Hi everyone!

Welcome to all the newcomers once again.  The learning curve on this keeps
going up!  I love it!  Thanks too for all the input on older women and lack
of milk supply.  When you start seeing things in practice that aren't
documented in the literature, you begin to wonder if you are just seeing
things, or if they are really there....  I've got another one for you:

How many of you have seen a relationship between Pitocin induction and delay
in milk production?  Now, let me qualify that.  There are two things that I
see in practice.  One is that moms that have been induced (not stimulated,
but induced), especially over several hours - and it isn't uncommon for an
induction to start one day, be stopped, and finished up the next (all too
often with a C/Sec for failed induction, I'm afraid), seem to end up with a
delay in milk "coming in."  The antidiuretic effect of the Pit may cause
edema of the breast and nipple tissue; the mom often has flat "meaty" nipples
that are hard for the baby to get around to compress the areola.  She'll tell
me they look a lot different than they did before delivery, and the staff
complains that "she should have done something about those flat nipples
during pregnancy!"  Also, she'll have a lot of edema in the ankles that
wasn't there prior to labor.  Milk production seems to be inversely
proportional to decrease in edema, so for some of these moms, milk doesn't
really come in for about 3-5 days instead of 2-3.  Again, this usually
happens in primips, because they are the ones that have the prolonged
inductions. Sometimes there is a delay in milk even if the baby is latching
on and breastfeeding well from the beginning because the breast tissue isn't
affected.  (I'm sensitive to the problem of the meaty nipples/failure to
latch on therefore no milk issue) Multips, if induced, generally dilate
faster, and I don't see as much edema and nipple problems in them.  Any
thoughts?  And, if others have seen this, and know how and why it happens, is
there anything we can do to speed the process along?  Attendant with milk
production delay is often a fussy baby, a mom who assumes she doesn't have
enough milk (and truly, she probably doesn't right now), supplementation, and
voila, all the problems attendant with that.

Jan Barger
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