Booby Traps Series: Postpartum hemorrhage and retained placenta – Two birth-related causes of low milk production

by Tanya Lieberman, IBCLC | August 18, 2011 4:03 pm

This is the 15th in a series of posts on Booby Traps, made possible by the generous support of Motherlove Herbal Company.

We’re getting close to the end of our birth-related Booby Traps series on the Best for Babes Blog, but I’d be remiss if I didn’t mention two lesser known causes of low milk production which derive from birth experiences:  postpartum hemorrhage and retained placenta.

Of course, no one knowingly lays these problems as traps for you.  But we think that the fact that their affect on milk production is poorly recognized constitutes a potential Booby Trap.™

How are these problems related to milk production?

Retained placenta.

You probably know that the body’s signal to start the production of mature milk is the birth of your placenta.  This triggers the release of hormones which are necessary for you to start producing mature milk.  But when that separation is incomplete – leaving fragments of the placenta intact in the uterus – the signal is interrupted.

In Diana West and Lisa Marasco’s excellent book, The Breastfeeding Mother’s Guide to Making More Milk, the authors describe the case of one mother who sought help because of very low milk supply.  Two weeks later her baby was gulping contentedly at the breast.  What had happened?

When asked if there were any significant changes that week, Marie responded, “Well, I did have this really weird thing happen last week.  I had a lot of cramping and then passed these big clots…”  The improvement in milk production occurred soon after this event.  Marie remembered that her obstetrician had kept traction on the umbilical cord until the placenta came out.  Case solved.

Postpartum hemorrhage/Sheehan’s Syndrome.

Blood loss that exceeds the normal range for vaginal birth (up to 500 cc) or cesarean birth (up to 1,000 cc) can place a mother at risk of low milk production.

When a mother experiences a significant hemorrhage during or after a birth, her blood pressure can drop so low that it fails to circulate to her pituitary gland.  This can cause some or all of the cells in her pituitary to stop functioning normally.  It’s the pituitary that secretes key milk making hormones, and when hormone production is affected, milk production can be, too.  For this reason, some experts recommend monitoring women who have have suffered postpartum hemorrhage for milk production problems.  Blood loss can also create anemia, which is another risk factor for low milk production.

Did you experience a hemorrhage or have retained placental fragments?  Did it affect your milk production?



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