Factors that can cause delayed milk production following delivery

There are various factors that can affect a mother’s milk supply. They can be maternal factors, labor and delivery-related factors, newborn factors, and postpartum  factors.   Maternal factors include: obesity, rapid and extreme weight gain during pregnancy, history of breast surgery, including breast augmentation or reduction surgery, nipple variances, such as flat or inverted nipples, hormonal imbalances, such as PCOS(Polycystic Ovarian Syndrome),  as well as certain medications  that can all directly impact milk production.

Labor and Delivery factors are described as prolonged and exhausting labor(pushing longer that 2 hours), rapid labor (less than 1 hour), traumatic delivery, for example, vacuum extraction, low forceps delivery, cesarean birth, preterm delivery, retained placenta and excessive blood loss(greater than 500 ml) which can affect hormone levels, and epidural or general anesthesia.

Newborn factors that can affect milk production can cover a wide range of circumstances or conditions, such as, difficult transition with respiratory distress, cleft lip/cleft palate, tongue/lip tie, jaundice, Down Syndrome, as well as other genetic conditions and abnormalities.

Postpartum factors that can affect milk production include failure to express milk either by hand expression, direct breastfeeding, or pumping, separation of mother and newborn due to cesarean birth recovery, NICU admission, and absent or minimal skin-to-skin contact. Research has found that timing of the  baby’s first breast feeding has an impact on how quickly a mother’s milk supply increases.  Babies who breastfed for the first time within the first two hours after birth had a higher milk intake on day 3 and 4 postpartum, than babies who had their first breastfeeding greater than 2 hours after birth.

Any of these factors, alone or combined, can contribute to delayed milk production. Working closely with a Lactation Consultant during a mother’s hospital stay or once discharged home can help mother’s work on improving that milk supply.


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