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Infant Insufficient Milk Syndrome Associated with Maternal Postpartum Hemorrhage

Verity Livingstone, MBBS, IBCLC

Vancouver Breastfeeding Centre; Department of Family Practice, University of British Columbia, 690 West 11th Avenue, Vancouver, BC, Canada V5Z 1M1.

Insufficient milk syndrome is defined as failure to thrive in infants due to insufficient daily breastmilk intake. This discussion examines a possible association between insufficient milk syndrome and maternal postpartum hemorrhage. Ten consecutive cases of insufficient milk syndrome associated with maternal postpartum hemorrhage were identified. The mothers presented between 3 and 35 days postpartum. Maternal postpartum blood loss ranged from 500-1500 ml in eight cases (mean: 963 ml); in two cases, blood loss was noted as 400++ and 200++, respectively. Six mothers experienced a drop of hemoglobin by >30g/L; two had a drop in blood pressure >30mmHg for >20 minutes. All infants were failing to thrive. Five infants suffered hypernatremic dehydration with serum sodium levels ranging from 148-166mmolfL. Breastmilk electrolytes were measured in six cases, and elevated sodium levels, ranging from 21-lO Ommol/L, in five cases. These data serve to heighten awareness of insufficient milk syndrome as a potential consequence of postpartum hemorrhage. Early postpartum review of all breast-feeding mothers and infants is strongly encouraged.

Key Words: breastfeeding • hypernatremic dehydration • insufficient milk syndrome • postpartum hemorrhage

Journal of Human Lactation, Vol. 11, No. 2, 123-126 (1995)
DOI: 10.1177/089033449501100218


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