Rhoda asks some interesting questions about the timing of the milk coming
in after placental abruption.  My feeling is that this is within the normal
range - average may be 72 hours, but some are earlier and some later.  For
the baby not to be compromised by the abruption I'd say what was left of
the placenta was functioning efficiently right up until the time of
removal.  Very lucky baby!
The more recent literature suggests that it's not the method of birthing
that could delay lactation (ie caesarean section), but the degree of stress
experienced.  Lactogenesis II is an endocrine function, so it's only
hormones that can delay it .. and cortisol from stress will do it.  That's
also why, in our discussions a couple of weeks ago, that anaemia or degree
of blood loss won't effect it until the degree of blood loss is sufficient
to cause catastrophic hormonal problems.

Now the question I would love answered is along the same lines.  Those of
you who have cared for a woman who went into preterm labour, which was
subsequently controlled, but the mother proceeded into lactogenesis II ....
what happened in the lactation when the baby was finally born?  I have seen
the hypothesis that it is the administration of the betamethasone to the
mother to help mature the baby's lungs that could cause the onset of lact
II in the 'still pregnant' woman.  And there are several posts in the
archives asking others about this, but I haven't seen any replies to what
the long-term outcome was.

Very interested
Denise

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Denise Fisher
Health e-Learning
http://www.health-e-learning.com
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