Dear Lactnetters,
     I attended a lecture at my hospital today by Dr. Karin Cadwell and she
really sent home the message that if a mom is not producing much breastmilk
and the babies are losing weight in the first month really consider retained
placental fragments as the culprit in inhibiting lactation.  Other  culprits
can be past injury to the breast especially the 4th intercostal nerve, breast
surgery, and hypoplastic breasts.  Of course there are always sucking problems
but for those 4 women that someone posted about with babies not gaining well
in the first month you may want to take a good history (no post partum
hemorrhage that could cause partial Sheehans Syndrome), and send them back to
their OB to see about the possibility of retained placental fragments even
small ones can inhibit lactogenesis.  This was just a thought.
                                                                     Dr.
Cynthia S. Marske DO
                                                                      Internal
Medicine
                                                                      Ft
Irwin, CA