No Breast Milk After Delivery: Reasons and Solutions

Discovering you have insufficient breast milk after birth can be heartbreaking. You likely spent months imagining that special bonding time, only to feel stressed when things don’t go according to plan.

But take a deep breath. Understanding why your milk isn’t immediately on tap can put your mind at ease.

It often takes a few days, or even weeks, for a full supply to establish itself. Let’s break down why milk production gets delayed and exactly what you can do to fix it.

What Stimulates Breast Milk Production?

Throughout pregnancy, your body is a hormonal highway. Players like prolactin, cortisol, oxytocin, and insulin are all prepping your system for milk production. Meanwhile, estrogen and progesterone act as gatekeepers, stopping the milk from flowing until the baby arrives.

Here is how each hormone handles its workload:

• Prolactin: Levels of this hormone skyrocket during pregnancy. It tells your mammary tissue to grow and prep for the job ahead. Once the baby starts suckling, prolactin surges to signal the alveoli to produce milk ⁽¹⁾.
• Cortisol and insulin: These helper hormones regulate your metabolism and ensure your breast milk supply has the energy it needs to be produced.
• Oxytocin: This is the “love hormone.” It triggers the let-down reflex, forcing milk out of the ducts. It responds to suckling, hearing a baby cry, or even just smelling your newborn.
• Progesterone: Think of this as the “brake.” During pregnancy, high progesterone keeps milk volume low. After you deliver the placenta, these levels plummet, releasing the brake on milk production.
• Estrogen: Similar to progesterone, estrogen keeps prolactin in check during pregnancy. Once the baby is born and estrogen drops, prolactin is free to get to work ⁽²⁾.

It usually takes about 30 to 40 hours after the placenta is delivered for progesterone and estrogen to drop low enough for milk synthesis to ramp up.

When Does Milk Actually Start?

You might expect a gush of milk the second the baby is born, but biology is a bit slower. Within a couple of days post-birth, your breasts will start to feel heavy and full. This is your milk coming in.

During those first 48 to 72 hours, your body produces colostrum. This is a thick, sticky, yellow or creamy fluid.

Don’t underestimate colostrum. It is a superfood packed with antibodies that coat your baby’s gut, protecting them from bacteria outside the womb.

Think of colostrum in teaspoonfuls, not ounces. It’s thick, almost jelly-like when expressed. Your baby will only need little bits at a time but will need it often.

Editor's Note:

Michelle Roth, BA, IBCLC

Around two to five days postpartum, colostrum blends with mature milk to form “transitional milk.” This helps your baby’s stomach stretch and adapt to larger volumes.

For some moms, it takes seven to ten days for milk to come in fully. Transitional milk might look creamy yellow at first, eventually turning into a thinner, bluish-white liquid known as mature milk.

Why Is My Milk Delayed?

Breastfeeding is the gold standard for nutrition, so it is stressful when things don’t happen on schedule. However, “delayed” does not mean “never.”

Most women produce colostrum immediately. If the volume increase (Lactogenesis II) is late, it is usually due to a specific physiological or environmental hurdle.

Medical Causes for Low or No Milk

Sometimes your body faces internal roadblocks. Here are the most common medical reasons for a delay.

1. Hormonal Imbalances

Your endocrine system runs the show. If it is out of sync, your milk will be too.

• Diabetes (Type 1, 2, or Gestational): Insulin plays a key role in lactation. If your insulin levels are fluctuating, your milk supply might be sluggish. Managing blood sugar closely can help mitigate this ⁽³⁾.
• Pituitary Issues: The pituitary gland pumps out oxytocin and prolactin. If you have a condition like hypopituitarism, or suffered severe blood loss during birth (Sheehan’s syndrome), this gland might not send the “make milk” signal ⁽⁴⁾.
• Thyroid Dysfunction: Your thyroid regulates hormones T3 and T4. If your thyroid is underactive (hypothyroid) or overactive (hyperthyroid), it can cause supply dips. Fortunately, this is often treatable with medication compatible with breastfeeding ⁽⁵⁾.

2. Medication Interference

Certain drugs act as milk suppressants. Antihistamines and decongestants (like pseudoephedrine) can dry up secretions, including milk. Additionally, starting hormonal birth control containing estrogen too soon after delivery can tank your supply.

Even natural remedies matter. excessive amounts of sage, parsley, peppermint, or spearmint are known to reduce milk output.

3. Ovarian Cysts

Gestational ovarian cysts can develop during pregnancy and pump out high levels of testosterone. This male hormone suppresses milk production. These usually resolve on their own within a month, but you may need to supplement and pump aggressively in the meantime ⁽⁶⁾.

4. Obesity

Having a higher BMI can delay the prolactin response to suckling. It doesn’t make breastfeeding impossible, but it often means your milk takes a few extra days to arrive ⁽⁷⁾.

5. Polycystic Ovary Syndrome (PCOS)

PCOS creates a hormonal storm of higher testosterone and insulin resistance. It can also cause insufficient glandular tissue in the breasts. If you have PCOS, work with a lactation consultant immediately to maximize your production window.

6. Breast Surgery

If you have had implants, reductions, or biopsies, the nerves or milk ducts may have been severed. While nerves can heal, significant damage to the areola or glandular tissue can result in chronic low supply ⁽⁸⁾.

Birth Factors That Delay Lactation

Sometimes your anatomy is fine, but the delivery itself threw a wrench in the gears.

• Traumatic delivery: Long labor, vacuum extraction, or emergency C-sections spike stress hormones. High stress can temporarily block the release of oxytocin, delaying your milk ⁽⁹⁾.
• IV fluids: If you received a lot of fluids during labor, your breasts may become swollen (edema). This swelling makes it hard for the milk to flow and difficult for the baby to latch deep enough to drain the breast ⁽¹⁰⁾.
• Retained placenta: This is a major trigger. If even a tiny piece of placenta remains inside the uterus, your body continues producing progesterone. Remember, progesterone stops milk production. Once the fragment is removed, milk usually flows freely.
• Pain medications: Some epidural or systemic pain relief can make the baby sleepy. A sleepy baby doesn’t suckle effectively, which fails to signal your body to make more milk ⁽¹¹⁾.
• Prematurity: If your baby arrives early, your glandular tissue might not have finished its preparation phase. However, with pumping and kangaroo care, most preemie moms can establish a full supply.
• Maternal Age: Moms over 30 or 35 may experience a slightly slower onset of Lactogenesis II compared to younger moms.

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How To Fix Delayed Milk Production

It is easy to panic, but stress is the enemy of oxytocin. The first step is to breathe. Next, call a lactation consultant (IBCLC). They can weigh your baby and do a “weighted feed” to see exactly how much milk is transferring.

If your baby is losing too much weight, is dehydrated (orange crystals in diaper), or is jaundice, you must feed them. Supplementing with formula or donor milk is a medical tool, not a failure. A fed baby has the energy to nurse better later.

To speed up your supply, follow the “Supply and Demand” rule:

• Hand express: In the first few days, hand expression is often more effective than a pump for collecting colostrum. Do this every 2-3 hours.
• Check the latch: A shallow latch hurts you and doesn’t drain the breast. If it hurts, break the suction and try again.
• Breast compressions: While the baby is nursing, gently squeeze your breast to push more milk into their mouth. This keeps them interested and awake.
• Switch sides: Offer both breasts at every feeding. If the baby falls asleep on side one, change their diaper to wake them up, then offer side two.
• Skin-to-skin: Strip the baby down to a diaper and place them against your bare chest. This releases huge amounts of milk-making hormones for both of you.
• Avoid artificial nipples: Try to avoid pacifiers or bottles in the first week if possible, using a cup or spoon for supplements instead to prevent nipple confusion.

FAQs

Why Am I Not Getting Any Colostrum?

A lack of visible colostrum is often due to high stress, traumatic birth, or retained placental fragments. However, just because you can’t hand express it doesn’t always mean it isn’t there. Keep stimulating the breast frequently to trigger production.

Can You Bring Your Milk Supply Back From Nothing?

Yes, relactation is possible. It requires intense dedication, including feeding or pumping 8-12 times a day, skin-to-skin contact, and possibly using galactagogues (milk-boosting meds/herbs). It takes time, but many women successfully rebuild a supply.

How Long Does It Take To Establish A Milk Supply?

It takes about 3 to 5 days for milk to “come in” and about 4 to 6 weeks to fully regulate your supply. During these first weeks, your supply is driven by hormones; after that, it is driven by how much milk is removed.

What Percentage Of Women Cannot Breastfeed?

True physiological inability to breastfeed (due to insufficient glandular tissue or nerve damage) affects an estimated 2% to 5% of women. Most supply issues are managerial, meaning they can be fixed with better latching and frequency techniques.

How Long After Birth Can A Baby Go Without Milk?

A healthy, full-term newborn has energy reserves for about 24 hours, but they should attempt to breastfeed within the first hour. If they haven’t fed successfully in the first 12 to 24 hours, or are showing signs of dehydration, medical intervention is needed.

Does Pitocin Delay Milk Production?

Yes, some studies indicate that high doses of synthetic oxytocin (Pitocin) during labor can downregulate the body’s natural oxytocin receptors, potentially delaying the onset of full milk production by a day or two.

Do Lactation Cookies Work?

Lactation cookies often contain galactagogues like oats, flaxseed, and brewer’s yeast. While anecdotal evidence is strong, scientific proof is mixed. They are a tasty snack that might help, but they cannot replace frequent milk removal.