Katherine,
I had a case about 3 months ago now where a mom bled out postnatally and
required 2 units of blood and an ICU stay in the hospital which caused me to
search the literature for more information and I didn't encounter any data on
actual percentages of blood loss and its correlation to milk volumes.  We need to
publish more case studies on these cases so that we can someday come up with
possible numbers of predictability, if that's even possible.

Anyways, the outcome was a good one considering the circumstances and I think
it was the lactation interventions that made the difference.  Last I knew mom
was returning to work and breastfeeding her baby with only supplementing
approx. 2 oz. per day.  The hospital LCs were wonderful!  They took the baby to
mom in the ICU on a daily basis and assisted her to express her milk with a
hospital grade electric breastpump soon after birth.  I know it took time and
commitment for them to bring her baby to her on a daily basis, but I betcha it
made a difference!  And, I know when I came into the picture at approx. 10 days
after birth, the mom had been well informed and supported with the sense of
continuing to pump her breasts because her milk supply was delayed, but would
have the best chances of coming in fully if she continued to stimulate her
breasts, and so she did.

I was referred to by the hospital LCs for follow-up post-discharge and
corrected the latch and accurately measured volume of intake.  The latch was
shallow, and probably was partially caused by mom's slow milk production.  This
particular mom was a very high-level functioning individual which may have
contributed to her outcomes, too.  I really enjoyed meeting her and talking with her
and she periodically keeps in touch with me.

The case studies publication that we need to do so that we can perhaps
provide accuracy in our predictions can facilitate improved outcomes for these
women, but I'm as quilty as the next person in not making the time to publish my
findings.  I did suggest publication with the hospital LCs, and one of the LCs
was going to use the case internally for her leveling merit, so it is serving a
purpose.

Carol Chamblin, RN, MS, IBCLC
Breast 'N Baby Lactation Services, Inc.
St. Charles, IL

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