Linda, I have also researched this and simply come up with very little addressing breastfeeding directly. I've had a couple of moms I've counseled who had one of these forms; one mom in particular had a perfect clean history except for the placental issue. It was removed and she was treated with methotrexate, I believe, for a short period of time. But her milk never came in well at all. I've also spoken with Pamela Berens and she's also known of a difficult case that did not resolve well. What I don't know is how often this happens and lactation proceeds normally anyways-- I just see the problems. So often mothers never even tell their HCPs when lactation doesn't occur successfully. When it comes to leaving the placenta in, my greatest concern is for how long it will issue progesterone and interfere with lactogenesis II. By theory I expect this to be a significant problem. If the mother is treated in this manner and you have the opportunity, perhaps her progesterone level could be monitored frequently to see what happens. I don't think anyone has ever done this and the information would be so valuable to the rest of us. Did you find the following JHL 17(2) 2001 article? Disruption of Lactogenesis by Retained Placental Fragments Ann M. Anderson, RN, BSN, IBCLC This case report describes a situation in which lack of milk production led the mother to seek help from a lactation consultant in private practice. Despite extensive breast stimulation with the baby at breast and mechanical breast expression, no milkwas produced. Retained placenta was suspected by the lactation consultant. The mother was later diagnosed with placenta increta. Only when this condition was diagnosed and resolved did milk onset occur. It is important to evaluate for retained placental fragments when lactation appears to be delayed. I would love to hear more about this case as it progresses. ~Lisa Marasco *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome