Hmmm, since the body is in a normal low estrogen state after delivery, why don't all post partum women suffer from having too much blood loss during their recovery?  If bleeding is an issue, I wonder if a oral ergot medication could be used to help keep the uterus contracted, or maybe progesterone.  Only reason why I suggest progesterone, is I have a friend who had dysfunctional uterine bleeding in the months following the birth of her son and she was given prometrium, to try to stop the bleeding.  I am not sure of how it works.  Really, I think she should seek a second opinion and stop the estrogen to save her milk supply.

Cordelia Merritt RN, BsN IBCLC

On Jul 28, 2010, at 7:47 PM, LACTNET automatic digest system wrote:

> Date:    Wed, 28 Jul 2010 21:10:43 -0400
> From:    Anne Brown <[log in to unmask]>
> Subject: retained placenta and premarin
> 
> Hello ladies,
> I have permission to post.  I have a mother G2 P2 who had a son 8 weeks ago @29weeks gestation.  Except for his prematurity, he fared well in the NICU and didn't have any serious health problems.  She used her own milk in a bottle (pumped 30oz/day) and he graduated to home last week.  She called for help with latching which he only did once or twice in the NICU.  We have an appointment Friday.
> The complication is that they discovered she had a piece of retained placenta and had a D&C last wednesday (7 weeks PP)  Apparently it was difficult to remove so they had to dig to remove the embedded piece.  As a result, her doc put her on Premarin 0.625 BID x 3 weeks to stop the post surgical bleeding, and that has dropped her supply to less than half.  I am not sure how this mother pumped as much milk as she did for this baby with retained tissue, but she had to buy another freezer to keep her stash.  She feels like she may have enough to feed her baby for the 3 weeks (plus what she is pumping now) but she is worried about her milk production going down even more during this time.
> She plans to continue pumping in the hopes that her milk supply will increase after she finishes the medication.  Since fenugreek carries a risk for hemorrhage, I am reluctant to suggest this herb.  Does anyone have any suggestions to help this mom?  Are there alternatives to Premarin for uterine bleeding?
> Thanks,
> Annie Brown, FNP, IBCLC
> Greenwich CT


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