Isolated Prolactin Deficiency: A Possible Culprit in Lactation Failure

Abstract

ABSTRACT: Objective: To review a case of a woman with postpartum prolactin deficiency after each of 2 pregnancies.Methods: We discuss isolated prolactin deficiency in a patient who presented to the office as a puerperal woman with lactation failure.Results: A 32-year-old woman who had given birth once presented to the office with insufficient milk supply postpartum. Her medical history was insignificant and she had an uncomplicated prenatal course and delivery. Despite multiple efforts, frequent breast emptying and stimulation, her prolactin levels remained low and she was unable to increase her supply. Breast exam showed palpable glandular tissue bilaterally with no abnormal spacing. At age 35, she accomplished a twin pregnancy through in vitro fertilization and embryo transfer secondary to oligospermia. She sought counseling during her prenatal care for proactive planning for future lactation. The patient had an uncomplicated twin delivery, had persistently low levels of prolactin, and was unable to lactate.Conclusion: Isolated prolactin deficiency is a rare disorder that presents clinically as postpartum lactation failure. Breastfeeding failure can cause significant stress on postpartum women. Physicians should be aware of any possible underlying conditions and assess any women with failure to breastfeed.Abbreviations: BMI = body mass index; LF = lactation failure