The midwife is sure that
>the placenta was delivered intact BUT it doesn't matter because retained
>fragments "do not present as delayed lactation".  I have been reading
>Lactnet and Ruth Lawrence etc. and * I* know that the midwife needs a
>little bit more education.

Sarah, last summer I had a similar case of very low milk supply.  Baby was 4
weeks old when I began working with them. I wanted the family practice MD to
pursue the retained placenta route but mom was not insistent.  He finally
referred mom to an OB who told her, same as your midwife, that retained
placenta would have no effect on milk supply. (Where do these folks study?
Don't they understand lactogenesis?)  He recommended an industrial strength
antibiotic with which mom couldn't breastfeed for 9 days.  (Who knows why
the abx.) Against my strong disagreement, mom took the drug.  And afterwards
began serious bleeding. There was a d&c, the contents of which was sent the
lab and guess what... retained placenta.  The day after the procedure mom
was engorged and dripping milk for the first time, but unfortunately after 9
days off the breast and all of that free-flowing formula baby refused the
breast. Will this OB know next time?

The parents decided that they didn't want to work with an LC anymore because
of cost, and baby never returned to the breast.

Is this knowledge so guarded that only LLLLs and LCs and a few select MDs
know about it?

Patricia Gima, IBCLC
Milwaukee
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