Hi Barbie, we haven't "talked" in quite a while!

I have quite a bit of experience with this, although we don't refer to
it by that name anymore.  Instead we use PIH (pregnancy induced
hypertension) or preeclampsia.  They aren't exactly the same, but close
enough for our purpose here.

It is typical for women experiencing this complication of pregnancy to
have delayed lactogenesis.  My experience is that 5 days is common,
sometimes as late as 7 days.  Depending on the situation, I encourage
them to nurse as often as possible, or pump every 2 hours.

I believe that the reason for the delay is that they frequently get a
bit "shocky" from the disease process and the body shuts down
non-essential (to mom) functions in an effort to consolidate resources,
energy and blood, to the essential organs, i.e.. brain, liver, kidneys.
Once the body recovers, then normal functioning returns and this usually
takes 2-3 days, then you have the usual 2-3 days of beginning bringing
in the mature milk.  "My" moms do have colostrum during the entire time,
which is very fortunate for baby.  You have to use supplements very
judiciously so as to not interfere with the whole process.  If the baby
was a normal, full term infant, you might want to just watch for signs
of dehydration and closely monitor weight to see if supplementation is
absolutely necessary.
--
Denny Rice, RN, IBCLC
Dallas Texas USA

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