I completely agree with Barbara about delayed Lactogenesis2. I have had three moms in the past couple of months with excatly this situation--2 of them had the most horrible edema. Two of the moms began pumping shortly before seeing me (one at 4 days, the other at 6 days), but in both cases, we needed to use herbs to get the supply going and with the mom I saw later, we also needed to use domperidone (I try to never have my clients use Reglan). The third mom did not have edema, but the birth was terribly traumatic and the baby was not latching efficiently at all. That mom also needed domperdone to fully establish her supply. All moms might have eventually had a full supply without galactogogues, but I prefer to start sooner and stop the AIM as soon as possible. Also, I think moms are less likely to give up if they can see progress sooner rather than later. Two of the babies are now fully breastfeeding and the other mom has a full supply, but baby is not yet willing to latch w/o a nipple shield. Interestingly, all three babies had traumatic births and all 3 needed CST to feed well. Also, one of the moms received acupuncture and the other received chiropractic to assist in releasing the trauma from their own bodies.
Jennifer Tow, IBCLC, CT, USA