Recognizing and treating delayed or failed lactogenesis II.

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.