HELLP and problems breastfeeding?

[sdbaby1984]

I had HELLP 6/07 and wasn't able to breastfeed. I am 22 weeks pregnant with no problems so far!! I would like to breastfeed this baby because with my last baby I didn't ever produce more than 1/8th oz of milk at a time. I pumped round the clock for two weeks. It was horrible and I don't want another pump near me again. In the hospital everyone was telling me that I just needed to pump more and everyone gets milk. When I did my own research I saw that in some women who have c-sections, general anesthesia, hemorrhage... there is low milk supply. It was very stressful, painful and time consuming so honestly I'm scared to try again or get my hopes up. Also, I have a daughter that needs any free time I have so pumping for 40 min every two hours isn't an option.

My question is, is there any connection between HELLP and breastfeeding problems? Have any of you had similar experiences or successful outcomes? Hope it's not too much information, but my breasts have grown much more this pregnancy then last. Could that a sign of anything?

[quincyf]

I don't know about the breast growth, but this very topic has been on my mind lately. I never made a ton of milk, but I always thought it was because of pumping exclusively (dd was too small and we couldn't latch). I had Class I HELLP w/ emerg c-section and extremely low platelets. My production problem was not as severe as yours, but compared to others I felt I didn't make that much. Maybe you're on to something. I always chalked it up to the (evil) pump. So hoping to BF normally this time around.

[caryn]

I think there's a theoretical mechanism, at least, by which milk production might be compromised in hypertensive pregnancies. Milk is made from the bloodstream, and our blood vessels are *shot* after a bout with this stuff, full of holes and chock-full of all sorts of weird soluble factors that aren't normally there or are usually in completely different ratios.

And I'm really wondering about the breast growth -- perhaps the placenta was so shallowly implanted last time that it wasn't able to signal in quite the same fashion? It's detachment of the placenta that triggers the milk, but it's also embedment of the placenta that turns on a whole bunch of the pregnancy-related physiologic changes and breast growth might (or might not) be the sort of thing a shallowly-implanted placenta would compromise.

But I'm not aware of any formal studies that show more problems breastfeeding in hypertensive pregnancy per se. I have seen a correlation with a later start to the milk and Caesarean.

I never could pump *anything*. Every two hours around the clock for a 30 minute stretch with a hospital pump earned me a max of 40 ml., and then it started to drop off and the IBCLC said I had pump resistance. But I could breastfeed on demand -- I let down for a baby, just not a pump -- and got lucky, because my son was only in NICU for a week and his suck reflex turned on that week. He learned to breastfeed just in time, because I just wasn't pumping more than 20 ml by then and wasn't going to be able to keep that up for much longer.

I hope this baby is a much smoother process in general for you. Keep us posted.

[ssaclolo6]

Very interesting thought. I can tell you from personal experiences through nursing 5 babies, some early some term. Let's see, my best pregnancy that I carried term and went into labor naturally I had so much milk and Bella was the fattest little thing. My oldest was also term, but I really struggled producing enough milk, and I finally supplemented at about 6 weeks because he wasn't gaining any weight, and I was young, in college, and just didn't have the reserves physically to get my body in gear. With my three pounder, I pumped the first few days almost non-stop. I was at a VERY non breastfeeding hospital and they were going to give him formula until I produced milk (not colostrum). I was so stressed and sick, I had more blood in the vials than anything else, it was just aweful. A sympathetic nurse let me put him to breast, and he and I got the start we both needed. The doctor still refused to let me feed him after they found out about this incident and made me go back to pumping, but I was allowed to put him to breast for two minutes every 5 hours and then I would hand express after that as my milk would let down.

I just cannot imagine not getting to *nurse* my first, and how hard it would have been. I wish you the best of luck. Just remember to give your body everything it needs: rest, hydration, good nutrients, lowest stress possible, etc. to give you the best chance.

Steph

[momofdylan]

Hi. I'm new here but in 2002 I delivered at 38 weeks with HELLP. We thought our son was healthy but later found out that the lining in his intestines was not developed and when we fed him he got an infection in his intestines (NEC) and died at 4 days old. He was only sick for the last day.
That being said. I was told by a very hateful advocate of breast feeding that if I would have breast fed my son, he would not have died. First of all, I couldn't. Due to my sickness, I did not produce any milk. I tried so hard to breast feed but I was too weak to even hold him. Has anyone else ran into these breast feeding only wackos? I believe it is best for the baby but there are extinuating circumstances.

[audrey s.]

To Momofdylan, I am so sorry to hear this. We went through this with my DD as well -- 37 weeks, sudden NEC because of too-early feeding with a formula that my daughter turned out to be allergic to. Luckily, she was already in a Level III NICU and the surgeon was in-house and she went on to a 4-hour surgery that in the end saved her life (although they removed her entire large intestine).

Unfortunately, breast milk might NOT have saved your son; in our institution we wait to feed anything with a newborn that is "distressed" for any reason (including magnesium toxicity, which my DD had) for this very reason.

My milk took ten full days to come in, and I only had enough to BF exclusively for six months; I was actually told to allow my milk to dry up as my DD would "never tolerate" breast milk. As it turned out, she was allergic to all the special formulas and in the end, breast milk was all she could have. However, I never did have a great supply. I did use fenugreek to help keep it up.

There are SO many reasons for a lack of milk supply besides just the pre-e; some people with perfectly normal pregnancies still don't have milk for a number of different reasons. Some people are such "lactivists" that they seem to lose track of any sense of compassion; that for so many reasons, it doesn't work every time with every mother/baby pair.

To the OP, Hopefully, as you're having a normal pregnancy (YAY! for normal), you should be able to have a normal BF-ing experience too!

[missgamecock]

I had no milk whatsoever with Kirsten. In fact, I was shocked that I had smaller boobs 3 days pp. They did give me a pill. So don't know if that helped. Nothing EVER came out. I didn't try with her anyway.

With Sara, it totally came in. I didn't breastfeed her. I just waited for it to dry up.

I am on the fence about the third.

[fiona]

Ruth - momofdylan - I think that was an unconscionable thing for anyone to have said. Not only hateful and insensitive, but without doubt, completely untrue.

I could not breastfeed my 30 weeker - I pumped during his ten week NICU stay, but by the time he was gearing up for proper-sized feeds, my supply had dwindled to nothing. I had no problems bfing my 36-weeker for nine months.

I think every pregnancy is different and we do the best we can under whatever circumstances we find ourselves.

[dohertyab]

I had HELLP, but no C-section and was lucky about pumping, it worked very well for me, so it is possible even if not the norm. I thought there was some link to low milk and mag sulfate though. I think as with PE and HELLP, every pregnancy is different, every child is different and so you can make yourself informed about options and then you have to muddle your way through by trial and error. Good luck

[catherine]

Breast growth is no measure of milk potential... if this were true my three would have starved because I'm a A at the best of times, barely a C immediately post partum and rapidly a B. I have visual proof in my avatar.. that chubby baby was dining exclusively on the unimpressive rack beside her head.

HELLP and preeclampsia can certainly impact milk production. One reasonably well understood mechanism is via brain swelling which presses on the pituitary gland. This little spot in your brain is responsible for the production of prolactin which is the milk-signaling hormone. If this gets disrupted, well, it is logical that your ability to produce milk will be diminished. When I had HELLP I certainly experienced some degree of hypertensive changes in my head because I experienced cortical blindness which is what happens when the optic nerve is squeezed by swelling. It took almost 9 days for my milk to "come in" and my OB told me that she would have bet against that ever happening the way things were looking. Subsequently, things settled down and we ended up nursing for about 16 months.

When this happened, I had the benefit of having previously nursed a baby and was reasonably familiar with both breast feeding and pumping. If it had been my first time, I'd have just let it go. Figuring out how to feed a baby with boobs is right up there with learning to drive a stick shift or writing a dissertation. Intensive, a rapid learning curve, a grumpy demanding instructor/partner.......

Don't assume that you are doomed in the lactation department. Every pregnancy, delivery and recovery is different. That said, things may not work out next time either for a bunch of unrelated reasons. It's a wonderful enhancement of the mother-child relationship when all participating are happy and satisfied, but it's not essential in our modern world where we are fortunate to have safe and healthy alternatives to use if necessary or desired. I don't understand why people would ever chose to use the way we feed our children as a stick to beat us with, that's simply insane.