Breastfeeding After Retained Placenta – 7 Common Questions

Breastfeeding After Retained Placenta – 7 Common Questions

Some mothers experience a retained placenta after the birth of their baby.

Aside from being a traumatic experience for some, mothers can be surprised to find that it can affect their milk coming in.

This may cause even more stress and pressure when you’re doing your best to get breastfeeding working well.

Rest assured that your breasts are just fine – it’s not your breasts fault.

However, there are several things you should be aware.

Here are the answers to 7 common questions about retained placenta and breastfeeding:

#1: What Is Retained Placenta?

During pregnancy, the levels of various hormones are high, including prolactin (the milk-making hormone). So why is it then that you don’t make a lot of breastmilk during pregnancy? This is because your milk-making ability is supressed due to the high levels of other hormones, including progesterone.

After your baby is born, there is an important third stage of labour to birth your placenta. Most of the time, little, if any, intervention is needed for this to occur. Skin-to-skin contact with your baby and starting breastfeeding increase the level of the hormone oxytocin. Oxytocin helps your uterus to contract which encourages the natural release of your placenta.

On rare occasions, a piece of placental tissue may break off and stay attached to the wall of your uterus. This is referred to as retained placenta. This is more likely to occur when the placenta is slow, or tension is applied to help it, to come out. It can occur with a c-section too.

#2: How Might Retained Placenta Affect Breastfeeding?

Birth of the placenta is an important step to kick-start the process of your milk coming in. This is because when your placenta is removed, your progesterone levels plummet. This then allows prolactin to start taking effect on the milk-making tissue in your breast.

If not all of your placenta is removed, this can mean that progesterone levels don’t fall as much and this can interfere with the process of your milk coming in. Hence, there can be a delay in your milk coming in.

#3: What Are The Signs And Symptoms Of Retained Placenta?

There are various signs and symptoms you may experience if you have retained placenta. Possible signs and symptoms include:

  • Examination of your placenta shows tears or missing pieces
  • Postpartum haemorrhage
  • Foul smelling vaginal discharge
  • Fever
  • Painful cramping of your uterus
  • Delay in your milk coming in

Please note that there can be various other causes for the above signs and symptoms. For example, a delay in your milk coming in could also be linked with other things such as diabetes, emergency c-section, obesity.

If you are worried you may have retained placenta, see your doctor immediately.

#4: What Does ‘A Delay In Milk Coming In’ Mean?

Many new mothers worry about whether they will have enough milk for their baby. For most, breastfeeding when your baby needs to be fed is all that is needed to ensure your baby gets enough.

In the case of retained placenta, there is a clear delay in your milk coming in, regardless of ruling out other possible reasons.

When your milk comes in, you may:

  • Have a fuller feeling in your breasts
  • If expressing at all, you may notice your milk gradually changing from a thick yellow coloured colostrum to a paler milkier colour
  • Notice your baby’s poos changing to a lighter colour
  • Be more aware of your let-down reflex. Some mothers don’t feel their let-down reflex. They only way they may recognise their let-down is when their baby’s sucking changes from a quick shallow suck at the very start of the feed to a deeper more rhythmical suck when the let-down occurs. They may also notice milk leaking from the breast their baby is not feeding from. Other mothers who feel their let-down, may feel:
  • A tingling sensation in their breasts
  • A sudden feel of breast fullness
  • A slight pain in their breasts

According to the Academy of Breastfeeding Medicine, a delay in a mother’s milk coming is defined as if her milk comes in ‘day 3–5 or later [72–120 hours] and inadequate intake by the infant’.

#5: What Needs To Be Done If I Have Retained Placenta?

If retained placenta is suspected, a pelvic ultrasound might be done. Manual removal or a D&C (Dilation & Curettage) with a local or general anaesthetic may follow if it is confirmed.

#6: Will My Baby Need To Be Supplemented With Formula Until My Milk Comes In?

With prompt evaluation and treatment, many mothers with retained placenta can exclusively breastfeed. There are few medical reasons when supplementation with formula is necessary. The Academy of Breastfeeding Medicine Supplementation protocol provides helpful and evidence-based information about when supplementation may be necessary.

#7: Will My Milk Come In After All My Placenta Is Removed?

Yes, once your placenta is fully removed, you can go on to make a fully milk supply. Speaking with an Australian Breastfeeding Association counsellor or seeing a lactation consultant can help provide you with support and information to help get breastfeeding working well for you and your baby.

 

CONTRIBUTOR

Renee Kam is mother to Jessica and Lara, an International Board Certified Lactation Consultant (IBCLC), a physiotherapist, author of 'The Newborn Baby Manual' and an Australian Breastfeeding Association Counsellor. In her spare time, Renee enjoys spending time with family and friends, horse riding, running and reading.


2 comments

  1. Hi there Renee, interesting read. I experienced retained placenta and post-partum blood loss of 2.5L, about 10minutes of skin-to-skin before surgery… 3 months on I had trouble with milk supply, now 8 months I feel i’ve done everything to increase supply but it’s still not adequate. My baby is comp feed. Could the birth have affected supply issues, 3 or even 8 months on?

    1. Hi Renee, I have the exact same question as E. I lost about 4L of blood and required a manual removal of my placenta after 1 hour of skin to skin and two injections to help the placenta release. Breastfeeding had never been in large amounts – maximum 3-4oz at a time. Baby dropped from 58th percentile at birth to 9th before starting solids at 5months. A lady put a drop of progessence (a progesterone oil) one drop onto my neck and I felt the let down reflex for the first time and lasted about two weeks, with one light spot of blood. Baby was 8 months old. At 8.5months my cycle still hasn’t returned but I’m interested like E is in how our retained placentas may have diminished our milk supply. I had used depo provera X 3injections (and it took 18months for my cycle to normalise after them). That was 15 years ago and have not mucked with my hormones since and am on no medication.

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