Retained placental fragment

Can passing a piece of placenta one week after delivery affect my milk supply?

Sometimes a piece of placenta (fragment) remains in the uterus after delivery (retained). The fragment may continue to produce a hormone (progesterone) that makes the body behave as if it were still pregnant and keeps it from making milk. In order for the milk to come in, the fragment must be removed, either by the uterus expelling it or by surgery. Having a retained placental fragment may result in the milk coming in late or in the mother never having enough milk.

A) Describing a retained placental fragment

Sometimes a piece (fragment) of placenta, the organ that feeds the baby in the uterus, stays in the uterus for days or even weeks after delivery. This situation is called having a retained placental fragment.

It is significantly less likely after a Caesarian delivery compared to a vaginal delivery.

B) Effects of a retained placental fragment

Some fragments have no effect on breastfeeding. Others continue to secrete the hormone progesterone into the mother’s body as long as they remain in the uterus. This causes the body to behave as if it were still pregnant. The fragment must be removed for the milk to come in (Knill 2021; Neifert 1981). Sometimes the uterus can expel it on its own and other times it may need to be surgically removed.

Having a retained fragment of placenta can result in the milk coming in late or in the mother never having enough milk.

Mothers who have a retained placental fragment may also notice one or more of the following:

  • Heavy bleeding
  • Cramping and pain
  • Fever
  • A bad vaginal odor

References

Knill CN, Crandall RS, Jurus DT. Insufficient Lactation Leading to Postpartum Diagnosis of Placenta Accreta Spectrum Disorder in a Primigravid Patient. Obstet Gynecol. 2021 Feb 1;137(2):273-276

Neifert MR, McDonough SL, Neville MC. Failure of lactogenesis associated with placental retention. Am J. Obstet Gynecol 1981; 140:477-48