What to do when your breast milk is delayed
In the first days following delivery, your milk volume may not reach the necessary amount to feed your child. This situation is rare and understandably upsetting, but it doesn’t necessarily mean that you won’t be able to breastfeed. There may be an addressable underlying cause.
What it is
After you’ve delivered your baby and placenta, your levels of the hormones estrogen and progesterone drop, making way for rising levels of prolactin and oxytocin. Your baby’s suckling then stimulates the nerve endings in your nipple and areola, which signal your brain’s pituitary gland to release these two hormones.
Prolactin prompts your alveoli, or sacs inside your breast, to convert proteins and sugars from your blood supply into a transitional breast milk that is thinner and whiter in consistency than the initial colostrum your breasts release. And oxytocin triggers your breasts’ small clusters of alveoli, called lobules, to release the milk stored in them, as it widens the milk ducts for easier flow to the nipple.
Sometimes a disruption or delay in this process results in a delay in the production and release of your transitional milk, commonly known as your “milk coming in.”
When it can occur
Transitional breast milk typically comes in between two and five days after you’ve given birth, when your body would normally be transitioning from colostrum to actual breast milk. But sometimes it can take a couple weeks—at which point it is considered delayed.
What causes it
Many factors can play a role in delaying the increase of your milk volume. If you had a C-section or a premature birth, where your baby was not immediately with you and able to nurse, your body may take longer to produce milk. It may also take longer, if you experienced a postpartum hemorrhage or a retained placenta (where a piece of the placenta remains in the uterus post-delivery).
If you experience less than adequate breast stimulation in the first hours and days after giving birth, whether it’s from being separate from your baby, your baby being sleepy, having latching issues, or just infrequently breastfeeding, you could also experience a delay in your milk coming in. Certain health conditions, including diabetes, polycystic ovary syndrome, and thyroid issues, can also play a role.
What to do
While the experience can be upsetting, there are things you can do that might help:
- Frequently stimulate your breasts: Breastfeed whenever your newborn shows hunger cues, at least 8 to 12 times every 24 hours. Consider hand-expressing or pumping, if you’re separated from your baby, as this can also help stimulate your milk production.
- Assess your baby’s latch: Sometimes babies lose too much weight after birth because of an inefficient latch, not because of your supply. Prematurity and tongue tie can also result in lower than adequate milk transfer. A lactation consultant or other health care provider can help assess your baby’s latch to help you create a supportive plan.
- Try pumping: High-quality pumps with adequate suction can help encourage milk flow, so your lactation consultant may recommend that you try to pump to get your milk more freely flowing.
When to get help
If your milk has not begun transitioning from colostrum, or your breasts aren’t feeling fuller three to five days after birth, consult with a lactation specialist. If you have a medical history that includes diabetes, polycystic ovary syndrome, or thyroid issues, your lactation specialist may work closely with your other health care providers to come up with a solution.
Additional resources
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