I am working with a mother who had a retained placenta which was
removed by D&C.  The placenta came out in fragments and was followed by
significant blood loss.  The mother's vitals crashed on day 2 and she
was given a transfusion of 3 units of blood.  Pumping was initiated on
day 3, but was infrequent.  Beginning on day 5, pumping was every 3
hours.  Today is day 8 and pumping yields 5cc. maximum.  Mother reports
never noticing primary engorgement.  Baby is just beginning to nurse at
the breast (35 week preemie now 8 days old).  Baby has been receiving
formula and any available EBM by bottle since birth.

What can be expected in terms of bringing in a milk supply at this
point?  I set them up with an SNS for supplementing at breast and
finger feeding.  I found them a Classic rather than a Lactina.  I gave
info about herbal galactogogues and Domperidone.  Any other
suggestions?

Thanks,

Michelle Stolow, MAT, ICCE, IBCLC

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