Just some context, I have worked in Tertiary Midwifery care hospitals and I recall a case where the woman had a case of accreta and the plan for her was a hysterectomy and methotrexate postpartum, and absolutely no breastfeeding or initiation of lactation. I understood this and the importance of possible PPH and of course lactation would unlikely be successful because of the remaining placental tissue, however recently I was advised that a LC helped a women to BF after her accreta pregnancy and I wanted to know if this was common and what others experiences were?
As far as I am aware the risk with breastfeeding in the first instance would be the methotrexate passing to the baby through the milk. Not all acreta/percreta placenta require hysterectomy and breastfeeding uses some of the same hormones as contractions so it can help the uterus contract down - with some placenta remaining this could be more difficult so increasing the risk of PPH there. However without the methotrexate or perhaps pumping and discarding the milk whilst it is being taken and then trying to initiate breastfeeding following, breastfeeding could be supported and safe.
Alex- student midwife
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