Hi Karen
Marginal lactation performance after a haemorrhage is fairly common,
particularly as the immediate postnatal care doesn't usually allow for good
lactation management.  From your post I was a bit unsure of just how poor
the mother's supply is.  Was the 30ml given after each feed all EBM?  Will
the 60ml you suggested be all EBM?  If so it sounds like the milk supply is
OK, or at least build-able, more a problem with the baby not transferring
the milk during feeding.

I'd just like to tell you about a woman who had a baby up my way about 6
months ago now.  It was her first baby and she had placenta accreta.  She
had a massive haemorrhage - reports have it that she had 3 or 4 surgeons
working on her at once at one stage trying to stop the bleeding.  There was
no way anyone expected she would live.  After surgery she went to intensive
care and was unconscious and ventilated for 3 or 4 days.  She was given her
last rites.  Her sister mentioned that she had wanted to breastfeed, and at
the suggestion of an LC they put her baby to her breast (unconscious,
ventilated, etc) - as a 'last thing I can do for my baby' action.  To cut a
long story short, she recovered.  Medical opinion was that there was no way
she would ever lactate, but again at the suggestion of the LC she
"demanded" domperidone and commenced breastfeeding using a Supply Line.  In
less than two months (from birth) the baby was totally breastfed and the
mother had heaps of breastmilk in the freezer.  This LC says "never say never".

Sheehans Syndrome - I don't know - I guess you have to be prone to it.  But
my suggestion is that the best thing you can do for this mother is totally
optimise breastfeeding - lots and lots of skin to skin, keep checking on
that latch, use breast compression during feeding and wait for about 45
mins to an hour before expressing, then use that in your Supply
Line.  Depending on how bad the supply is start the domperidone.  And yes,
iron, rest and a good healthy diet for the mother are probably all very
important.

Not sure how you can lactoengineer breastmilk unless you have an
oversupply.  If you don't have enough I'd be giving every single ml of it,
low fat or not.

Keep us informed, and good luck.
Denise

Denise Fisher
mailto:[log in to unmask]
http://www.health-e-learning.com

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html