Pam - how heavy is her lochia? Could she have some retained placenta?
  Julie

Pamela Mazzella Di Bosco <[log in to unmask]> wrote:
  I am working with a mom who is struggling to have a full supply of milk for 
her baby. She has done everything right. Great nursling, great pumping, and 
no breast issues. Everything but domperidone as she cannot get a doctor to 
prescribe for her. Her ob/gyn has ruled out anemia and thyroid issues. Or 
should I say blew off her concerns about them and told her there was none, but 
did not give her levels. I have asked her to call back and ask for the 
levels, not just 'you are fine'. Assuming there is no problems with either though 
as she has no history and no difficulty at all conceiving. She had a cesarean 
delivery, which I could consider reason for a delay for a week or so, but 
by now at 8 weeks she should have her supply full just from what she has been 
doing. 

The one thing she mentioned to me today that we did not think of before is 
she is still having postpartum bleeding. It is not heavy, but it is there. 
My question is what are the chances that her postpartum levels of estrogen 
are not low enough and that is contributing to the bleeding and the milk 
supply not being fully established. I googled for more information, and what I 
find is what we already know...high estrogen levels, low milk supply. What I 
am having a harder time finding out is if there is any correlation between 
high estrogen levels and lochia flow past six weeks. AND, if there is a 
correlation, can the assumption be made that when the lochia stops, the estrogen 
levels have finally leveled off and milk supply will increase? OR, is this just 
my wishful thinking....

Anyone have any thoughts or better yet any research out there I can read 
more about this?

Thanks a bunch,
Pam MazzellaDiBoso, IBCLC, RLC

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