< you might consider having this mom checked for placnetal fragments.>

I thought retained placental fragments were associated with delayed
lactogenesis and/or low supply, not oversupply.

If I remember correctly, I think the mechanism is supposed to be an
incomplete fall in the progesterone level due to the remaining fragments,
and therefore inhibition of prolactin secretion. Also, this would occur
in the immediate or early postpartum period, well before 7 weeks.

While writing this, the question occurred to me as to whether the
mini-pill, and also, depo-provera, which is derivative of progesterone,
might, by the same mechanism,  just be taking over prolactin inhibition
and causing supply problems if given in the hospital before discharge.

I know the PDR says it should not be given until 6 weeks postpartum to
breastfeeding women, but in their urgent desire to prevent pregnancy in
teens especially, I am not certain that HCP's in our area are always
following this guideline.

Comments, anyone?

K. Jean Cotterman RNC, IBCLC
Dayton, Ohio

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