Retained Placenta / Low Milk Supply (Updated to ask for more general advice)

[BumbleBump]

Has anyone had any dealings with this / got any knowledge on the subject? I'm pretty sure it's what's happening to me and Katie I also think I need a bit of a rant over what's happened since she was born.

After delivering her, I had a managed third stage and the main midwife let the student midwife deliver the placenta. It didn't seem to be coming away easily and the student was yanking away at it until she eventually admitted she didn't know what she was doing and asked the main one to take over... I had a lot of bleeding after delivering, and kept passing big clots, the second night one came out that was bigger than my hand - I was also getting a lot of pains in my uterus and when I tried to get up to walk around I'd feel dizzy and find it hard to breathe. I kept reporting my symptoms to the midwifes but as my uterus was contracting normally (I'm now assuming only because I was bfing!) they told me it was "normal", which I found hard to believe as I didn't remember feeling that bad after DD1 and her birth was a LOT more difficult, Katie practically flew out!

Yesterday (tmi alert) I went to the loo and when I stood up I had a long piece of grey tissue hanging out of me - I freaked out, thinking I'd had a prolapse or something as it wouldn't come out, thankfully my community MW was due to come round and turned up 5 mins later (lucky she came round at all as the hospital midwifes hadn't bothered to tell them we were home, they only knew when we phoned to ask why they hadn't been round yet!). The midwife took a look and explained it was a placental lobe about 15cm in length and had to pull it out. She then got me an emergency appointment at the maternity unit as I've developed a severe uterine infection due to it being left behind, no wonder I've been feeling so crap She kept appoligising saying an incidence form would be filed about it. The hospital put me on antibioctics and I think blood thinners to help with the clots, and I've got an ultrasound on monday to see if anything else has been left behind. I'm so glad I'm bfing otherwise it probably wouldn't have come out at all and the hospital MWs kept making me think I was making a big deal out of nothing

Anyway, on to the BF issue. With DD1, I had no problems with milk supply at all - in fact I oversupplied big style. When my milk came in, I engorged as normal. This time round although my milks definately come in, my breasts have felt heavy but not rock solid at any point like they did the first time round. The mornings and night we don't seem to have a problem, she feeds and seems contented but she has to drain both breasts each time before this happens. But from about 6pm to 10pm she has to feed near constantly before she finally contents herself She's a really quiet content baby, she doesn't even fuss over dirty nappies so it's heartbreaking seeing her get fussy for that length of time. She spits up quite a bit of milk, so I know she's getting some at least but obviously something isn't right? I've looked up retained placenta on the net and how it can cause lacation problems as your body doesn't fully recognise that it's not pregnant any more. Do you think this means there's still some left? Does anyone know how long it would take for my body to sort itself out once everything is gone? Hopefully after my ultrasound on Monday I'll get it sorted out if there is anything more there, but is it going to do her major damage in the meantime if she's not getting enough until after Monday and should I be supplimenting with formula in the meantime (something I REALLY don't want to do!!)?. Should I start expressing now and try her on bottles? It seems really early, and I don't want to cause nipple confusion.

I really don't want to give up solely BFing because of this, but I'm worried I'm doing her harm when she's obviously so unsettled in the evening.

 

[Mervs Mum]

While I dont have any experience of retained placentas and BFing I personally think what you are describing sounds totally normal at your stage. I was waiting for the big 'milk coming in' moment and the massive rock hard boobs with #2 and it never happened. I was CONVINCED my milk wasnt coming in right - and I had a really easy birth with no complications! I think that the lack of engorgement just made me doubt my body. I since learned it's not unusual for you not to get that with your second or subsequent babies.

Unfortunately for me, I reached for the formula. I just felt like you. so bad that she appeared not to be getting enough from me and in particular in the evenings.

We topped up until day 10 and then I saw a BF advisor who helped me to believe in myself and my body's ability to feed my baby - I just had to stop topping her up so my body got the right signals to up the supply of milk.

I think at day 5 you are still very much in the process of bringing the milk in and what you are describing is just that. I think the placenta issue is just adding to you doubting yourself.

You'll know for sure after the scan - I had a similar issue with #1 and the scan came back clear - and then you can put that out of your mind and carry on with the wonderful job you have already started

You are doing really well honey

 

[BumbleBump]

Thankyou so much for the reassurance! I'm glad I'm doing the right thing by perservering, she seems to be having a decent ammount of wet/dirty nappies so hopefully she's getting enough for the meantime and it will sort itself out There's a BF support group on Tuesday which I'm hoping to get to, but my minds definately a lot more restful till then. Thanks hun

 

[asacia]

I don't have any personal experience, but I know I've read a lot of Mum posting thier worries about milk supplies with second and third babies. It seems that it is very common for things to feel different the second time around, and a lot of second time Mums don't get the real engorged feeling or leaking like they did previously.

 

[BumbleBump]

I've noticed I've been leaking a lot less this time round which was another thing adding to my worry - If it's normal though that's ace, I used to have to change my top a couple of times a day despite wearing pads the first time round!

I've just had the community support midwife round, and she's down to 3400g from 3570g which she said is within the acceptable limits so that's been good to know She also checked my latch, and helped me correct it a bit so hopefully that will help us too! She asked how often she was feeding apart from the fussy time, and when I said roughly about every 2 hours apart from a 4 hour stretch from 10pm/11pm - 2am/3am she seemed to think this was too often? (her words were "So near constantly then?") She said to try to hold off feeding her so she takes more each feed? That's the only bit of advice that she gave that I'm not so sure about, the rest of what she said was great - but is every two hours really too often and should I really be refusing when she's obviously hungry? (she gives VERY clear cues without needing to cry! But if I hold off, my usually very quiet baby would definately ball her eyes out for a solid hour, she loves booby so far!)

 

[britmum]

It would make sense that a retained placenta would have an affect on your milk supply and if you are feeling ill from it (which you would) then that would affect your production too!! Obviously you need to get the placenta issue resolved and in the meantime you could consider taking some herbs to help with milk supply. Fenugreek and Blessed Thistle are both excellent for improving milk supply if taken early enough. You would take 3 capsules of each three times a day.

DO NOT start bottles, your milk supply will only be increased by your baby stimulating your breasts and she cannot do that if she is on a bottle. Pumping just makes more work for you too!! If you want to you could pump after she has eaten from both sides. You might get nothing but if you pump from both sides for about 5 minutes then you will send the message to your body that it needs to produce more milk!

As for spitting up...this is nothing to worry about in an exclusively breastfed baby...in fact its good for them Babies are born sterile...I mean by that, that they have no bacteria, we need the good bacterial flora to help our digestive systems and also to start building our immune system. when you breastfed baby spits up she is lining her throat with good bacteria, if it runs out her mouth and into her nose or ears they get colonised by good bacteria too This will only make her stronger

I hope that helps? Please try to relax a little...I remember how crazy I felt the first few weeks after my babies were born and I had no issues so I can only imahine how much more worrying it must be for you...(((hugs)))

 

[Louise-B]

I don't think feeding every two hours at this stage is too often. My LO wanted feeding every two hours for about the first 12 weeks!! Especially if your baby was small (as in my LO's case). I am sure you are aware their stomachs are only very small and breast milk is digested faster/easier so they need filling up regularly!

I'd suggest you go with what your baby needs rather than the advice of the midwife on this one, as you know your baby and her signals best. xxx

 

[Mervs Mum]

I've not leaked at all this time hun

 

[Sarahkka]

Regarding the "constant" feeding, my son was this way as well. In our case, he was mildly tongue-tied and my milk supply was actually low due to an undiagnosed case of thrush. So sometimes the frequent feeds are telling you something. Having said that, Simon loves the boob and still preferred long "sip 'n' snooze" sessions after the other problems were corrected.
It's really hard to tell in the beginnning what they need for sustenance and what they need for comfort, so if it's not driving you too crazy, I don't think you can go wrong by responding to your daughter's cues. I'm sure the HV was trying to help, but I think it's usually best to follow your gut and give baby what she's asking for.

 

[Sonyax]

Evenings have been constant feeding for me until this week (week 4)I think at first babes are just getting the hang of it. this is my first bf one so can't help with the second time stuff except you may need to know I had huge doses of antibiotics after infection in c section scar and my boobs were great during this time but really tender and sensitive nipples once I finished them. dunno why.
You are doing really well I was signed off finally on tuesday (24 days after his birth) so I know how tough it is dragging it all out and taking a while to recover I'm still ill. Rest as much as you can x the feeding sounds as it should be.