The study analyzed the medical records of 325 women aged 35 and over who gave birth by caesarean section in a Chinese hospital in 2021-2022. Delayed lactogenesis II (DLII), i.e. copious secretion of milk after 72 hours after delivery, affected 117 women (36%). Independent risk factors were older maternal age (aOR=1.15, 95% CI 1.01–1.32), higher pre-pregnancy BMI (aOR=1.10, 95% CI 1.00–1.22), primiparity (aOR=1.74, 95% CI 0.71–?) and shorter gestational age (aOR=0.95, 95% CI 0.55–0.91). Conversely, elective caesarean section and early postpartum measures (rooming-in within 24 hours, initiation of breastfeeding within 24 hours, skin-to-skin contact) reduced the risk of DLII (all p<0.05). The developed predictive model with nomogram achieved AUC=0.870 (95% CI 0.830–0.910) and good calibration (Hosmer-Lemeshow χ²=5.60, p=0.692). The model is used for early risk identification and breastfeeding support.