Hello out there! I'm looking for evidence--or your clinical
observations--around hypertension (chronic, PIH, pre-e) and its effect on
lactation. I have so many questions, but a search through my available
resources didn't turn up much. Many mothers I see with hypertension that is
severe, poorly controlled, or lasts into the postpartum period do not make
milk well early on. Can anyone explain (or make a guess about) the
mechanism of this? Does the low production typically persist?

I also wonder if antihypertensive meds often suppress lactation--although
it's hard to tease apart the medication from the condition itself. There's
plenty of data telling us meds like labetalol are "safe" for breastfeeding,
as they are unlikely to affect baby, but what about their impact on milk
production? And should a mother's production rebound when she stops the
meds?

What specific strategies have you found to be effective for helping
hypertensive moms make milk and guide them through the establishment of
breastfeeding? This is tricky because there are often additional risk
factors at play, like obesity, induction of labor, preterm birth and all
the attendant disruptions to the normal course of things.

There is so much that I wonder about!

Thank you,

Julie-Ann Toalston, BA, IBCLC
New Britain, Connecticut, USA
...Who is presently snuggling and nursing her adorable toddler through a GI
virus

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