Your first ever breast milk has a special name – ‘Colostrum’, and for a good reason. After all, it is so very special. A little low on the volume side but positively bursting with immune factors, this special milk is actually synthesized by your breasts long before the birth of you baby. Post delivery, a chain of events stimulates breast milk production regardless of your plans of breastfeeding.
Yes, it’s possible that initially, you aren’t able to yield the colostrum by yourself or on the other hand, you’re anxious about why the milk hasn’t come in yet or if it’s late. But a true failure of your breasts to synthesize milk is very rare. Almost certainly, mommy, there is going to be some breast milk. It’s just late, and we’re here to figure out exactly why.
Reasons For Delayed Breast Milk
Colostrum usually arrives 32 to 40 hours post your delivery. Two to three days after the birth is generally when mothers notice the arrival of breast milk. In 25% of mothers, however, the breast milk can arrive up to 5 days later (1). When breast milk is slow to arrive, we refer to it as “delayed onset of lactation”. Nevertheless, just ‘cause your breast milk is late doesn’t mean it’s ultimately not arriving. Certain medications as well as some birth practices could all be a possible reason for the delay. Here are the likely culprits:
1. Factors during delivery
- A stressful or traumatic birth: A prolonged labor, the use of forceps or having a C-section can affect stress hormone levels that could delay breast milk (2).
- Large volumes of IV fluids: If administered during the birth, they could engorge your breasts, thereby delaying milk availability until the engorgement subsides.
- Losing too much blood: If greater than 500ml is lost, it could potentially damage the pituitary gland residing in the brain, which is responsible for triggering lactation (3).
- Still retaining fragments of the placenta: Can lead to high progesterone levels whose drop is required to stimulate lactation.
- Meds for pain relief: When given during labor, they have been linked to delayed breast milk production (6).
- Damage to nerves: Especially those nerves involved in ‘letting down’ of milk, or if your spinal vertebra is misaligned – can all impact milk production. Manual therapy has been found to help such mommies (7).
- Premature birth: Could mean that your breasts didn’t have enough time to develop glandular tissue to produce milk. Though this will affect your initial breast milk supply, if carefully managed, glandular tissue can still continue developing post birth.
2. Poor breastfeeding start
Every new mommy is taught this cardinal rule: “If milk isn’t removed, the breast milk production will begin to close down.” Removal of the early milk during those first few hours and initial days have been associated with a higher breast milk yield. Hence, hand expressing or breastfeeding during that first-hour post birth is vital (8, 9). Without frequent milk removal, the production of milk closes down.
3. Medical condition
- Diabetes: This is a condition where we either can’t produce insulin (type-1) or we aren’t able to use it (type-2). Since insulin is one of the major hormones responsible for milk production, fluctuations in its levels can have an impact on lactation. But, if a diabetic mother carefully controls blood sugar as well as insulin levels, she should have a stable milk supply.
- Medications: Certain medications, like hormonal birth control pills, especially during those initial few months, can lead to decreased milk supply as a side effect (10).
- Being obese or overweight: If your BMI pre-pregnancy is greater than 26, then this is considered as a risk factor for delayed milk production and also a lower supply (11, 12, 13).
- Age: If you’re an older first-time mommy then this could also put you at risk of experiencing delayed breast milk production (14).
Most mothers who experience delayed onset of lactation start stressing about it, which raises their cortisol (read: stress hormone) levels, and only serves to create a vicious circle. The true failure of lactation is, once again, very rare. Consult your doctor for more information and concerns.
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