Regarding Beth's inquiry about the mother who suffered
an amniotic fluid embolism 5 days ago...just to
ventilate, what an awful experience!  These types of
emboli have about an 85% mortality, a higher rate than
eclamptic seizures, although emboli are much more
rare. Whew!  My heart is pounding just thinking about
it...

If this mom's clotting factors are stable, she could
be started pumping, if she feels able.  She should
follow the recommendations for moms separated from
their babies during the establishment of milk supply
(hospital-grade pump, double pumping if possible,
pumping at least 10-12 times in 24 hours, etc.).
Since she had an extreme physical crisis, and has not
had any nipple/breast stim since the birth
(understandably a low priority in light of a
life-threatening situation), she can expect a delay in
full milk production.  If her baby is at all
compromised or ill, she should be informed of the
option and vast benefits of donor milk, until she can
provide sufficient amounts of her own breast milk to
feed her baby.

My best to this mother and baby; they will be in my
prayers!
Carole Jernigan RN,BSN
veteran of 8 years in high-risk OB

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