A Delay In the Onset of Breast Milk Production

What is it, what are the causes, and what are the signs

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

When Does Breast Milk Normally Come In?

The first breast 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 over from colostrum to 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, the process is delayed.

What Can Cause a Delay In the Onset of Breast Milk Production?

When breast milk doesn't begin to fill up the breasts by the 3rd day after childbirth, what can be causing the delay? Here are ten reasons your breast milk may be slow or late to come in. 

#1. It's Your First Baby 

If this is your first baby, you may experience a slight delay in onset of your breast milk production. It could take up to the 5th day postpartum for a first-time mother's breasts to fill up with breast milk. With your next baby, your breast milk will most likely come in sooner.

#2. You Had 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. Keep putting your baby to the breast as often as possible.

#3. Your Baby Was Born Premature

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 breast milk.

Use a breast pump to try to stimulate your milk production and pump your breast milk for your baby.

#4. You Had a C-section

Surgery, stress, pain, and the emotional factors associated with having a cesarean section can make it take longer for your breast milk to come in. Start breastfeeding as soon as you can after your c-section and breastfeed very frequently.

#5. A Poor Breastfeeding 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, a 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 harder to get breastfeeding started. Ask for help from your nurse or a lactation professional to be sure that your baby is latching on to your breast correctly.

#6. You Have Diabetes

It may take longer for milk production to begin in mothers who have diabetes. This delay 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. Put your newborn to the breast very often and have her monitored to be sure she's getting enough breast milk

#7.  There's a Hormonal Issue 

If you have symptoms of hypothyroidism or PCOS, it may take longer for you to make breast milk. Breastfeed your baby on demand at least every 2 to 3 hours around the clock and have your child's doctor monitor his weight closely. 

#8. You Are Overweight

Being overweight before conception, or gaining too much weight during pregnancy, can interfere with the onset of your breast milk production after the delivery of your baby.

Keep putting your little one to the breast to stimulate the production of breast milk and have your child's doctor monitor her to be sure she's gaining weight and growing at a healthy pace.

#9. You Have Retained Placental Fragments 

When part of the placenta stays behind after childbirth, it can prevent the hormone changes needed in your body for breast milk production to begin. Once your doctor diagnoses and removes the retained placental fragments, the hormones will shift, and your body will begin to make breast milk. 

#10. You Have Theca Lutein Cysts 

These testosterone-producing ovarian cysts can delay the onset of milk production.

They typically go away on their own within a few weeks after childbirth. And, once they resolve, the testosterone levels decrease allowing full milk production to begin.

Your Baby May Show These Signs If Your Breast Milk Isn't Coming In

When to Worry About a Delay In Your Breast Milk Production

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 breast milk to come in, the more dangerous it is for your child. If your baby shows signs of dehydration, jaundice, or excessive weight loss, call the doctor immediately. These symptoms are serious and need to be corrected as soon as possible.

 

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. 2015.

Riordan, J., Wambach, K. Breastfeeding and Human Lactation Fifth Edition. Jones and Bartlett Learning. 2014.

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