I have posted before and include in my lectures on risk factors for estab.
lactation discussion of systemic maternal edema and observed delayed onset
lactogenesis II.  For years I have noted that there is a tendancy for moms
with those swollen ankles, etc. to have no early experience of engorgement.
Their milk trickles in, and doesn't typically build to a good supply for
several weeks.  In the meantime, the baby can't wait that long and often
needs supplementation to hold them over until the milk shows up.  I see it
with PIH (pregnancy induced hypertension) and have seen it in some women who
haven't had IV fluids, but it is most common in women with pitocin
inductions who have had lots of IV fluids.  I definately think this needs
study.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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