Pat mentioned to be sure the mom is not anemic.  Suggest to the mother that
she ask her doctor for a blood test called "serum ferritin."  This test is more
expensive than a hemoglobin test, so the docs often don't want to run it.
But I have several times seen that the hemoglobin test just does not seem to be
a valid test in breastfeeding moms.  Most breastfeeding moms are still taking
their iron-fortified prenatal vitamins, so the hemoglobin will usually look
alright, unless the mom is *very* anemic.  But the mom's *stores* of iron can be
low due to pregnancy and/or other stresses.  The serum ferritin test measures
the stores of iron.  If the stores are low, a mother can have trouble making
enough milk and be more prone to infections, even if her hemoglobin looks
alright.
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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