Hemoglobin and hematocrit levels are expected to be low after a significant postpartum hemorrhage, which is correlated with delayed lactogenesis and Sheehan's Syndrome. Approximately 8 years or so ago in an inpatient setting, I met with a mother of multiples who had delayed lactogenesis with reported onset on Day 9 following a greater amount of blood loss associated with cesarean birth and complications that followed. For example, following a complication with a cesarean birth and a subsequent return to the OR, a mother's hemoglobin level could drop as low as in the 6 range. Have been in private practice for a while and don't have lab values at my fingertips, but I believe a normal hemoglobin range for females is 12 to 16 (please someone correct me if I'm mistaken on this). For various reasons, some mothers may decline a medically recommended blood transfusion for situations of greater volumes of blood loss, and a delay in lactogenesis is not surprising. As a less-experienced LC back then, I recall a more experienced colleague commenting that a woman's body must get back in to balance re: dramatic blood loss and the regeneration of red blood cells, etc. for the woman's overall wellbeing, before her body can expend the necessary energy on milk production/lactogenesis II (more RBC's to the mammary glands during lactogenesis II). Debra Swank, RN IBCLC Ashburn, Virginia USA *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome