I have worked with any number of women who have had bad bleeds after
delivery, including one Sheehan's syndrome after a twin birth.  Short of
Sheehan's, there is potential for recovery of milk supply, but it takes a
long while for most women to recover enough metabolic energy to make milk.
Their bodies are prioritizing energy toward their own survival.  What I
generally do to support these women is institute some kind of regimen which
has them doing token breastfeeding for pacification (in bed with baby) and
then pumping to whatever level their activity and comfort permits.  If they
can keep the prolactin receptors activated in their breasts, as they
recover, more milk production resumes.  I had one woman who did this for two
months, limping along with a really crippled production level.  Finally, as
her health returned, so did her milk.  By three months she was exclusively
bfg.  Remember, anemia is a classic reason for low supply.  These moms need
iron replacement and lots of help so they can rest.  I;m not sure I'd advise
Reglan.  Seems to me that the stress of a bad bleed to the pituitary would
make me cautious about stimulating it, but I could be ignorant about that.
Reglan just seems like a kind of harsh drug.  Lots of my clients have
complained about how it made them feel.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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