Why Did My Milk Come in Late?

September 05, 2018

Written by Tanya, IBCLC  

You've given birth and are waiting for your milk to come in.  And waiting. And waiting.  

For those of us who find that our milk has come in late - generally defined as later than 72 hours after birth - it can be a frustrating and puzzling experience.  

So, what are the factors associated with a delay in milk coming in?  

According to Breastfeeding Answers Made Simple, there are a number of factors having to do with us (as mothers), including: 

  • Being a first time mother
  • Diabetes
  • Overweight and obesity
  • Hormonal conditions (PCOS, thyroid or pituitary issues, hypertension, luteal phase defect, prolactin resistance, theca lutein cysts)
  • Medications (pseudoephedrine)
  • Underdeveloped breasts (insufficient glandular tissue)
  • Breast surgery or injury
  • Unusual nipple anatomy or piercing

There are also factors related to your birth, including: 

  • Cesarean birth
  • Long labor or traumatic birth
  • Preterm birth
  • Retained placenta
  • Blood loss of more than 500 ml

And yet more factors associated with feeding and contact after the birth:

  • Little or no breastfeeding or milk expression
  • Separation of mother and baby, little to no skin-to-skin contact
  • Any condition of the baby that limits the baby's breastfeeding or breastfeeding effectiveness

What should you do if you find that your milk has come in late?  

Get help as soon as possible from your health care provider, and breastfeeding support people, including a lactation consultant (IBCLC), a La Leche League leader, a Breastfeeding USA counselor, or your local WIC office breastfeeding peer counselor.  In addition, kellymom.com has some good advice for when your milk comes in late, including optimizing feedings and monitoring your baby's weight gain. 

Breastfeeding support works best when you get it early, so never hesitate to reach out for help! 

This post is provided for educational purposes only and is not intended as medical advice.  Contact your health care provider for care for any medical condition. 


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