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Tue, 30 Jun 2009 22:40:47 -0400 |
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Hemoglobin and hematocrit levels are expected to be low after a significant
postpartum hemorrhage, which is correlated with delayed lactogenesis and
Sheehan's Syndrome.
Approximately 8 years or so ago in an inpatient setting, I met with a mother of
multiples who had delayed lactogenesis with reported onset on Day 9 following
a greater amount of blood loss associated with cesarean birth and
complications that followed. For example, following a complication with a
cesarean birth and a subsequent return to the OR, a mother's hemoglobin level
could drop as low as in the 6 range. Have been in private practice for a while
and don't have lab values at my fingertips, but I believe a normal hemoglobin
range for females is 12 to 16 (please someone correct me if I'm mistaken on
this). For various reasons, some mothers may decline a medically
recommended blood transfusion for situations of greater volumes of blood loss,
and a delay in lactogenesis is not surprising. As a less-experienced LC back
then, I recall a more experienced colleague commenting that a woman's body
must get back in to balance re: dramatic blood loss and the regeneration of
red blood cells, etc. for the woman's overall wellbeing, before her body can
expend the necessary energy on milk production/lactogenesis II (more RBC's
to the mammary glands during lactogenesis II).
Debra Swank, RN IBCLC
Ashburn, Virginia USA
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