In a message dated 6/1/2004 9:36:23 AM Eastern Daylight Time,
[log in to unmask] writes:
Forgive me, as I have not read the above-mentioned article, but could
she be anemic?
Dear Friends:
    An update on this mother, whose milk volume is still minimal at a week
postpartum...........her OB didn't think that bright red bleeding on day 5 was
significant, even when coupled with her delay in Lactogenesis II. However, the
OB did ask me what lab values should be checked, which is where the Betzold
and Hoover article came in so handily.
    As of last night, the mother's bright red lochia is increasing in volume,
despite her spending most of the time in bed. I expect the hCG level to be
high........but in any case, I wish the OB would do a vaginal ultrasound and
check for retained placental fragments.
    Anemia per se doesn't reduce milk supply; the Henley article (630 dyads)
found that anemia can increase perceived insufficiency. An anemic mother is
too tired to interact with her baby in a way that supports adequate
breastfeeding. However, if the mother I am working with continues with bright red
bleeding, it might lead to a starved pituitary and a lowered supply.
    warmly,
Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI
Maternal-Child Adjunct Faculty Union Institute and University
Film Reviews Editor, Journal of Human Lactation
Support the WHO Code and the Mother-Friendly Childbirth Initiative

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