Journal of Community Medicine & Health Education
Open Access

Abstract

Statement of the problem: “I have no milk” Lactogenesis is the onset of milk secretion and includes all of the changes in the mammary epithelium necessary to go from undifferentiated mammary gland in early pregnancy to full lactation sometime after parturition. Some women are at risk of having delayed lactogenesis. These risk factors can include: first time mother, large amount fluid during delivery, pain medications / anaesthetics during delivery, stressful birth, C-section, blood loss >500ml, insulin resistance, poor controlled type 1, GDM, preterm birth, unusual nipple anatomy, maternal illness, separation mother and baby as well as infant factors. This is a case study that highlights a number of these risk factors including gestational diabetes and Sheehan syndrome. A primigravida with gestational diabetes presented in hospital at 36 weeks with APH. Baby delivered via emergency c-section. Baby was admitted into the NICU with breathing difficulties. Day 5 postpartum mother was referred to me as she was still unable to produce milk. We take a look at the impact of the gestational diabetes as well as the blood loss during the delivery, together with a number of other risk factors and the impact on milk production. Management of the mother and baby with power pumping regimen, SNS, and medications allowed her to obtain about 70% of milk production. This allowed her to obtain her breastfeeding goals and empower her for future births. Discussion around how this can help us manage these triads earlier in order to protect the breastfeeding relationship and ultimately the long term health of mother and baby.

Biography

Completed BNURS degree in 2001 including general, community, psychiatric and midwifery. Worked well baby clinic for few years, moved corporate worked pharmaceutical company in sales and training. Passion midwifery revived when had my own kids. Completed SACLC cumm in 2016. Run private practice seeing new parents. Started online parenting training courses. Run workshops and speak at events for parents and health care professionals.