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Subject:
From:
Hope Overholt <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 29 Feb 2008 10:53:55 -0800
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I was called from a local hospital by a sobbing mother. She suffered severe hemorrhage 7 days post cesarean resulting in hysterectomy. The were no hospital grade pumps available to her, she was not allowed to pump untill about 12 hours post surgery. The husband purchased a small electric pump from Walmart, I'm unsure of the brand, not hospital grade is all that matters. Her first pumping= 5oz; 2 nd=3oz; 3rd= drops.
The blood loss was severe and she was still receiving blod as of yesterday.
She appears to be at risk for Sheehan's syndrome. I found in Lawrence that they mention successful treatment with Oxytocin nasal spray and use of nursing supplementation at the breast for about two weeks that restored the milk supply. 
My questions:
1. How do I determine if this in fact a Sheehan's episode?
2. Do I proceed and ask the doctor to order the oxytocin nasal spray now?
3. Would oral Reglan be of benefit?
The baby was nursing well at home prior to the hemmorrhage by mother's report. Unfortunately the hospital will not allow children < 12yrs. onto patient care areas due to RSV precautions so mother has no access to baby until discharge home Sat. or Sunday. She will have a hospital grade pump today however. 
What else should I be doing?
Hope Overholt RN, IBCLC 

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