I'm not sure if I posted this, but here goes---- I've been working with a mom for three weeks now, they first came to me at 3 wks pp. Baby #5, all previous breastfed, #4 and #5 having bfg/wt gain problems. Ped's office where I work sighed about them, say that all of the kids "have problems", lots of allergies and illnesses other problems..... I corrected some L-O technique, and pushed mom to feed a little more frequently; I also tackled her diet and removed dairy, since there was a family history of problems. Management didn't really seem like the bottom issue, and my only guess was that perhaps allergies were interfering with wt and growth, though the diapers were just in the acceptable range. Mom was too busy to keep good records for me, so I was working on pinning her down so that I could rule out inadequate intake. At visit 2, I discovered a sore-nipple issue; this mom wasn't a complainer, hadn't brought this up until then! Great! So I got really focused on that positioning. Nothing else in hx to flag.... Until visit #3. Mom says that baby seemed to be doing better, milk supply seemed to be increasing, for the past few days. I asked if anything had changed, since I knew that she and baby had been sick recently..... she said, "well, you know, I had some terrible cramping and bleeding one day last week, and I passed this big piece of what looked like placenta....." She didn't understand the possible correlation, but when I asked her if the situation had improved after this, she verified that fact. Then dad spoke up and mentioned how the doctor had been pulling on the cord and placenta right after birth, as if to speed up the process so that he could go home...... it all added up to me! I'll know in the next week or so, if all continues to go well, that a retained placental fragment was probably the culprit of our low wt gain. Looking back, I don't know how I could have caught this earlier, since mom was so understated in personal complaints, and described what appeared to be normal lochia at 3 wks pp. One of those hindsight things... Thought this was an interesting case to share. -Lisa ************************************************* Lisa Marasco, BA, LLLL, IBCLC [log in to unmask] / [log in to unmask] *************************************************