Lactation Anaphylaxis: A Case Study
This case describes a 32-year-old primiparous woman who experienced an anaphylactic reaction associated with breastfeeding and milk expression on postpartum day four. With each episode her symptoms worsened and she developed hives, edema and difficulty breathing and swallowing. She had to be treated for her anaphylactic reaction in a hospital ER and ICU and she was released on postpartum day five on antihistamines.
Lactation anaphylaxis is a very rare condition that was first reported in the scientific literature in 1991. Since then there have been 11 other reported cases. Lactation anaphylaxis can be life-threatening and symptoms can include a rash, hives, edema resulting in difficulty breathing or swallowing, a dangerous decrease in blood pressure and a loss of consciousness. We will review this case and do a brief review of the previous case reports. We will discuss the possible causes for lactation anaphylaxis, the related risk factors, common treatments and possible breastfeeding outcomes. In most cases with proper treatment and management breastfeeding and milk expression can continue. Enhanced awareness of and knowledge about this rare condition will allow lactation consultants and other members of the health care team to better support breastfeeding parents who experience lactation anaphylaxis.
This lecture was originally offered as part of the GOLD Lactation Conference 2020.
Dixie Whetsell, MS, IBCLC, has a Master’s Degree in Community Health Education from the University of Oregon. She began working with breastfeeding families in 1992 and became an IBCLC in 1998. She has worked as a lactation consultant in a variety of settings including private practice, county and state public health programs and high risk maternal and pediatric hospitals. She began teaching lactation training courses in 2003 and is currently an adjunct faculty member teaching in the Pathway 2 Lactation Training Program in the OHSU-PSU School of Public Health at Portland State University. She is a past presenter for the GOLD Perinatal Conference. She is an active member of the Oregon Washington Lactation Association, the US Lactation Consultant Association and the International Lactation Consultant Association. She was a founding Board Member for Northwest Mothers Milk Bank, a HMBANA non-profit donor milk bank.
Lisa Gonzales, BSN, RN, IBCLC earned her Bachelor of Science in Nursing from Linfield College. She started her nursing career as a Labor and Delivery nurse at a Level III OB hospital in 2006. After having her first baby, Lisa pursued lactation education and became an IBCLC in 2013. She made full career change in 2015 to become a lactation nurse in a high risk maternity and pediatric hospital, providing inpatient and outpatient consults to growing families. She is an active member of the Oregon Washington Lactation Association, the US Lactation Consultant Association and the International Lactation Consultant Association. Lisa currently helps families during in-home visits with her private practice.
Objective 1: Define what lactation anaphylaxis is, what the common symptoms are and when it is most likely to occur;
Objective 2: Describe common treatments for this condition and options for long-term medical management of this condition;
Objective 3: Discuss how this condition can impact the breastfeeding relationship and how an IBCLC can best support a breastfeeding parent that experiences this condition.
This case describes a 32-year-old primiparous woman who experienced an anaphylactic reaction associated with breastfeeding and milk expression on postpartum day four. With each episode her symptoms worsened and she developed hives, edema and difficulty breathing and swallowing. She had to be treated for her anaphylactic reaction in a hospital ER and ICU and she was released on postpartum day five on antihistamines.
Lactation anaphylaxis is a very rare condition that was first reported in the scientific literature in 1991. Since then there have been 11 other reported cases. Lactation anaphylaxis can be life-threatening and symptoms can include a rash, hives, edema resulting in difficulty breathing or swallowing, a dangerous decrease in blood pressure and a loss of consciousness. We will review this case and do a brief review of the previous case reports. We will discuss the possible causes for lactation anaphylaxis, the related risk factors, common treatments and possible breastfeeding outcomes. In most cases with proper treatment and management breastfeeding and milk expression can continue. Enhanced awareness of and knowledge about this rare condition will allow lactation consultants and other members of the health care team to better support breastfeeding parents who experience lactation anaphylaxis.
Accreditation
CERPs - Continuing Education Recognition Points
Applicable to International Board Certified Lactation Consultants (IBCLCs), Certified Lactation Counsellors (CLCs), Certified Lactation Educators (CLEs), Childbirth Educators (CBEs) and doulas. This lecture has been approved for 1 L CERP. GOLD Learning is designated as a Long Term Provider of CERPs by the International Board of Lactation Consultant Examiners (IBLCE) -Approval #CLT114-07.
Midwifery CEUs (MEAC Schools):
This program is accredited through the Midwifery Education & Accreditation Council (MEAC) and is approved for 1 Hour, the equivalent of 0.1 CEU. Please note that 0.1 MEAC Midwifery CEU is equivalent to 1.0 NARM CEUs.
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