When DOL is suspected, intervention should be cause-driven, with a common purpose to improve<unk>  performance. The strategies include<unk>  consultation, regular removal of milk from breasts, nipple stimulation or surgical procedures to remove the retained placenta.<unk>  consultation Mothers experiencing breastfeeding difficulties are often being referred to the<unk>  consultants attached to the maternity unit or a child-and-family health center.<unk>  consultants provide breastfeeding assistance, training and advice for the mother-infant pairs facing challenges during breastfeeding. For instance, the consultants provide suck training. It is a special technique aiming to help infants with difficulties in coordinating with the undulation of the tongue to learn proper muscle coordination in breastfeeding. In addition, these trained experts can intervene by supporting mothers in establishing long-term breastfeeding goals, as well as by giving practical assistance in breastfeeding. It is also observed that obese women and women undergoing emergency cesareans are likely not to breastfeed owing to the fear of DOL or breastfeeding failure. In such cases, effective and sustained breastfeeding can be initiated under a supportive environment, which can be achieved through providing emotional sessions and informing them about the minimal amounts of colostrum secreted on day one postpartum, to increase their confidence in breastfeeding. Regular removal of milk and nipple stimulation Breast emptying using breast pumps can increase the chance of successful establishment of lactogenesis.234x234px<unk>  is maintained by routine deposition of milk and nipple stimulation, which triggers prolactin and oxytocin release from the pituitary glands. Women are encouraged to remove the milk from their breasts every 2 to 3 hours to maintain a steady milk supply. Effective ways of emptying the breasts involve breast pumping with a hospital-grade breast pump, for the pumping action promotes complete breast emptying and breast stimulation. This emptying process has to begin at around day three postpartum to increase the chance of successful establishment of lactogenesis. Stimulation of the nipple can also be achieved by means of terminating estrogen treatment and supplementation. Estrogen treatment can diminish nipple sensitivity, which leads to decreased prolactin release. Therefore pausing estrogen treatment can effectively restore nipple tactile-sensitivity to infant suckling, thereby activating the release of lactogenic hormones. Placental fragment removal Removal of placental fragments is needed when the placenta cannot be expelled by natural uterine contraction, this can be illustrated with two scenarios that require different treatment methods. In situations where fragments have been separated from the uterus but yet to be expelled, manual extraction will be performed by directly pulling the detached placenta by hand to bring it outside of the body. Whereas in cases where placental fragments are firmly attached to the wall of the uterus, dilation and curettage is the definitive and therapeutic method of choice. Once the remaining placenta is removed, the mother will be able to restore the expected decline in progesterone level and initiate the<unk>  of<unk> .
Delayed onset of lactation
Low milk supply
Poor ovarian reserve
Lactational amenorrhea
Postpartum physiological changes
Obstetric transition
Premenstrual water retention
Primary ovarian insufficiency