Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 Hello, Leigh Anne. I've been taught that by Day 4 postpartum, the lochia should be turning brown. If it is still bright red beyond that, it can be a symptom of retained placenta. The trouble with breasts is that they can be good-sized but you can't really be sure how much is ductal tissue and how much is fatty tissue. Dee Kassing Hello Women, I saw a mom today with a 4 day old baby. She is 43 years old, this is her first baby and he was conceived naturally. She is fairly thin, gained about 35-ish pounds during pregnancy. She did say that her breasts changed somewhat. She mainly wears sporty type bras - not sized the traditional way. Her baby has a posterior tongue-tie and has really damaged her nipples. She sent him to the nursery a few times to rest. She rented a Hygeia pump yesterday and pumped twice between then and when I saw her this afternoon. She pumped a bit of blood tinged colostrum - about 6 or 7 mls. I had her pump today while I was there - the baby took in zero! Very little was coming out so we stopped after a couple of minutes and I massaged her breasts. They felt so limp - like nothing. They we a good size - at least a C cup but they were so flaccid. I have been doing this a long time but I feel green about this one. Could breasts be hypoplastic on a thin woman with a good amount of breast tissue? How can I be sure that it isn't retained placenta? And, of course, there is the obvious - not much stimulation but typically there is some fullness by this point in my experience. Any feedback is greatly appreciated. Leigh Anne O'Connor, IBCLC leighanne625@... www.leighanneoconnor.com www.mamamilkandme.wordpress.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 24, 2012 Report Share Posted January 24, 2012 I should add this: If you suspect retained placenta, be prepared to suggest that the mother get a second opinion. So far, I have found only one doctor willing to test a mother for retained placenta. And in that particular case, it had been a rough delivery and the doctor told the mother immediately that she should watch for prolonged bleeding and call the doctor immediately if it happens. It did happen, and the doctor readily wrote orders for the appropriate testing. All the other mothers have had to go to a different doctor to get the testing and in some cases to get the antibiotics they need. If she is still bleeding, one of the doctors explained that this means the walls of the uterus haven't closed off and can be open to infection. When the mother who went to him was still bleeding rather heavily at 3 weeks pp, he immediately put her on antibiotics and brought her in for an emergency D & C. Well, that's not exactly right. He got her in immediately for the ultrasound that did indeed show large amounts of retained placenta, and *then* scheduled her immediately for D & C. What I've been told is that the placenta is supposed to be carefully examined before being discarded. It is to be examined both for uneven surface areas and tears that could indicate pieces of it stayed behind in the uterus, and also for a specific rare cancer that grows between the placenta and the uterine wall during pregnancy and once the placenta is delivered, the cancer can spread through the woman's body. So to agree to write the orders for testing for retained placenta basically means the doctor admits that s/he didn't check so carefully. They don't want to admit that, so are often quite uncooperative about finding out if there really is retained placenta. At least, that's what I've been told. Dee Kassing Hello Women, I saw a mom today with a 4 day old baby. She is 43 years old, this is her first baby and he was conceived naturally. She is fairly thin, gained about 35-ish pounds during pregnancy. She did say that her breasts changed somewhat. She mainly wears sporty type bras - not sized the traditional way. Her baby has a posterior tongue-tie and has really damaged her nipples. She sent him to the nursery a few times to rest. She rented a Hygeia pump yesterday and pumped twice between then and when I saw her this afternoon. She pumped a bit of blood tinged colostrum - about 6 or 7 mls. I had her pump today while I was there - the baby took in zero! Very little was coming out so we stopped after a couple of minutes and I massaged her breasts. They felt so limp - like nothing. They we a good size - at least a C cup but they were so flaccid. I have been doing this a long time but I feel green about this one. Could breasts be hypoplastic on a thin woman with a good amount of breast tissue? How can I be sure that it isn't retained placenta? And, of course, there is the obvious - not much stimulation but typically there is some fullness by this point in my experience. Any feedback is greatly appreciated. Leigh Anne O'Connor, IBCLC leighanne625@... www.leighanneoconnor.com www.mamamilkandme.wordpress.com Quote Link to comment Share on other sites More sharing options...
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