Delayed Onset Milk Production

The Causes and Signs

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With your first baby, it could take longer for your milk to come in. Ariel Skelley/Getty Images

The first milk that your baby receives after birth is colostrum. Colostrum is concentrated and produced in small amounts so it doesn't make your breasts feel full. The change of colostrum into the creamy transitional milk that fills your breasts takes a few days. This filling of the breasts usually starts at approximately the 3rd day postpartum, but for some women this process is delayed.

The Causes of Delayed Onset Milk Production

  • A First Baby: If you're having your first baby, you may experience a slight delay in your milk production. It could take up to the 5th day postpartum for a first-time mother's breasts to fill up with milk. With your next baby, your milk will most likely come in sooner.
  • A Difficult Delivery: A long stressful labor, and a traumatic birth experience with the use of anesthesia, pitocin, and an abundance of IV fluids, can slow down the production of breast milk.
  • A Premature Delivery: Although your body is capable of making breast milk by the end of your second trimester, the early end of pregnancy, the stress of a premature delivery, and the inability to breastfeed your preemie immediately after birth, can delay the production of your milk.
  • A C-section: Due to surgery, stress, pain, and the emotional factors associated with having a cesarean section, it can take longer for your milk to come in.
  • A Poor Latch: Any problems with your baby's ability to latch on and breastfeed can interfere with the initiation of milk production. Newborns with a tongue-tie, cleft lip/palate, or neurological issues may not be able to latch on well. Or, if your nipples are flatinverted or very large, it may be more difficult to get breastfeeding started.
  • Diabetes: It may take longer for milk production to begin in diabetic mothers. This could be due to a combination of reasons including hormonal issues, the high rate of c-sections in diabetic mothers, premature delivery, and the separation of mom and baby at birth.
  • Other Hormonal Issues: Mothers who have symptoms of hypothyroidism or PCOS may also take longer to make breast milk.
  • Obesity: Being overweight before conception, or gaining too much weight during pregnancy, can interfere with the onset of your milk production after the delivery of your baby.
  • Retained Placental Fragments: When some of the placenta stays behind after childbirth, it can prevent the hormone changes needed in your body for milk production to begin.
  • Theca Lutein Cysts: These testosterone producing ovarian cysts can delay the onset of milk production. They normally go away on their own within a few weeks after childbirth. Once they resolve, the testosterone levels decrease allowing full milk production to begin.

The Signs of Delayed Onset Milk Production In Your Baby

When your breast milk supply is low due to a delay in the onset of milk production, your baby can appear constantly hungry and frustrated.

If it's only a slight delay, it isn't necessarily a problem. However, the longer it takes for your milk production to begin, the more dangerous it is for your child. If your baby shows signs of dehydration, jaundice and/or excessive weight loss, call the doctor immediately. These symptoms are serious and need to be corrected as soon as possible.

See Also: Tips For Dealing With A Delay In Your Milk Production

Sources:

American Academy of Pediatrics. New Mother’s Guide To Breastfeeding. Bantam Books. New York. 2011.

Hartmann, P. and Cregan, M. Lactogenesis and the Effects of Insulin-Dependent Diabetes Mellitus and Prematurity. The Journal of Nutrition. 2001; 131(11): 3016S-3020S.

Hurst, N. M. Recognizing and Treating Delayed or Failed Lactogenesis II. Journal of Midwifery & Women’s Health. 2007; 52(6): 588-594.

Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Seventh Edition.  Mosby. 2011.

Riordan, J., Wambach, K. Breastfeeding and Human Lactation Fourth Edition. Jones and Bartlett Learning. 2010.

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