I met w/a mom today whose chief complaint was sore nipples.  Her infant is 4
weeks old and gaining more than 1oz per day.  This is mom's 2nd baby, both
born by c-section.  Mom states she had heavy bleeding during 2nd c-section
and OB remarked that her healing from 1st section  was poor with many
adhesions, so 2nd c-section took longer than expected.  She experienced
oversupply w/1st as well as prolonged vaginal bleeding.  She is experiencing
the same with this baby.  She reports feeling let-down almost "every 1/2hr"
when she is not nursing the baby, and experiences several let-downs while
nursing.  Her vaginal flow is heavy, she is still using hospital grade
sanitary napkins and still reports increased blood flow  when nursing (she
used the term "gushes").  She also states that she just bought at the
pharmacy 240 disposable breastpads because she leaks so much.

This baby was born at 37+ weeks of age, & mom started w/flu while in labor.
On day 5 baby was admitted to hospital with RSV and was in NICU  for 10 days.
 While there, when mom couldn't feed baby she pumped to maintain milk supply.
 Baby had difficulty w/latch-on before hospital admission, but improved while
in hospital.  But since coming home latch on is getting worse.  Mom states
she waits to insert breast when baby's mouth is open and baby accepts it.  I
worked w/mom on positioning and latch on, and mom is going to go back to one
breast per feed (one week ago she changed her bfdg pattern  and tried to have
baby nurse both breasts per feed) and will use cabbage leaves to try and
reduce her supply.  Mom also to work with baby to help baby learn to "open
wide" and let baby do work of taking in breast.  Also, mom to call OB about
vaginal discharge.

I know I read an article on retained placenta and oversupply (I know it most
commonly causes low supply), but this report was about oversupply.  Does
anyone have  any  other suggestions or could this be retained placenta
fragment??
Thanks, Karin  DiSanto