We have noticed a problem with lactation in mothes who have been pre
eclamptic with oedema or who have been given large amounts of IV fluids
during their labour. If the woman's serum albumen is below 30 she often
has a long delay in establishing lactation. If she has been very ill and
serum albumen has dropped to around the 20-22 level lactation can be
severely delayed even when all oedema has gone. It appears to take a
long time to recover from such a low level. We often have women with
babies admitted to the NICU who have started expressing straight away
and regularly but until the albumen comes up very little happens in the
way of milk production. If the woman keeps going with the stimulation
and the situation is explained to her lactation does eventually occur
although it is obviously a very stressful time. Due to the large number
of women in labour having epidurals and IV fluids this is a relatively
common problem in our hospital. Most women with full term babies who
have suffered oedema due to IV fluid overload have an initial delay
which is usually resolved on about day 5 or 6. The lactation coordinator
is preparing to undertake a study on this. More details later!
Carol Bartle RN RM (NICU Christchurch Womens Hospital NZ)

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