offered to prevent short inter-delivery intervals with its attendant risks. Similarly, safe and affordable methods of feeding should be provided for the infant to prevent malnutrition and associated problems.

Nigerian Medical Practitioner Vol. 49(1&2) 2006: 10-13