"Pregnancy Induced Hypertension can affect milk supply.  I'll be darned if I
can remember how, but seems like it has to do with fluid shifts and edema
for mom."

But 2 weeks out? The PIH, pre-eclampsia resolves very quickly after
delivery. So I would think that the problem is more likely to be created by
delay in initiating BFing, and any attendant problems secondary to that
whole issue, than by the physiology of the pre-eclampsia, etc. I've observed
over the years that some women who have had PIH have had a harder time
getting started with BFing, but it has always seemed to me to be related to
the fact that they've had a "medicalized" end-of-pregnancy and birth. They
(and those "managing" their care) have gotten used to being treated as
"patients", in need of a lot of extra care and precautions and of course
worry, and seem to me to have a hard time after the birth switching back to
"normal" mode. It *is* always hard to really believe that OK, the baby's
out, we're all OK, and now it's time to stop worrying and get on with the
next step.

As is the case, in fact, with "normal", uncomplicated births, to some
extent, and more so with C/S - that re-living and "taking in" stage of the
birth experience. I see lots of women (especially primips) who could easily
spend the first 3-4 days recovering and integrating this awesome thing
they've just experienced, and just not quite get around to focusing on
nursing the actual baby. Like, "Oh yeah, the BABY...You mean I should nurse
him so soon? So often? I'm tired, my bottom hurts, all my friends are here
and I have to tell everyone all about this, the baby's so adorable but he
just wants to sleep...". I'm not in any way being critical - this is a
normal and necessary stage, but even when those moms dawdle around too long
they have problems getting started. So medicalizing the whole process
certainly aggravates that, esp. if there's a lot of pain to mom involved.

Cathy Bargar, RN, IBCLC Ithaca NY

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