I have a new mom, primip, 30 years old who delivered a 6-8lb baby after 5 short hours of labor.  Unfortunately there was some placenta remaining and the resulting bleeding necessitated a D&C 6 hours later.  During those 6 hours she lost a considerable amount of blood.  Her initial hemoglobin before delivery was 122; before surgery it was down to 90.  Next morning it was 56 and the issue of blood transfusions was raised.  Today it is 46 and I think they will really press her to accept blood.  Amazingly she is does not "look" like someone with a hemoglobin of that level.  Aside from being very pale, she is quite bright, states she feels well BUT is not doing much other than walking to bathroom in her room.  

She is my dear daughter.  She breastfed right after delivery and baby appears to have been born with the instruction manual cleared attached to some body part because he just knew, without a doubt, what to do.  He has fed as needed (q2-4 hrs) and has stooled 2-3 times and met the requirements for "peeing".  Bili level up a little but has not reached phototherapy levels. Baby has been generally content. Weight down 4 oz yesterday. She is now 48 hours since delivery.  My question is regards to the collective experience of this group regarding the general outcome for milk supply, with and without blood transfusion, given what has been a substantial hemmorrhage and reduction in hemoglobin. 

Many thanks in advance, 
Anne Brooks RN,BN,IBCLC
Canada  

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