Erin Michaud posts about a mother whose milk supply has been low all along,
after many unfortunate events around the birth.
I don't know enough about teratomas and fatty liver to say anything
intelligent about how they might affect lactation.  But delaying the start
of breastfeeding is never an advantage, and retained placental fragments are
a major culprit in preventing prolactin surge.  That's why I was startled to
read this:
"After the D & C the surgeon told her that there were placental fragments in
her uterus still that weren't able to be removed."
Retained placenta can cause prolonged bleeding, increase the risk of
endometritis, and of course impede milk production.  In some cases there is
malignant invasion of the myometrium from placental fragments.  Even though
she is understandably traumatized and worn down by all this, she should very
definitely make sure that her doctor is not concerned about this last
possibility!  Surely there is a medical plan for how to follow this woman
until the placental fragments have been expelled?  I've literally never
heard of just leaving retained placenta in the uterus because it wasn't
'able to be removed'.  Perhaps she  misunderstood?
I'm more than willing to be educated on this, if there is something I have
missed in my profession in the last 20 years or so.  I was trained to be
scrupulous about making sure the entire placenta is delivered before so much
as leaving the mother's side after birth, and I have not heard that there
are exceptions to this rule.
Rachel Myr, *midwife*/IBCLC
Kristiansand, Norway

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