Bf, pg and low-lying placenta (and bleeding therefrom)

[berolina]

I'm 17 weeks pg. As described on my thread over in Pregnancy, I was in hospital on Fri/Sat after having a sudden and fairly copious but painless bleed, which apparently came from my placenta, which is low-lying and part of which appears to be touching the cervix. I know it can and probably will 'move' up over the next few weeks, and am hoping it will. But the doctor who examined my when I was admitted said I should be weaning ds (who'll be 2 next month) over the next few weeks because the oxytocin-induced contractions from bf can provoke further bleeds. I really don't want to wean him - he's currently showing no real signs of imminent self-weaning, although he is asking for milk less frequently (or often he'll ask and then be distracted by something else before I have a chance to feed him) and although I usually still do have to bf him to sleep, he'll often bf but only go to sleep when I hold and rock him (without him bf at the same time) for a bit. I didn't feed him at all from Thurs evening until Sat morning (due to being in hospital) and my breasts really weren't engorged at all, which is making me think my supply is dwindling anyway (and dh didn't have much of a struggle at all to get him off to sleep). But the last thing I want is to wean him against his wishes. I thought I'd get a second opinion here, as I could see the scepticism on the doctor's face when I told him how old ds is (you know, the old 'what, she's still at it?' reaction ). Any advice, anyone? What if this does actually turn into placenta praevia?
TIA

Hi Berolina - I'm sorry that I don't have any advice for you on this one - it's a really hard situation. I hope someone else comes along soon who can help.

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x posts jw! thank you

i;d get a second opinion re stopping BF

is the risk

a) blood loss

or

b) abruption

if it is b, that is more dangerous , IMHO , non medical opinion too !

placenta previa is what you have, i beleive...~BUT there are four grades, with 1 and 2 being near or just on the cervix, 3 and 4 partially and fully covering the internal os of the cervix, which if you tried to deliver vaginally would cause horrendous bleeding

it cannot get lower than it is now, so there is every chance as your uterus grows and stretches up, it will move ,

are the oxytocin induced contractions really that powerful at this stage...when you are feeding a new born, they are , but at aged 2, and pregnant again, surely the contractions are not the same?

i might be talking absolute nonsense ( it has been known ) so would seek an opinion from another doctor and speak to someone in La Leche or elsewhere re the whole oxytocin thing....would be to stop bf, having come so far if there is a chance you don;t need to x

Thank you lulu

Doctor suggested renewed bleeding was the risk, didn't mention abruption. He said atm the womb is not that responsive to oxytocin but that would change in the next few weeks as the pg progresses. But OTOH I think you must be right about the contractions being weaker/different than the typical newborn bf ones. I certainly haven't noticed any in this pg so far.

Oh, and the MW in hospital said I shouldn't rub my tummy (not even stroke it gently) as that can cause contractions??? Is that right?

Well, it IS already placenta praevia and it IS serious. I had it! I wasn't breastfeedign when I was pg with ds (first child) so don't know about effects on placenta/contactions, but it is a very serious medical condition.

just seems to me, that the nursing / pregnant womans body would be doing all it could to sustain the feeding child and to sustain the baby in utero..so surely the oxytocin levels would be different???

just don;t know

but would not stop BF until absolutely sure , as you know, there is such poor advice given re BF a new born, never mind a toddler, that you might well have had the wrong advice..i know you don;t want to do anything that might interfere with this pregnancy, but by the same token, you do not want to end up weaning before you and your DS are ready to , if it is not neccesary..

hard call, isn;t it?

see another obstetrician if you can, definitely seek outside help and opinions, LLL being a good place to start, i would have thought

sorry cannot offer more help x

aloha, I thought at this stage of pg they wouldn't call it PP yet because it's likely to 'move'? Going by lulu's description of the various grades and what the doctor said to me after the scan I would suppose it's about a grade 2.

x posts lulu - I know a LLL person so will talk to her, and expect I will go and see my regular gynaecologist sometime this week, see what she says. I tried kellymom but they only talk in very general terms about the (non-) effect of bf on premature labour.

(and thanks )

i hope you get some good advice..

Sorry, didnt' mean to scare you. Yes, things may well change, but it is very low and you should be careful. I do have no idea about any real risks involved in breastfeeding though. Certainly not against breastfeeding!

s'alright aloha - suppose it's no good me blithely assuming it'll move only to be completely unprepared if it doesn't.

Hi berolina, I had a low laying placenta with my dd2, had alot of bleeding, my placenta didn't move and I had a C.section. I really feel for you as it is a terrifying thing when you see blood, I have not heard of not being able to touch your tummy after all its the baby who starts the contractions not stroking the tummy.. I'm not in the medical proffession though so don't quote me on it.

I wold recommend not lifting anything or walking too far etc.. rest lots & put your feet up, also check you are not group B strep positive as if you are and you are bleeding your baby could be at risk of a group B Strep infection comming in from the birth cannal.

You will be in hosptial alot for regular monitoring & probably in the late stages too.

My thoughts are with you

Sorry I didnt brestfeed when I was pregant.

yes, the tummy stroking thing does sound rather odd, doesn't it Can I have a GBS test now, or does it need to be near the due date?

erm I think it can only be done at around 35 weeks, the NHS dont like doing the test as it costs money but you can have it done privatley for about £18 (and the results of this one are around 95% accurate)

My dd2 was born with a GBS positive infection, she survived but only just If you are positive then all you will need is antibiotics via a IV line 4hours prior to delivery (and it must be 4 hours in order to cross the placenta)

Yes stroking your bump can cause contractions - I can vouch for it (well sort of)

I had an irritable uterus when I was preg with DD3. This basically meant that it would contract under certain circumstances, such as

Urinary tract Infection
Full bladder
Upset bowel (actually put me in hospital with threatened premature labour)
Baby moving
Touching my bump

I had heard that stroking your bump can cause contractions before but was sceptical. In my case (and my uterus seemed pretty responsive to all of the above) it took a bit more than a stroke. That said an examination by the midwife would certainly set it off. Indeed in one instance it triggered weak contractions every 5 mins for nearly an hour (which was obviously concerning at 24wks!!!).

Come to think of it, Hillary, I had a GBS test at about 34 weeks in my last successful pg - I can't remember whether I had to pay for it or not (am in Germany, have health insurance, not the posh kind though). Is there an extra risk with PP? Your poor dd - glad she was alright in the end.

SMS, how scary for you - I'll duly keep my hands off my bump, which isn't easy as it's already lovely and round, and I think I've started feeling the baby move

As I said - it took a bit more than a stroke to set me off. I would get the odd contraction if I tried to prod baby too often (I liked playing with her foot when she was kicking!).

The long chain of contractions were set off by a particularly heavy handed MW who decided she would do a ward round with the doppler at 6am. I was not impressed, and neither was my consultant who then had to keep me in hospital for another 24hrs!!!

I just wanted to assure that contact ith your bump can trigger contractions and that your MW isn't talking a pile of crap. I am sure gentle stroking will be fine.

Oh and I don't know if it has been mentioned either on here or in RL - but if you are worried about oxytocin release causing Contractions - sex and orgasms are def worth avoiding (sorry!) as they def cause oxytocin release.

thanks sms - fortunately the thought of sex makes me rather atm, so no hardship...

6am no danger of that here, fortunately

did you get a 2nd opinion re bfing? i ask cause was told by 1 dr that bfing would increase chance if mc then by 2nd dr & mw that that was misintperpreting the research. i know its not the same thing but may be worth checking.

mush, afaik bf does not increase mc risk (there's a page on this on www.kellymom.com) and does not increase prem labour risk in healthy pgs - haven't been able to find anything about PP yet though.