Re: postpartum blood loss

[Guest guest]

Cytotech is used for PP bleeding r/t hemorrhage . For a vaginal birth anything over 500 mL is considered a hemorrhage.

Kim

LLLL

Subject: postpartum blood lossTo: Date: Thursday, July 28, 2011, 6:46 PM

I am working with a mother who lost about 1 liter of blood after a home birth. She was given Pitocin, methergine, and cytotec(?) and did not end up being transferred to hospital. Midwife says mother was “asymptomatic,†but at 12 days pp, she is having a lot of difficulty with milk supply. At what amount of blood loss would you expect an impact on production? I have seen blood loss have anywhere from no effect to a profound effect on milk production. I am wondering about your collective experience. Would you expect a lingering milk production issue in this case? Also, is cytotec frequently used for this purpose, and have you seen an impact on production? I notice that according to Hale, there is some controversy about methergine effecting prolactin levels.

Thanks for your thoughts!

Becky , IBCLC

Milky Way

La Plata, MD

[Guest guest]

I have seen blood loss cause a problem with milk supply. but I don't know about the meds. I do know that mom should be in bed, resting as much as possible and eating very well! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- Subject: postpartum blood lossTo: Date: Thursday, July 28, 2011, 3:46 PM

I am working with a mother who lost about 1 liter of blood after a home birth. She was given Pitocin, methergine, and cytotec(?) and did not end up being transferred to hospital. Midwife says mother was “asymptomatic,†but at 12 days pp, she is having a lot of difficulty with milk supply. At what amount of blood loss would you expect an impact on production? I have seen blood loss have anywhere from no effect to a profound effect on milk production. I am wondering about your collective experience. Would you expect a lingering milk production issue in this case? Also, is cytotec frequently used for this purpose, and have you seen an impact on production? I notice that according to Hale, there is some controversy about methergine effecting prolactin levels. Thanks for your thoughts! Becky , IBCLCMilky WayLa Plata, MD

[Guest guest]

Yikes! Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.netwww.facebook.com/CradleholdBreastfeedingEducationandsupportProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyHow Were YOU Supported to Breastfeed?http://www.usbreastfeeding.org/LegislationPolicy/ActionCampaigns/SupportStories/tabid/198/Default.aspxFrom: Becky To: Sent: Thursday, July 28, 2011 6:46 PMSubject: postpartum blood loss

I am working with a mother who lost about 1 liter of blood after a home birth. She was given Pitocin, methergine, and cytotec(?) and did not end up being transferred to hospital. Midwife says mother was “asymptomatic,†but at 12 days pp, she is having a lot of difficulty with milk supply. At what amount of blood loss would you expect an impact on production? I have seen blood loss have anywhere from no effect to a profound effect on milk production. I am wondering about your collective experience. Would you expect a lingering milk production issue in this case? Also, is cytotec frequently used for this purpose, and have you seen an impact on production? I notice that according to Hale, there is some controversy about methergine effecting prolactin levels. Thanks for your thoughts! Becky , IBCLCMilky WayLa Plata, MD

[Guest guest]

I also use Making More Milk for reference to issue of loss of blood

after delivery.

West and Marasco say that loss of up to a

pint (500 cubic centimeters) of blood with a vaginal birth and up to two pints with

a cesarean delivery is considered within normal limits.

I think one pint is roughly half a liter.

So this mother has lost more than is within normal limits.

They talk about how a sudden large loss of

blood can damage the pituitary.

I found a reference to an article in the

JHL from 1995. Infant insufficient milk

syndrome associated with maternal postpartum hemorrhage.

Ellen

Simpson, IBCLC

Tampa Florida

From: [mailto: ] On Behalf Of Becky

Sent: Thursday, July 28, 2011 6:46

PM

To:

Subject: postpartum

blood loss

I am working with

a mother who lost about 1 liter of blood after a home birth. She was

given Pitocin, methergine, and cytotec(?) and did not end up being transferred

to hospital. Midwife says mother was “asymptomatic,” but at

12 days pp, she is having a lot of difficulty with milk supply. At what

amount of blood loss would you expect an impact on production? I have

seen blood loss have anywhere from no effect to a profound effect on milk

production. I am wondering about your collective experience. Would

you expect a lingering milk production issue in this case? Also, is

cytotec frequently used for this purpose, and have you seen an impact on

production? I notice that according to Hale, there is some controversy

about methergine effecting prolactin levels.

Thanks for your

thoughts!

Becky , IBCLC

Milky Way

La Plata, MD

[Guest guest]

I lost

a liter of blood with my fourth baby. Had breastfed the previous 3 siblings 1

year, and two for 3 years. Milk was delayed coming in until day 5, but it did

come in just fine. Mom should be IN BED, lots of fluids and iron supplement

with lots of iron rich foods. I have attached the list my midwives gave me at

the time of iron rich foods. My iron levels were back to normal range by a

couple of weeks but I was exhausted for about 18 months afterward. It makes you

face your mortality going through an experience like that. I have never

been diagnosed with pituitary damage, but I do believe there was some. In the

subsequent 5 years, I had depression and 3 miscarriages without any

explanation. When my fifth baby was 5 months old I fractured vertebrae while

cleaning house and learned I had osteoporosis and 50% loss of spinal bone

density (typically seen in 80 year old women). I was in severe pain for about 8

months after the fractures with no treatment except ibuprofen, Tylenol and a

TENS unit for pain. I refused Fosamax. Around 8 months I my pcp offered me

estrogen as a treatment so I took a birth control pill with estrogen and my

pain went away in 2 days. My daughter’s nursing increased to every 2

hours day and night and stayed that way for a long time. She gained only 1# in

5 months even though she was on solids as well. I went to a naturopath at that

point and began taking the natural hormones (compounded capsules) and I used

fenugreek which seemed to increase my milk supply. My hormone levels of

estrogen and progesterone were checked then and were negligible. I treated

osteoporosis successfully with natural hormone replacement resulting in

improved bone density of about 5% each year during the next 5 years while I

continued breastfeeding my daughter until she was about 5. She is almost 12 and

I have now passed menopause. I tried many regimens to eliminate taking hormone

replacement, but it hasn’t worked. It takes the energy out of me if I don’t

have some exogenous hormones, synthetic or natural both work.

This is

just a story and no science, but I would advise any mother to follow-up with

good labs for hormones and pituitary if she isn’t feeling back to herself

in a few weeks.

Judy

Judith

L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell

Phone

Fax

1 of 1 File(s)

Iron Rich foods.txt

[Guest guest]

I had a 12 week miscarriage when my daughter was 2 1/2 and nursing a lot and a

month later, hemorrhaged due to retained placenta. I lost a lot of blood before

I got the bleeding under control with homeopathy and bought myself time to get

the to OB of my choice for a D & C. I took liquid chlorophyll and the homeopathic

cell salt ferr phos to normalize my iron (I also chose to take abx, bc I had a

severe uterine infection by that point and wanted to preserve my fertility). My

milk supply was trashed--I think more due to the infection--although a

nursed until she was 5, including through another much earlier miscarriage.

This is my recommendation to everyone who has significant blood loss bc it works

so well and so fast. I learned to use it bc my son lost two units of blood and

was transfused when he was 5 1/2 and it worked so well for him. I have seen

amazing results even in moms with delayed LactII and whose supplies are pretty

much non-existent.

Now, I add other supplements and foods for moms bc I want them to feel much

better overall, but this is still key. Fenugreek would not be my galactogogue

choice at all (it rarely is) either. I would use really nourishing herbs that

include fenugreek--red raspberry leaf, goat's rue, nettles, blessed thistle,

milk thistle (for liver support), fennel, oat straw and alfalafa.

Tow, IBCLC, France

>

> I lost a liter of blood with my fourth baby. Had breastfed the previous 3

> siblings 1 year, and two for 3 years. Milk was delayed coming in until day

> 5, but it did come in just fine. Mom should be IN BED, lots of fluids and

> iron supplement with lots of iron rich foods. I have attached the list my

> midwives gave me at the time of iron rich foods. My iron levels were back to

> normal range by a couple of weeks but I was exhausted for about 18 months

> afterward. It makes you face your mortality going through an experience like

> that. I have never been diagnosed with pituitary damage, but I do believe

> there was some. In the subsequent 5 years, I had depression and 3

> miscarriages without any explanation. When my fifth baby was 5 months old I

> fractured vertebrae while cleaning house and learned I had osteoporosis and

> 50% loss of spinal bone density (typically seen in 80 year old women). I was

> in severe pain for about 8 months after the fractures with no treatment

> except ibuprofen, Tylenol and a TENS unit for pain. I refused Fosamax.

> Around 8 months I my pcp offered me estrogen as a treatment so I took a

> birth control pill with estrogen and my pain went away in 2 days. My

> daughter's nursing increased to every 2 hours day and night and stayed that

> way for a long time. She gained only 1# in 5 months even though she was on

> solids as well. I went to a naturopath at that point and began taking the

> natural hormones (compounded capsules) and I used fenugreek which seemed to

> increase my milk supply. My hormone levels of estrogen and progesterone were

> checked then and were negligible. I treated osteoporosis successfully with

> natural hormone replacement resulting in improved bone density of about 5%

> each year during the next 5 years while I continued breastfeeding my

> daughter until she was about 5. She is almost 12 and I have now passed

> menopause. I tried many regimens to eliminate taking hormone replacement,

> but it hasn't worked. It takes the energy out of me if I don't have some

> exogenous hormones, synthetic or natural both work.

>

> This is just a story and no science, but I would advise any mother to

> follow-up with good labs for hormones and pituitary if she isn't feeling

> back to herself in a few weeks.

>

>

>

> Judy

>

> Judith L. Gutowski, BA, IBCLC, RLC

>

> 135 McGrath Lane

>

> P Box 1

>

> Hannastown, PA 15635-0001

>

> Cell Phone

>

> Fax

>

[Guest guest]

Um – having just survived a hemorrhage and emergency

D & C where I lost at least a liter of blood (due to a miscarriage gone to

hell in a handbasket), where I was given cytotec, pitocin, methergine and

massive amounts of pain killers (because the regular dose didn’t work)

and had an interesting out of body experience, I have one major question:

Why the hell wasn’t she taken to the hospital?

Losing that much blood – she would have done well with

getting a unit of blood I think. I didn’t receive any and it

complicated my recovery something fierce. It is possible that mom may be

suffering not only from severe anemia, but low hemoglobin, and worse,

Sheehans. It is my opinion that she needs medical care now.

Physically she is likely to be exhausted as a result of that kind of blood

loss. And absolutely that can affect the milk supply. It will take her a

couple months if not longer to recover from the blood loss alone if she gets no

medical care.

With my hemorrhage I received no transfusion at all –

negligence on their part in my opinion. The resulting health problems

have been unreal. The exhaustion, anemia, Thyroid (which plays a large

part in supply!), adrenals, hormone imbalances…wow! And this

happened to me Feb 21 – I nearly died. I am not fully

recovered. I wasn’t looking for a supply like your client is and I

didn’t have a baby to take care of – I would strongly recommend she

talk to a Dr ASAP and be evaluated for Sheehans, Thyroid, prolactin,

everything! A CBC will tell you how anemic she is (which can also cause

serious issues with supply) as well as where her hemoglobin – the works.

As much as I love home births – she should have been

transported. But everything she just went throough could easily affect

her supply. Get her to a Dr.

Warmly,

Jaye

Jaye Simpson, IBCLC, CIIM

Breastfeeding Network

Sacramento, CA

www.breastfeedingnetwork.net

[Guest guest]

Jaye,

Other than bloodwork--which a midwife can (and might have) ordered--what are you

thinking a doctor is going to do for this mom? The other thing I would suggest

though, in addition to the herbs I suggested earlier is that this mom drink

coconut water. And, if she is not e vegetarian--that she make bone broths (not

from factory-farmed animals) and really pound them down. Jaye--I would suggest

that for you as well.

Tow, IBCLC, France

>

> Um - having just survived a hemorrhage and emergency D & C where I lost at

> least a liter of blood (due to a miscarriage gone to hell in a handbasket),

> where I was given cytotec, pitocin, methergine and massive amounts of pain

> killers (because the regular dose didn't work) and had an interesting out of

> body experience, I have one major question: Why the hell wasn't she taken

> to the hospital?

>

>

>

> Losing that much blood - she would have done well with getting a unit of

> blood I think. I didn't receive any and it complicated my recovery

> something fierce. It is possible that mom may be suffering not only from

> severe anemia, but low hemoglobin, and worse, Sheehans. It is my opinion

> that she needs medical care now. Physically she is likely to be exhausted

> as a result of that kind of blood loss. And absolutely that can affect the

> milk supply. It will take her a couple months if not longer to recover from

> the blood loss alone if she gets no medical care.

>

>

>

> With my hemorrhage I received no transfusion at all - negligence on their

> part in my opinion. The resulting health problems have been unreal. The

> exhaustion, anemia, Thyroid (which plays a large part in supply!), adrenals,

> hormone imbalances.wow! And this happened to me Feb 21 - I nearly died. I

> am not fully recovered. I wasn't looking for a supply like your client is

> and I didn't have a baby to take care of - I would strongly recommend she

> talk to a Dr ASAP and be evaluated for Sheehans, Thyroid, prolactin,

> everything! A CBC will tell you how anemic she is (which can also cause

> serious issues with supply) as well as where her hemoglobin - the works.

>

>

>

> As much as I love home births - she should have been transported. But

> everything she just went throough could easily affect her supply. Get her

> to a Dr.

>

>

>

> Warmly,

>

> Jaye

>

>

>

> Jaye Simpson, IBCLC, CIIM

>

> Breastfeeding Network

>

> Sacramento, CA

>

> www.breastfeedingnetwork.net

>

[Guest guest]

Thanks for all the input. Mother looks good but definitely is not getting the rest she needs: new in town, no family here and husband back at work already. She is a vegetarian, so have to work with non-meat sources of iron. I’m going to talk with her this afternoon and will pass on the suggestions. The midwife is suggesting Reglan. I am less than enthusiastic about this because it won’t stop us from having to start formula and I’m not sure that increasing prolactin is the answer when anemia is really the issue. I will let you know what happens. Becky , IBCLCMilky WayLa Plata, MD

[Guest guest]

Given the risks of Reglan, I personally think that is in irresponsible

recommendation. Just so you know--I am vegan and the protocol I used worked

fabulously not just to normalize bloodwork but to help me heal from the

infection and regain my energy.

Tow, IBCLC, France

>

> Thanks for all the input. Mother looks good but definitely is not getting

> the rest she needs: new in town, no family here and husband back at work

> already. She is a vegetarian, so have to work with non-meat sources of

> iron. I'm going to talk with her this afternoon and will pass on the

> suggestions. The midwife is suggesting Reglan. I am less than enthusiastic

> about this because it won't stop us from having to start formula and I'm

> not sure that increasing prolactin is the answer when anemia is really the

> issue. I will let you know what happens.

>

>

>

> Becky , IBCLC

>

> Milky Way

>

> La Plata, MD

>

[Guest guest]

Jaye, I lost alot of blood, enough to be on bedrest for 3 weeks and literally unable to walk to the bathroom across the room without being out of breath.  However, I would not ever take blood unless I was actually nearly dead, and I would not accept transport.  Don't be so sure the care was not adequate. Just saying mothers do often refuse transport.  I actually had great midwives, I was given IV fluids for the volume and then herbs, homeopathics, reading 's list of what she took sounds very similar to my bedside for awhile. I know my milk supply was affected, but I kept a scale beside me and weighed my baby regularly and she was fine, but I nursed nonstop because I really could not get up anyway and waited. After a few weeks my milk supply was fine.  I continued to use the chlorophyl and alfalfa for a few months. Is there any long term damage to my body from not receiving the transfusion? I don't know.  I know I did not pass out. I know the midwife flat out told me if I passed out she was calling 911 and all bets were off...and she sat beside me all night watching me.

As a doula, I have been at a few births where there was blood loss beyond normal and not all received blood. Some because the mothers said no.  I have not seen anything done differently for hospital birthing mothers than was done for me and the hospital does not do the nutrient education, tell the mother to rest, etc.  I know of others of course who had the kind of blood loss that landed them in the ICU with an emergency hysterectomy and others who lost enough to require a transfusion just because they said yes to it. 

I don't know how many had a large volume of blood loss and no problems, because if I am working with them, they have a problem. And all the moms I worked with where a major blood loss was an issue had a degree of supply issues in the beginning and some never did make milk.

-- Pam MazzellaDiBosco, IBCLC, RLCBirthing & Beyond, Inc.Labor Support and Lactation Consultant Services

[Guest guest]

Well, I'm a midwife, an IBCLC, a mom who had a late postpartum hemorrhage and

-to this day has had issues with milk supply... so here's my 2 sense worth...

I agree that most home birthing moms would refuse transport+blood, even if they

hemorrhage, and as long as they remained stable for 24 hrs, midwives aren't

going to argue.

The body is designed to loose some blood after birth, some bodies can loose

more, some less. My question for hemorrhages that are hard to stop + affect milk

supply - are there retained placental fragments? Because that is 1.life

threatening and 2. going to affect milk supply because of continued progesterone

release

if she's no longer bleeding, then she probably doesn't have fragments, but if

she's still bleeding, a vaginal ultrasound might be prudent...

Also, yes Methergine has been linked to lowering milk supply levels

and I'm very wary of Reglan. I'm surprised the midwife would recommend Reglan

instead of Domperidone (not that Domperidone is even necessary, but why Reglan?)

As far as what to feed mamas who bled more than their body should have bled?

**Sunlight + Liquid chlorophyll and coconut water (not milk, water)**

And lots of vegetables, and pulse, nuts, beans, lentils

Oats, Brewers Yeast, Ground Flaxmeal

Bananas & Avocados

Well, good luck!

>

> Jaye, I lost alot of blood, enough to be on bedrest for 3 weeks and

> literally unable to walk to the bathroom across the room without being out

> of breath. However, I would not ever take blood unless I was actually

> nearly dead, and I would not accept transport. Don't be so sure the care

> was not adequate. Just saying mothers do often refuse transport. I actually

> had great midwives, I was given IV fluids for the volume and then herbs,

> homeopathics, reading 's list of what she took sounds very similar

> to my bedside for awhile. I know my milk supply was affected, but I kept a

> scale beside me and weighed my baby regularly and she was fine, but I nursed

> nonstop because I really could not get up anyway and waited. After a few

> weeks my milk supply was fine. I continued to use the chlorophyl and

> alfalfa for a few months. Is there any long term damage to my body from not

> receiving the transfusion? I don't know. I know I did not pass out. I know

> the midwife flat out told me if I passed out she was calling 911 and all

> bets were off...and she sat beside me all night watching me.

> As a doula, I have been at a few births where there was blood loss beyond

> normal and not all received blood. Some because the mothers said no. I have

> not seen anything done differently for hospital birthing mothers than was

> done for me and the hospital does not do the nutrient education, tell the

> mother to rest, etc. I know of others of course who had the kind of blood

> loss that landed them in the ICU with an emergency hysterectomy and others

> who lost enough to require a transfusion just because they said yes to it.

> I don't know how many had a large volume of blood loss and no problems,

> because if I am working with them, they have a problem. And all the moms I

> worked with where a major blood loss was an issue had a degree of supply

> issues in the beginning and some never did make milk.

>

> --

> Pam MazzellaDiBosco, IBCLC, RLC

> Birthing & Beyond, Inc.

> Labor Support and Lactation Consultant Services

>

>

[Guest guest]

what is pulse? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- Subject: Re: postpartum blood lossTo:

Date: Friday, July 29, 2011, 5:41 PM

Well, I'm a midwife, an IBCLC, a mom who had a late postpartum hemorrhage and -to this day has had issues with milk supply... so here's my 2 sense worth...

I agree that most home birthing moms would refuse transport+blood, even if they hemorrhage, and as long as they remained stable for 24 hrs, midwives aren't going to argue.

The body is designed to loose some blood after birth, some bodies can loose more, some less. My question for hemorrhages that are hard to stop + affect milk supply - are there retained placental fragments? Because that is 1.life threatening and 2. going to affect milk supply because of continued progesterone release

if she's no longer bleeding, then she probably doesn't have fragments, but if she's still bleeding, a vaginal ultrasound might be prudent...

Also, yes Methergine has been linked to lowering milk supply levels

and I'm very wary of Reglan. I'm surprised the midwife would recommend Reglan instead of Domperidone (not that Domperidone is even necessary, but why Reglan?)

As far as what to feed mamas who bled more than their body should have bled?

**Sunlight + Liquid chlorophyll and coconut water (not milk, water)**

And lots of vegetables, and pulse, nuts, beans, lentils

Oats, Brewers Yeast, Ground Flaxmeal

Bananas & Avocados

Well, good luck!

>

> Jaye, I lost alot of blood, enough to be on bedrest for 3 weeks and

> literally unable to walk to the bathroom across the room without being out

> of breath. However, I would not ever take blood unless I was actually

> nearly dead, and I would not accept transport. Don't be so sure the care

> was not adequate. Just saying mothers do often refuse transport. I actually

> had great midwives, I was given IV fluids for the volume and then herbs,

> homeopathics, reading 's list of what she took sounds very similar

> to my bedside for awhile. I know my milk supply was affected, but I kept a

> scale beside me and weighed my baby regularly and she was fine, but I nursed

> nonstop because I really could not get up anyway and waited. After a few

> weeks my milk supply was fine. I continued to use the chlorophyl and

> alfalfa for a few months. Is there any long term damage to my body from not

> receiving the transfusion? I don't know. I know I did not pass out. I know

> the midwife flat out told me if I passed out she was calling 911 and all

> bets were off...and she sat beside me all night watching me.

> As a doula, I have been at a few births where there was blood loss beyond

> normal and not all received blood. Some because the mothers said no. I have

> not seen anything done differently for hospital birthing mothers than was

> done for me and the hospital does not do the nutrient education, tell the

> mother to rest, etc. I know of others of course who had the kind of blood

> loss that landed them in the ICU with an emergency hysterectomy and others

> who lost enough to require a transfusion just because they said yes to it.

> I don't know how many had a large volume of blood loss and no problems,

> because if I am working with them, they have a problem. And all the moms I

> worked with where a major blood loss was an issue had a degree of supply

> issues in the beginning and some never did make milk.

>

> --

> Pam MazzellaDiBosco, IBCLC, RLC

> Birthing & Beyond, Inc.

> Labor Support and Lactation Consultant Services

>

>

[Guest guest]

I haven't read all the messages but - anecdotolay(sp) I had a client - homebirth, major blood loss, she had an acupuncturist help her and she had placenta soup - which she kept secret from her mother - and all were shocked at her recovery!Leigh Anne(Checking messages while waiting for Ellie Goulding to perform - without my glasses but with my 2 girls in NYC)Sent from my Verizon Wireless BlackBerrySender: Date: Sat, 30 Jul 2011 00:41:40 -0000To: < >ReplyTo: Subject: Re: postpartum blood loss Well, I'm a midwife, an IBCLC, a mom who had a late postpartum hemorrhage and -to this day has had issues with milk supply... so here's my 2 sense worth...I agree that most home birthing moms would refuse transport+blood, even if they hemorrhage, and as long as they remained stable for 24 hrs, midwives aren't going to argue. The body is designed to loose some blood after birth, some bodies can loose more, some less. My question for hemorrhages that are hard to stop + affect milk supply - are there retained placental fragments? Because that is 1.life threatening and 2. going to affect milk supply because of continued progesterone releaseif she's no longer bleeding, then she probably doesn't have fragments, but if she's still bleeding, a vaginal ultrasound might be prudent...Also, yes Methergine has been linked to lowering milk supply levelsand I'm very wary of Reglan. I'm surprised the midwife would recommend Reglan instead of Domperidone (not that Domperidone is even necessary, but why Reglan?)As far as what to feed mamas who bled more than their body should have bled?**Sunlight + Liquid chlorophyll and coconut water (not milk, water)**And lots of vegetables, and pulse, nuts, beans, lentilsOats, Brewers Yeast, Ground FlaxmealBananas & AvocadosWell, good luck!>> Jaye, I lost alot of blood, enough to be on bedrest for 3 weeks and> literally unable to walk to the bathroom across the room without being out> of breath. However, I would not ever take blood unless I was actually> nearly dead, and I would not accept transport. Don't be so sure the care> was not adequate. Just saying mothers do often refuse transport. I actually> had great midwives, I was given IV fluids for the volume and then herbs,> homeopathics, reading 's list of what she took sounds very similar> to my bedside for awhile. I know my milk supply was affected, but I kept a> scale beside me and weighed my baby regularly and she was fine, but I nursed> nonstop because I really could not get up anyway and waited. After a few> weeks my milk supply was fine. I continued to use the chlorophyl and> alfalfa for a few months. Is there any long term damage to my body from not> receiving the transfusion? I don't know. I know I did not pass out. I know> the midwife flat out told me if I passed out she was calling 911 and all> bets were off...and she sat beside me all night watching me.> As a doula, I have been at a few births where there was blood loss beyond> normal and not all received blood. Some because the mothers said no. I have> not seen anything done differently for hospital birthing mothers than was> done for me and the hospital does not do the nutrient education, tell the> mother to rest, etc. I know of others of course who had the kind of blood> loss that landed them in the ICU with an emergency hysterectomy and others> who lost enough to require a transfusion just because they said yes to it.> I don't know how many had a large volume of blood loss and no problems,> because if I am working with them, they have a problem. And all the moms I> worked with where a major blood loss was an issue had a degree of supply> issues in the beginning and some never did make milk.> > -- > Pam MazzellaDiBosco, IBCLC, RLC> Birthing & Beyond, Inc.> Labor Support and Lactation Consultant Services> >

[Guest guest]

, you wrote: "Fenugreek would not be my galactogogue choice at all (it rarely is) either. I would use really nourishing herbs that include fenugreek--red raspberry leaf, goat's rue, nettles, blessed thistle, milk thistle (for liver support), fennel, oat straw and alfalafa." I am confused by this. Did you mis-type? Did you mean "I would use really nourishing herbs that **do not** include fenugreek" etc?

Dee Kassing

I had a 12 week miscarriage when my daughter was 2 1/2 and nursing a lot and a month later, hemorrhaged due to retained placenta. I lost a lot of blood before I got the bleeding under control with homeopathy and bought myself time to get the to OB of my choice for a D & C. I took liquid chlorophyll and the homeopathic cell salt ferr phos to normalize my iron (I also chose to take abx, bc I had a severe uterine infection by that point and wanted to preserve my fertility). My milk supply was trashed--I think more due to the infection--although a nursed until she was 5, including through another much earlier miscarriage. This is my recommendation to everyone who has significant blood loss bc it works so well and so fast. I learned to use it bc my son lost two units of blood and was transfused when he was 5 1/2 and it worked so well for him. I have seen amazing results even in moms with delayed LactII and whose supplies are pretty much

non-existent. Now, I add other supplements and foods for moms bc I want them to feel much better overall, but this is still key. Fenugreek would not be my galactogogue choice at all (it rarely is) either. I would use really nourishing herbs that include fenugreek--red raspberry leaf, goat's rue, nettles, blessed thistle, milk thistle (for liver support), fennel, oat straw and alfalafa. Tow, IBCLC, France

[Guest guest]

Dear Colleagues:

Here is another story.....after the birth of my second baby, clots lodged in my

cervix, preventing it from closing. I kept bleeding. My midwife had to go in and

scoop out the clots (oh, I did NOT like that!) and I also receiving an injection

of methergine.

Went home 6 hours after the birth. My midwife recorded the blood loss as 600cc,

so that I could get out of that place.

I stayed upstairs for a week, mostly in bed, resting. I was so weak at one point

that my dear husband fed me. My girlfriend who was at the birth, brought over a

week's worth of iron-rich dinners that were wonderful.

Never any issues with milk supply. I recovered my energy and got back into my

life. When my baby was 5 months old, I started pumping once a day in addition

to nursing. I got between 6 and 10 ounces from that one pumping session plus my

baby was growing well. I did the pumping for a year.

When my nursling was 4 years old, I developed a number of annoying symptoms:

vaginal dryness, low energy, insomnia, menstrual flooding, and extreme hair

loss. By extreme, I mean that when I was nude for a shower, the hair falling out

on my skin felt like rain and i could hear it hit the floor.

I went to a Chinese physician who didn't speak much English. She looked at my

tongue. She assessed my pulses. She asked me 2 questions. " How were your

births? " I remembered 2 unmedicated spontaneous labors with pride and said

" Fine. " Her next question was, " No bleeding? " Then I remembered my postpartum

hemorrhage, which was really 1500 cc. (My midwife told me that a few years after

my baby was born.)

She treated me with herbs and acupuncture and I recovered completely.

As for the hemorrhage, my midwife knew me well and knew that I would not want to

be in a hospital. She called me every day, and saw me twice during the first

week. I know that if I hadn't been recovering, she would have noticed that

immediately. I appreciate her care.

Just another story. From what I know of the OBs in my area, I can't imagine any

of them putting the whole picture of symptoms together. I imagine that they

would have been more likely to prescribe me vaginal estrogen cream and advise me

to stop nursing.

warmly,

Nikki

[Guest guest]

No--I include fenugreek--I just don't think of it as the primary herb.

Tow, IBCLC, France

 

>

>

>

>

>

> I had a 12 week miscarriage when my daughter was 2 1/2 and nursing a lot and a

month later, hemorrhaged due to retained placenta. I lost a lot of blood before

I got the bleeding under control with homeopathy and bought myself time to get

the to OB of my choice for a D & C. I took liquid chlorophyll and the homeopathic

cell salt ferr phos to normalize my iron (I also chose to take abx, bc I had a

severe uterine infection by that point and wanted to preserve my fertility). My

milk supply was trashed--I think more due to the infection--although a

nursed until she was 5, including through another much earlier miscarriage.

>

> This is my recommendation to everyone who has significant blood loss bc it

works so well and so fast. I learned to use it bc my son lost two units of blood

and was transfused when he was 5 1/2 and it worked so well for him. I have seen

amazing results even in moms with delayed LactII and whose supplies are pretty

much non-existent.

>

> Now, I add other supplements and foods for moms bc I want them to feel much

better overall, but this is still key. Fenugreek would not be my galactogogue

choice at all (it rarely is) either. I would use really nourishing herbs that

include fenugreek--red raspberry leaf, goat's rue, nettles, blessed thistle,

milk thistle (for liver support), fennel, oat straw and alfalafa.

>

> Tow, IBCLC, France

>

[Guest guest]

One more thing.

A woman's blood volume increases by about 5 quarts during a full-term

pregnancy....so there is a safety mechanism for blood loss at delivery. That

said, I am sure that each woman has her own individual volume that is her margin

of safety.

warmly,

Nikki

[Guest guest]

Hi,

Asked why go to the hospital what would that have done…

I guess for me that would be a personal opinion as my recent scare actually

scared the hell out of me and my partner. So I am probably not being

terribly objective there. J When I have

to talk about my situation I have to joke about it because it scared me so

badly and my wife worse. The reality of what happened is honestly still a

bit too much to take in – 5 months later – for either of us. She

watched me leave my body – she begged me to get back in and stay present

because she knew how much pain I was in and how much blood I was losing.

I saw the monitors, heard the alarms and saw my numbers dropping fast, the Drs

freaking out under me – and I saw her crying. Jo doesn’t

cry. It took them over 6 hours to stabilize me and they moved me out of

the ER and into the trauma center. They allowed her to stay by my side

because every single time they made her leave my side – I crashed –

hard. I think the only reason they didn’t give me any blood at all

was because I had no insurance – I think getting some would have been

very helpful for me.

So for me and it seems a few others here, it was highly

traumatic. I’m not over it frankly and don’t know if I ever

will be. That was the worst thing to ever happen to me. And while I

know some are not keen on transfusions, I would have taken at least something

because my recovery has been fairly miserable – even with all the iron,

and herbs and thyroid/adrenal assistance, etc. I used to be able to do 10

consults a week no problem. I can barely do 3. I am chronically

exhausted and have no medical insurance to go determine what my actual state it

– I just know I feel like crap most of the time. I run a consistent

low grade temp of 99.8 -100.9 now and my body aches from head to toe (the

aching is new the fever is from stress). We won’t talk about the

weight I’ve put on as a result. Ugh. That’s just adding

insult to injury!

So – when it comes to moms hemorrhaging like that –

my prior self knows that can affect milk supply as well as general

health. My current self has a knee jerk reaction due to my own situation –

no objectivity there I have to admit. I appreciate Tow’s

suggestions and took what I could find and feel they did help

tremendously. Thank you! And I am going to look in to some of the

other things suggested for this mom as well and continue my work to put myself

back together. They were good ideas and I need to make sure I have that

information handy as I have already, go figure, worked with 5 moms since my own

situation, who had situations similar to mine – but they brought a baby

home. J It’s really hard

to stay objective in situations like that…

Now time to put my place together as I am having a large

group of struggling moms come over to talk with moms who struggled and made it

through to the side of breastfeeding hell… J

Thanks for letting me share…

Warmly,

Jaye

Jaye Simpson, IBCLC, CIIM

Breastfeeding Network

Sacramento, CA

www.breastfeedingnetwork.net

[Guest guest]

I think the only reason they didn’t give me any blood at all

was because I had no insurance – I think getting some would have been

very helpful for me.What the & & %$# !!!norma, speechless. Norma Ritter, IBCLC, RLCBreastfeeding Matters in the Capital Regionwww.NormaRitter.com

Join us on Facebook for the latest birthing and breastfeeding news and views:http://tinyurl.com/BMCRonFB

[Guest guest]

I wonder if it's a typo and she meant dulse - which is a kind of seaweed??  Oh so nourishing, especially in soups - a nice post partum soup will work wonders!  If anyone is looking for delish, reputable seaweed sources, I love this guy ...

http://www.theseaweedman.com/warmly,Deirdre On Fri, Jul 29, 2011 at 8:58 PM, Beebe wrote:

 

what is pulse? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula

www.second9months.comBreastfeeding Between the Lines:  http://second9months.wordpress.com/

Subject: Re: postpartum blood lossTo:

Date: Friday, July 29, 2011, 5:41 PM

 

Well, I'm a midwife, an IBCLC, a mom who had a late postpartum hemorrhage and -to this day has had issues with milk supply... so here's my 2 sense worth...

I agree that most home birthing moms would refuse transport+blood, even if they hemorrhage, and as long as they remained stable for 24 hrs, midwives aren't going to argue.

The body is designed to loose some blood after birth, some bodies can loose more, some less. My question for hemorrhages that are hard to stop + affect milk supply - are there retained placental fragments? Because that is 1.life threatening and 2. going to affect milk supply because of continued progesterone release

if she's no longer bleeding, then she probably doesn't have fragments, but if she's still bleeding, a vaginal ultrasound might be prudent...

Also, yes Methergine has been linked to lowering milk supply levels

and I'm very wary of Reglan. I'm surprised the midwife would recommend Reglan instead of Domperidone (not that Domperidone is even necessary, but why Reglan?)

As far as what to feed mamas who bled more than their body should have bled?

**Sunlight + Liquid chlorophyll and coconut water (not milk, water)**

And lots of vegetables, and pulse, nuts, beans, lentils

Oats, Brewers Yeast, Ground Flaxmeal

Bananas & Avocados

Well, good luck!

>

> Jaye, I lost alot of blood, enough to be on bedrest for 3 weeks and

> literally unable to walk to the bathroom across the room without being out

> of breath. However, I would not ever take blood unless I was actually

> nearly dead, and I would not accept transport. Don't be so sure the care

> was not adequate. Just saying mothers do often refuse transport. I actually

> had great midwives, I was given IV fluids for the volume and then herbs,

> homeopathics, reading 's list of what she took sounds very similar

> to my bedside for awhile. I know my milk supply was affected, but I kept a

> scale beside me and weighed my baby regularly and she was fine, but I nursed

> nonstop because I really could not get up anyway and waited. After a few

> weeks my milk supply was fine. I continued to use the chlorophyl and

> alfalfa for a few months. Is there any long term damage to my body from not

> receiving the transfusion? I don't know. I know I did not pass out. I know

> the midwife flat out told me if I passed out she was calling 911 and all

> bets were off...and she sat beside me all night watching me.

> As a doula, I have been at a few births where there was blood loss beyond

> normal and not all received blood. Some because the mothers said no. I have

> not seen anything done differently for hospital birthing mothers than was

> done for me and the hospital does not do the nutrient education, tell the

> mother to rest, etc. I know of others of course who had the kind of blood

> loss that landed them in the ICU with an emergency hysterectomy and others

> who lost enough to require a transfusion just because they said yes to it.

> I don't know how many had a large volume of blood loss and no problems,

> because if I am working with them, they have a problem. And all the moms I

> worked with where a major blood loss was an issue had a degree of supply

> issues in the beginning and some never did make milk.

>

> --

> Pam MazzellaDiBosco, IBCLC, RLC

> Birthing & Beyond, Inc.

> Labor Support and Lactation Consultant Services

>

>

--

Breastfeeding Arts

Deirdre McLary, IBCLC, RLC, CD, LLLLBreastfeeding, Birth Education & Doula Care since 1997

www.breastfeedingarts.com

Follow us on twitter:  @BreastfeedingNYFriend us on Facebook:  http://www.facebook.com/BreastfeedingArts1

Bloggin 'Bout Breastfeeding:  http://breastfeedingarts.wordpress.com/

[Guest guest]

oh...that makes sense! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- Subject: Re: Re: postpartum blood

lossTo: Date: Saturday, July 30, 2011, 10:10 AM

I wonder if it's a typo and she meant dulse - which is a kind of seaweed?? Oh so nourishing, especially in soups - a nice post partum soup will work wonders! If anyone is looking for delish, reputable seaweed sources, I love this guy ...

http://www.theseaweedman.com/warmly,Deirdre On Fri, Jul 29, 2011 at 8:58 PM, Beebe wrote:

what is pulse? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula

www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/

Subject: Re: postpartum blood lossTo:

Date: Friday, July 29, 2011, 5:41 PM

Well, I'm a midwife, an IBCLC, a mom who had a late postpartum hemorrhage and -to this day has had issues with milk supply... so here's my 2 sense worth...

I agree that most home birthing moms would refuse transport+blood, even if they hemorrhage, and as long as they remained stable for 24 hrs, midwives aren't going to argue.

The body is designed to loose some blood after birth, some bodies can loose more, some less. My question for hemorrhages that are hard to stop + affect milk supply - are there retained placental fragments? Because that is 1.life threatening and 2. going to affect milk supply because of continued progesterone release

if she's no longer bleeding, then she probably doesn't have fragments, but if she's still bleeding, a vaginal ultrasound might be prudent...

Also, yes Methergine has been linked to lowering milk supply levels

and I'm very wary of Reglan. I'm surprised the midwife would recommend Reglan instead of Domperidone (not that Domperidone is even necessary, but why Reglan?)

As far as what to feed mamas who bled more than their body should have bled?

**Sunlight + Liquid chlorophyll and coconut water (not milk, water)**

And lots of vegetables, and pulse, nuts, beans, lentils

Oats, Brewers Yeast, Ground Flaxmeal

Bananas & Avocados

Well, good luck!

>

> Jaye, I lost alot of blood, enough to be on bedrest for 3 weeks and

> literally unable to walk to the bathroom across the room without being out

> of breath. However, I would not ever take blood unless I was actually

> nearly dead, and I would not accept transport. Don't be so sure the care

> was not adequate. Just saying mothers do often refuse transport. I actually

> had great midwives, I was given IV fluids for the volume and then herbs,

> homeopathics, reading 's list of what she took sounds very similar

> to my bedside for awhile. I know my milk supply was affected, but I kept a

> scale beside me and weighed my baby regularly and she was fine, but I nursed

> nonstop because I really could not get up anyway and waited. After a few

> weeks my milk supply was fine. I continued to use the chlorophyl and

> alfalfa for a few months. Is there any long term damage to my body from not

> receiving the transfusion? I don't know. I know I did not pass out. I know

> the midwife flat out told me if I passed out she was calling 911 and all

> bets were off...and she sat beside me all night watching me.

> As a doula, I have been at a few births where there was blood loss beyond

> normal and not all received blood. Some because the mothers said no. I have

> not seen anything done differently for hospital birthing mothers than was

> done for me and the hospital does not do the nutrient education, tell the

> mother to rest, etc. I know of others of course who had the kind of blood

> loss that landed them in the ICU with an emergency hysterectomy and others

> who lost enough to require a transfusion just because they said yes to it.

> I don't know how many had a large volume of blood loss and no problems,

> because if I am working with them, they have a problem. And all the moms I

> worked with where a major blood loss was an issue had a degree of supply

> issues in the beginning and some never did make milk.

>

> --

> Pam MazzellaDiBosco, IBCLC, RLC

> Birthing & Beyond, Inc.

> Labor Support and Lactation Consultant Services

>

>

--

Breastfeeding Arts

Deirdre McLary, IBCLC, RLC, CD, LLLLBreastfeeding, Birth Education & Doula Care since 1997

www.breastfeedingarts.com

Follow us on twitter: @BreastfeedingNYFriend us on Facebook: http://www.facebook.com/BreastfeedingArts1

Bloggin 'Bout Breastfeeding: http://breastfeedingarts.wordpress.com/

[Guest guest]



Pulses are beans. Don't know where the term comes from.

Re: postpartum blood lossTo: Date: Friday, July 29, 2011, 5:41 PM

Well, I'm a midwife, an IBCLC, a mom who had a late postpartum hemorrhage and -to this day has had issues with milk supply... so here's my 2 sense worth...I agree that most home birthing moms would refuse transport+blood, even if they hemorrhage, and as long as they remained stable for 24 hrs, midwives aren't going to argue. The body is designed to loose some blood after birth, some bodies can loose more, some less. My question for hemorrhages that are hard to stop + affect milk supply - are there retained placental fragments? Because that is 1.life threatening and 2. going to affect milk supply because of continued progesterone releaseif she's no longer bleeding, then she probably doesn't have fragments, but if she's still bleeding, a vaginal ultrasound might be prudent...Also, yes Methergine has been linked to lowering milk supply levelsand I'm very wary of Reglan. I'm surprised the midwife would recommend Reglan instead of Domperidone (not that Domperidone is even necessary, but why Reglan?)As far as what to feed mamas who bled more than their body should have bled?**Sunlight + Liquid chlorophyll and coconut water (not milk, water)**And lots of vegetables, and pulse, nuts, beans, lentilsOats, Brewers Yeast, Ground FlaxmealBananas & AvocadosWell, good luck!>> Jaye, I lost alot of blood, enough to be on bedrest for 3 weeks and> literally unable to walk to the bathroom across the room without being out> of breath. However, I would not ever take blood unless I was actually> nearly dead, and I would not accept transport. Don't be so sure the care> was not adequate. Just saying mothers do often refuse transport. I actually> had great midwives, I was given IV fluids for the volume and then herbs,> homeopathics, reading 's list of what she took sounds very similar> to my bedside for awhile. I know my milk supply was affected, but I kept a> scale beside me and weighed my baby regularly and she was fine, but I nursed> nonstop because I really could not get up anyway and waited. After a few> weeks my milk supply was fine. I continued to use the chlorophyl and> alfalfa for a few months. Is there any long term damage to my body from not> receiving the transfusion? I don't know. I know I did not pass out. I know> the midwife flat out told me if I passed out she was calling 911 and all> bets were off...and she sat beside me all night watching me.> As a doula, I have been at a few births where there was blood loss beyond> normal and not all received blood. Some because the mothers said no. I have> not seen anything done differently for hospital birthing mothers than was> done for me and the hospital does not do the nutrient education, tell the> mother to rest, etc. I know of others of course who had the kind of blood> loss that landed them in the ICU with an emergency hysterectomy and others> who lost enough to require a transfusion just because they said yes to it.> I don't know how many had a large volume of blood loss and no problems,> because if I am working with them, they have a problem. And all the moms I> worked with where a major blood loss was an issue had a degree of supply> issues in the beginning and some never did make milk.> > -- > Pam MazzellaDiBosco, IBCLC, RLC> Birthing & Beyond, Inc.> Labor Support and Lactation Consultant Services> >

--

Breastfeeding ArtsDeirdre McLary, IBCLC, RLC, CD, LLLL

Breastfeeding, Birth Education & Doula Care since 1997

www.breastfeedingarts.comFollow us on twitter: @BreastfeedingNYFriend us on Facebook: http://www.facebook.com/BreastfeedingArts1Bloggin 'Bout Breastfeeding: http://breastfeedingarts.wordpress.com/

[Guest guest]

Jaye,

When my son was sick, he had 2 transfusions and it took him a year to be able to

do anything a normal 6 year old does. It changed him forever in subtle ways,

even though he was so young. He, of course, had to quit gymnastics, but he even

had to quit piano lessons bc he fell asleep at the piano. His platelets will

never be normal, and he required far more than just recovering blood volume and

composition as his condition is structural (he has no portal vein). But, in

addition to the nutrients, supplements, Chinese herbs and homeopathy, he had

Integrated Manual Therapy three times per week, acupuncture once per week and

energy work. OTOH, he actually flew in the face of all the " common wisdom " for a

kid with his anatomy and became a competitive athlete. The body is an amazing

eco-system--but I know that we really needed to support mind-body-soul to see

the recovery that we did. Even now, when he energy fluctuates dramatically--it

is the Asian medicine (we prefer Japanese acupuncture) that seems to have the

best affinity for restoring blood and thus chi.

Tow, IBCLC, France

>

> > I think the only reason they didn't give me any blood at all was because I

> > had no insurance – I think getting some would have been very helpful for me.

>

>

> What the & & %$# !!!

>

> norma, speechless.

>

> Norma Ritter, IBCLC, RLC

> Breastfeeding Matters in the Capital Region

> www.NormaRitter.com <http://www.normaritter.com/>

> Join us on Facebook for the latest birthing and breastfeeding news and

> views:

> http://tinyurl.com/BMCRonFB

>

[Guest guest]

Yes, our bodies are amazing. what a journey, ! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- Subject: Re: postpartum blood

lossTo: Date: Saturday, July 30, 2011, 1:44 PM

Jaye,

When my son was sick, he had 2 transfusions and it took him a year to be able to do anything a normal 6 year old does. It changed him forever in subtle ways, even though he was so young. He, of course, had to quit gymnastics, but he even had to quit piano lessons bc he fell asleep at the piano. His platelets will never be normal, and he required far more than just recovering blood volume and composition as his condition is structural (he has no portal vein). But, in addition to the nutrients, supplements, Chinese herbs and homeopathy, he had Integrated Manual Therapy three times per week, acupuncture once per week and energy work. OTOH, he actually flew in the face of all the "common wisdom" for a kid with his anatomy and became a competitive athlete. The body is an amazing eco-system--but I know that we really needed to support mind-body-soul to see the recovery that we did. Even now, when he energy fluctuates dramatically--it is the Asian medicine (we

prefer Japanese acupuncture) that seems to have the best affinity for restoring blood and thus chi.

Tow, IBCLC, France

>

> > I think the only reason they didn't give me any blood at all was because I

> > had no insurance – I think getting some would have been very helpful for me.

>

>

> What the & & %$# !!!

>

> norma, speechless.

>

> Norma Ritter, IBCLC, RLC

> Breastfeeding Matters in the Capital Region

> www.NormaRitter.com <http://www.normaritter.com/>

> Join us on Facebook for the latest birthing and breastfeeding news and

> views:

> http://tinyurl.com/BMCRonFB

>