Delayed Onset of Breast Milk

The delayed onset of milk refers to the late arrival of mature breast milk. This occurrence is often referred to as the "coming in" of breast milk. 


How do my Breasts make Milk?


When should I Start Breastfeeding?

The first 20 to 30 minutes after birth is the best time to put your baby on the breast. During this time, he/she is still very alert and can easily latch on and start to suckle.

Read more about the benefits of breastfeeding immediately after birth. 


How Long does it take for my Milk to “Come In”?

The first milk your baby will drink is called Colostrum. It is a concentrated, high-protein, low-fat substance with a creamy look to it.

It is easy to digest and full of antibodies that are very important to strengthen your baby’s immune system. Read more about the immunity that breast milk offers a baby. 

The quantity of the Colostrum (a few spoons per feed) is more than enough to feed your baby during the first few days, before your mature milk comes in.

In normal circumstances, your mature milk will come in at the third or fourth day after birth. This is due to the production of a hormone called Prolactin.  Prolactin stimulates the mammary glands in your breasts to produce milk (lactation).

Read more about the different lactation hormones and how they work. 


Why the Delayed Onset of Breast Milk?

In some cases the onset of milk can be delayed, meaning it will take a few days longer to “come in”. Some mothers will only start producing milk after seven to fourteen days after birth.

A lot of research has been done on the delayed onset of milk, but the direct cause has not yet been discovered.

According to the experts, the following factors play a role in the delayed onset:

  • Some of the placenta might have been left in your body. This rarely happens, but it is still possible. The presence of the placenta will result in a delay of the production of Prolactin. If you continue to have heavy bleeding after birth, this could be the reason. A normal ultrasound should pick it up immediately.
  • Stress caused by a difficult birth or any other factors can influence your milk production.
  • Cesarean (surgical) delivery: A cesarean delivery is not according to nature and it may result in the delayed production of the hormone Prolactin. Rest assured, your body is amazing! The moment your baby suckles on your breast, your brain will get the message to start developing the hormone.
  • Postpartum hemorrhage.
  • Maternal obesity.
  • Infection or illness with fever.
  • Medical conditions: Medical conditions such as diabetes or thyroid conditions can cause slow or delayed production of milk.
  • Strict or prolonged bed rest during pregnancy.
  • Hormonal Issues (such as hypothyroidism or PCOS).
  • Theca Lutein Cysts: This is a type of cyst that produces testosterone and the heightened levels of testosterone can delay the production of milk. They usually go away on their own after a few weeks after birth. 


Signs of Delayed Onset of Breast Milk


What To Do?

  • Breastfeed as soon as possible.
  • Engage in skin-to-skin contact.
  • Breastfeed or express regularly (the more you express, the more Prolactin receptors will develop, thus more milk production).
  • Look after yourself (emotionally and physically).
  • Eat healthy foods.
  • Drink plenty of water.
  • Continue with prenatal vitamin supplements.


Signs that your Milk has “Come In”

  • Your breasts will feel full (heavy, warm, engorged, tingly and may feel hard)
  • Your breasts may leak.
  • Change in your baby’s feeding patterns.
  • The appearance of the milk will change to a white colour, which is much thinner than Colostrum.


Other pages on breastfeeding problems in connection with this page

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