Permission to post.
 
I received a call from a LLLL tonight about a mother who has been on bed  
rest for four weeks and is now 32 weeks pregnant.  She has had intermittent  
bleeding since 12 weeks.  Placenta previa.  Pre-term labor. Was being  given mag. 
sulfate to stop contractions. Recently given an injection of  terbutaline and 
is now on oral dose of the same. Was told her bleeding is  from uterus rubbing 
against placenta.
 
She is experiencing a lot of milk leaking and breast discomfort which  sounds 
like Lactogenesis II.  When she called her OB he told her to pump  and store 
the milk.  She called the hospital and spoke to the IBCLC there  who told her 
to absolutely NOT pump.  She called LLLL looking for more  information on how 
to resolve this issue and her comfort.
 

First, a lot of this is outside the scope of what I can really talk to as  an 
IBCLC and some of it is really over my head in terms of what I know re:  
lactation.  I suggested a second opinion from a high-risk OB that has  already 
consulted on her case while she was in-patient.  I also suggested  ruling out 
placental abruption.

 
Her concerns regarding breastfeeding are:
1.  If she dries up soon will she produce any/enough milk once baby is  born?
2.  What can she do for her comfort at this time that will not  stimulate 
more uterine contractions?
3.  What might be the cause of this onset of milk production?
 
She has two other children (3.5 yrs and 19 mos) who are out of the state  
with family due to her bed rest.  She nursed her second child and  experienced 
many difficulties which she was able to overcome.  She is  determined to nurse 
this baby.
 
We discussed the possibility of her body going through Lacto II again (if  
that is indeed what is going on now) once the placenta is separated from uterine 
 wall after birth OR she will basically be re-lactating at birth through 
nursing,  pumping, herbs, Reglan etc.
 
She is worried about causing her milk to dry up or decrease now b/c of the  
unknown milk supply at birth.
 
We discussed ice packs, heat, Tylenol, as well as areolar compression to  
attempt to express milk.  She said she feels a let down frequently but  doesn't 
feel any contractions with that let down.  She asked about just  allowing 
nipples to rub the inside of her shirt (without bra) and see if that  helped 
increase leaking (to move milk for comfort) without actually causing more  
contractions.
 
I am researching more info but any input, suggestions etc would be greatly  
appreciated.
 
TIA, 
 
Christie Pillado, IBCLC
Motherhood Intact
"Mother's Milk...Building Blocks for Healthy Humans"
El Paso, Texas


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