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Date: | Thu, 30 Nov 2006 23:18:21 EST |
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Permission to post.
I received a call from a LLLL tonight about a mother who has been on bed
rest for four weeks and is now 32 weeks pregnant. She has had intermittent
bleeding since 12 weeks. Placenta previa. Pre-term labor. Was being given mag.
sulfate to stop contractions. Recently given an injection of terbutaline and
is now on oral dose of the same. Was told her bleeding is from uterus rubbing
against placenta.
She is experiencing a lot of milk leaking and breast discomfort which sounds
like Lactogenesis II. When she called her OB he told her to pump and store
the milk. She called the hospital and spoke to the IBCLC there who told her
to absolutely NOT pump. She called LLLL looking for more information on how
to resolve this issue and her comfort.
First, a lot of this is outside the scope of what I can really talk to as an
IBCLC and some of it is really over my head in terms of what I know re:
lactation. I suggested a second opinion from a high-risk OB that has already
consulted on her case while she was in-patient. I also suggested ruling out
placental abruption.
Her concerns regarding breastfeeding are:
1. If she dries up soon will she produce any/enough milk once baby is born?
2. What can she do for her comfort at this time that will not stimulate
more uterine contractions?
3. What might be the cause of this onset of milk production?
She has two other children (3.5 yrs and 19 mos) who are out of the state
with family due to her bed rest. She nursed her second child and experienced
many difficulties which she was able to overcome. She is determined to nurse
this baby.
We discussed the possibility of her body going through Lacto II again (if
that is indeed what is going on now) once the placenta is separated from uterine
wall after birth OR she will basically be re-lactating at birth through
nursing, pumping, herbs, Reglan etc.
She is worried about causing her milk to dry up or decrease now b/c of the
unknown milk supply at birth.
We discussed ice packs, heat, Tylenol, as well as areolar compression to
attempt to express milk. She said she feels a let down frequently but doesn't
feel any contractions with that let down. She asked about just allowing
nipples to rub the inside of her shirt (without bra) and see if that helped
increase leaking (to move milk for comfort) without actually causing more
contractions.
I am researching more info but any input, suggestions etc would be greatly
appreciated.
TIA,
Christie Pillado, IBCLC
Motherhood Intact
"Mother's Milk...Building Blocks for Healthy Humans"
El Paso, Texas
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