I also cannot find any evidence that hypertension specifically can cause low milk supply. I am mostly finding information that breastfeeding can reduce the risk of hypertension. I have also seen delays and low supply concerns in moms with hypertension, but I think it has more to do factors related to having hypertension/pre-eclampsia versus the hypertension itself.

We do know that treatment with magnesium sulfate can cause a delay in lactogenesis II. From my experience in the hospital environment, this medication makes mom very drowsy so she may not be latching or pumping as often as she should. Babies tend to be much more lethargic as well if mom was on mag before and/or after delivery so feedings aren't ideal. If you add in baby being in the NICU, then that could also be another hurdle to overcome. Many moms with pre-eclampsia end up with c-sections which is another factor that can delay lactogenesis II. High blood pressure tends to cause fluid retention so the extra pressure in the breasts could affect supply. So premature/sick baby, magnesium sulfate, c-sections, retained fluid all can have an affect on mom's supply. These are just observations from my experience and from what I've learned over the years.

The best way to support mom is to help her with getting that extra stimulation (more latching and pumping) and if that isn't working then galactogogues can be tried.

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