Recognizing and Treating Delayed or Failed Lactogenesis II

Nancy M. Hurst, RN, DSN, IBCLC


J Midwifery Womens Health. 2007;52(6):588-594. 

In This Article

Abstract and Introduction


Delayed or failed achievement of lactogenesis II -- the onset of copious milk volume -- occurs as a result of various maternal and/or infant factors. Early recognition of these risk factors is critical for clinicians who interact with breastfeeding women so that intervention and achievement of full or partial breastfeeding can be preserved. This article describes the maternal and infant conditions that contribute to the unsuccessful establishment of a full lactation. Treatment modalities that can maximize maternal lactation capacity and infant growth rates are offered.


One of the most frequently cited concerns voiced by new breastfeeding mothers is the question of whether she is providing sufficient milk for her infant.[1] This concern, coupled with the national initiative to increase breastfeeding rates,[2] points to the critical responsibility of clinicians who care for breastfeeding women to ensure proper instruction and follow-up when needed. The ability to recognize delayed or failed lactogenesis is essential so that clinicians can intervene to both assure that infants' nutritional needs are being met and to potentially preserve full or partial breastfeeding. This article describes the normal onset of lactogenesis and conditions whereby lactogenesis II is delayed or fails to completely attain sufficient milk volume levels to support adequate infant growth. Implications for clinical practice and suggested management strategies are reviewed.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.