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What Causes Delayed Milk Production, According To Experts

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Lactogenesis isn’t just a great spelling bee word — it’s the scientific term for the process of a woman's body making milk for baby. And when lactogenesis is delayed and your milk supply comes in later than you might hope, it's a stressful situation for mom and baby. But what causes delayed milk production? There are a number of risk factors for moms to keep in mind.

“Many people are under the impression that it’s normal for milk to come in three to five days after delivery,” says Lynnette Hafken, MA, International Board Certified Lactation Consultant (IBCLC), in an interview with Romper. “While this may be common, milk coming in later than 72 hours is considered delayed.”

The first few days after birth, women produce an early form of milk called colostrum. Colostrum comes in small amounts, and most babies drink about an ounce per day, which is sufficient for their tiny tummies. After those first 72 hours, the next stage of milk production (lactogenesis II) should transition colostrum into mature breast milk. When that stage is delayed, baby could be "at risk of insufficient feeding," says Hafken. And if baby isn't feeding early on, that can affect breastfeeding in the long-term. “The insufficient stimulation of the mother’s breasts can also threaten her plan for continued breastfeeding by permanently reducing her supply,” she says.

So, what can make your milk supply come in late? Here’s what the experts say can contribute to delayed milk production.

1. A Stressful Labor & Delivery Can Delay Milk Production

Jody Segrave-Daly, RN, IBCLC, cites a study that looked at how a woman’s stressful or traumatic birth affected her milk supply. The findings confirmed that the longer and more stressful labor is for mom and baby, the later her milk supply will develop.

If a mom loses a lot of blood during the birth, that can take its toll on milk production, too. “The weakness and fatigue that accompany blood loss often disrupt the mother’s ability to hold and breastfeed her baby,” Segrave-Daly says. She adds that major blood loss can also lead to Sheehan's syndrome, which can result in difficulty lactating.

2. Having A Chronic Illness Can Delay Milk Production

Segrave-Daly says not every chronic illness is associated with delaying your milk production, but some may include:

  • Autoimmune diseases, like Crohn’s disease, lupus, multiple sclerosis, rheumatoid arthritis, and ulcerative colitis
  • Diabetes, type 1 or 2
  • Hypertension
  • Hypopituitarism
  • Hypothyroidism
  • Polycystic ovarian syndrome
  • Sickle cell disease

Most importantly, she says having a chronic illness does not mean a mother can't breastfeed successfully. It is, however, something women with chronic illness should discuss with their doctor and lactation professionals.

3. Having A Preterm Baby Can Delay Milk Production

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Preterm babies are those born before 37 weeks gestation, and Segrave-Daly points out that they can have a tougher time breastfeeding.

“Your baby may have some difficulty if they’re small for their gestational age, or are born with any oral abnormalities making it hard to breastfeed,” she says. Babies born earlier than term often do not have the energy to vigorously suckle, reducing stimulation to the mother’s breasts, says Segrave-Daly. "Infrequent and ineffective feeding can delay lactogenesis due to decreased removal of colostrum and possibly because the mother’s body is not getting as strong a hormonal signal,” she says.

4. Having A High BMI Can Impact Breast Milk Production

Another primary risk factor for delayed milk supply is having a body mass index (BMI) in the overweight or obese range, according to Segrave-Daly. While BMI’s validity for gauging healthy weight has been questioned, she still suggests keeping it in mind as a guideline.

5. Major Stress During Your First Trimester Can Delay Your Milk Production

While physical stress during labor and delivery has a direct impact on milk production, so can mental stress months in advance. When major life changes or losses occur, they can take a toll on the body, and this includes milk production in pregnant women.

Segrave-Daly says in a study of 3,316 women, "Stressful life events, such as job loss, divorce, or the death of a family member in the first trimester of pregnancy were correlated with delayed onset of lactogenesis."

With all these risk factors in mind, what can a mom-to-be really do? Many of these situations are out of women’s control, but there are certain things you can do to make the best of a delayed milk supply.

“We do have some evidence that the more breastfeeding a baby does in the early days, the greater the overall milk production," Hafken says. "If a mother is separated from her baby, she can hand express and pump her milk to encourage her body to make more.”

Both experts agree that moms who have delayed milk supplies can still go on to breastfeed successfully when their milk is ready.

“A delay in lactogenesis does not mean chronic low milk production,” says Segrave-Daly. “Once the milk starts coming in, whether on day four or day 10, frequent and thorough milk removal is a powerful way to support full milk production.”

The most important thing a new mom can do is avoid blaming herself for whatever amount of milk her body produces or how long it takes to get there, says Hafken.

Experts:

Jody Segrave-Daly, RN, IBCLC, cofounder of the Fed Is Best Foundation

Lynnette Hafken, MA, IBCLC