In reviewing textbooks for sitting my recertification test this summer, 
I was surprised to come across this on pg. 527 of the new 4th edition of 
"Breastfeeding and Human Lactation" by Riordan & Wambach : "Nearly half 
of all women who fully breastfeed experience some vaginal bleeding or 
spotting between 6 and 8 weeks postpartum" (Visness, Kennedy & Ramos, 
1997).  I guess I haven't asked mothers specificially, but has this been 
anyone's experience?  Perhaps this could be part of the explanation for 
Maureen's question about a mother at 6 weeks having some spotting.  
Maybe the fenugreek is a red herring.

Could the plugged ducts suggest that the baby isn't removing milk as 
effectively as possible?  Maybe a lot of compression and massage to help 
the baby remove what's there and send a good message.

Does the fenugreek seem to be helping?  Nothing works for everyone.  If 
it doesn't seem to be helping after a week or two, maybe she'd be open 
to trying some other herbs, such as the Motherlove Goat's Rue, or 
Shatavari.  There's some good discussion on herbals and prescription 
galactogogues, as well as some overviews of other ideas, at the website 
connected with the book "Making More Milk" by West and Marasco,
http://www.lowmilksupply.org/increasingmilk.shtml
  which would be a very useful resource to have, to help you do 
detective work on these multi-variable cases


Milk production difficulties are so hard to deal with.  She stopped 
earlier with her older children.  Sometimes it helps to get across the 
idea of the longer view,  that in these unusual situations, 
breastfeeding doesn't have to be all or nothing.  If she's producing any 
milk at all, why should she have to stop?  She should be proud of every 
drop.   Being in the mode of trying to increase supply is a hard, 
unpredictable climb up up a rocky mountain -- to change the amount 
someone is making, she has to keep stepping up the demand, trying 
different things.  The body is thrifty, and doesn't want to make more.   
Maintaining supply is generally easier -- the body assumes it's going to 
breastfeed for years..  So sometimes a mother will reach a nice meadow 
on the side of the mountain, and decide that's where she's going to hold 
her ground and enjoy the view.  As solids come on the scene, the amount 
she's making may eventually be perfect.  Many women have breastfed for 
years, never having all the milk they deserved to have,  But in the big 
picture, that baby does get a substantial amount of milk and they both 
enjoy a lovely breastfeeding relationship.

Margaret Wills, IBCLC, Maryland
> Date:    Tue, 19 Apr 2011 22:21:09 -0400
> From:    Maureen Fletcher<[log in to unmask]>
> Subject: Bleeding while taking Fenugreek
>
> Dear Lacnet Teachers,
>
> I had a message from a mother last night asking about if its normal for slight menstruation to occur while taking fenugreek.
> This is my first time encountering such situation.
>
> The mother is 1.5months postpartum, do not have any history of hypertension nor diabetic, but she has a history of migraine in which resulted her to take Imigran, but she has yet to use it for the past 1 year. The mother is in her late 20s and this is her 3rd child whom she is trying to prolong breastfeeding beyond 1 month as compared to her first 2 children. She is currently taking Motherlove's More Milk Plus, 2 capsules 3x a day (dosage for above 80kgs)
>
> She had noticed small amounts of bright red to brownish discharge about 1-3 teaspoon in amount after taking fenugreek. She had started on fenugreek 2 weeks ago (with 60 capsules) and she has then bought another bottle of 90 capsules earlier this week.
>
> I had to check online and found out that Fenugreek is also a uterine stimulant (hence not suitable to be used during pregnancy) however it was indicated that large quantities will result to this and I do not think  that the mother would have uterine contractions if the recommended dosage is being taken.
>
> The mother also has recurrent plugged ducts and I had suggested Letchitin as the supplement to help this and it did.
>
> I had presented to her possible side effects of fenugreek being a uterine contractor and told her to see her doctor to rule out any other possibilities and from our last conversation, it seems that she will not be seeing her doctor and told me that she "will monitor the situation for the next few days and see how".
>
> I'm dealing with a conservative Chinese mother here.
>
> Has anyone encountered anything like this before? I'm really lost here...
>
> Your advise is greatly appreciated.
>
> Warmest,
> Moe Fletcher,CLEC
> Brunei Darussalam
>
>               ***********************************************

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