We have a good-sized antepartum/high risk unit. I have seen MANY cases of ante-partum lactation and several cases of breast engorgement. This is probably related more to why the mothers are getting terbutaline than to the terbutaline itself. If the placenta is not functioning well, producing hormones that allow the pregnancy to fare well, perhaps it is not producing adequate amounts of prolactin inhibiting factor that stops lactogenesis. Think about moms with delayed lactogenesis related to retained placental fragments. Same process is probably involved here. I have tried to get our perinatologist interested in doing some research on this area. wouldn't it be neat if we could figure out and analyze the PIF with a blood test? If we detected low levels, we might be able to predict pre-term labor related to placental malfunction and do something to prevent. If we detected high levels, we could look at retained fragments as a cause of delayed production. I have also seen early engorgment and production with women with HELLP and other forms of pre-eclampsia which is also thought to have some relationship to placental function. Thanks, Jane Kershaw mailto [log in to unmask]