Marie--

Over my couple of years on Lactnet I have posted similar cases--- same
results--makes me want to become an MD just so I could order the tests for
info gathering.

One mom (P5G5)  couldn't get a flow started for a couple weeks after the
birth of her 28 week premie (also there was a molar pregnancy twin....)
doc prescribed syntocinon  "for her let down" (of nonexistent milk
flow...)---but it helped!! Why?  within 24 hours of the puffs, and
subsequent cramping, she passed a major clot, and within 24 hours more her
milk was free flowing.  So doc was not correct in rationale but it saved
her a d & c down the line I am sure-,and brought in her milk--she was no
longer "pregnant"!!

Lisa Marasco in CA has posted similar frustrations--- we need a sympathetic
doc to make the statements of protocol of what do you do when milk doesn't
come in.  If prolactin levels are nil when they are supposed to be high, we
need protocols or something to see what is going on--if only to have a
reason, and not leave a mom high and dry as to why she wasn't "normal" in
her breastfeeding.

Karen Foard, IBCLC, State College, PA

<<Several frustrations lately have led me to post this to the list.
Many of our "Classic texts" describe what the problem could be but never how
to deal with them.  I have been faced with this question several times in the
past few weeks: "OK what do we do now?"
For example
CASE 1--Suspected retained placental fragments: What tests should be run?
What should the results be?


Case 2-- G3P3 mom at 2.5 months pp with low supply.  States her milk never
came in with this baby like it did the others.  Had post partum hemorrhage.
Blood tests showed she was still slightly anemic and the prolactin level was 5
post feeding.
Sheehan's syndrome, right?  So now what do I do for this mom?>>