How interesting you should ask this question. We have had a run of HELLP
patients starting last Friday at a rate of one a day. One patient whose baby was
34 weeks had her platelets drop to 18,000 after the delivery. The baby's ped
was concerned about the very same issue you mention-will pumping bruise her
nipples. Her OB was not worried-he felt that if she was that sick we would
have seen other things, like bleeding from her incision, before we saw damaged
nipples. She was 2 days post delivery before she even felt well enough to
pump. We offered to teach her hand expression but she was not too keen on the
idea. So we used the Symphony pump. We taught her about the pressure settings,
timing of pumping sessions (every 3-4 hours) and instructed her to notify us
of any problems. Our biggest concern for her was her milk making ability
after her body went through so much. Her liver enzymes were through the roof!
The next mom to deliver had platelets more like your mom but was filling the
day after birth. The third had platelets of 80, 000 and baby was able to
directly BF without having to spend time in the special care nursery.
The great wonders of Lactnet where something always pops up whenever
I have a question on a very similar issue!!
Allyson Michaels RN, IBCLC
Charlottesville, VA
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