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No Breast Milk After Delivery: Causes And What To Do For It?

Experiencing no breast milk after delivery can be stressful and overwhelming for new mothers. Mothers are recommended to feed their babies immediately or at the earliest after childbirth. However, at times, things may not go as planned, and the mother’s milk may not come in. The absence of breast milk after delivery can happen for several reasons, such as the delayed onset of lactation or complications associated with childbirth.

It is essential to know that most mothers start producing breast milk within three to five days after childbirth (1). However, even after a few days post-delivery, if your breast milk supply is insufficient, you may consult a lactation consultant or a pediatrician to find a safe formula for your baby until you establish your milk supply.

Read this post to learn about the possible causes of no breast milk after delivery and tips on overcoming the situation.

What Triggers Production And Supply Of Breast Milk?

Breast milk production (colostrum) starts during  the second trimester. Until delivery, this mechanism stays under check by progesterone hormone. But, as soon as a  baby is born and the placenta is delivered, progesterone levels rapidly drop and prolactin hormone levels rise, triggering milk production (2). When a baby suckles from his mother’s breast, it causes the release of a hormone called oxytocin and a further surge in prolactin.

Oxytocin works on the muscles around the alveoli of the breast to contract and release milk out from the milk ducts. This process is known as the let-down reflex (3). For the first three to five days after delivery, babies consume colostrum. This early breast milk is a thick, yellowish-white fluid rich in vital nutritional and immunological components (4). Most mothers’ mature milk will come in, and replace colostrum, within the first three to five days after delivery.

Causes For Little Or No Milk After Delivery

In most cases, little or no milk after delivery is temporary and is caused by delayed onset of lactation (lactogenesis) which can happen for several reasons (5) (6) (7).

1. Overweight or obesity: Carrying too much weight during pregnancy can delay lactation onset postpartum. Keeping one’s pre-pregnancy weight at healthy levels and maintaining a healthy weight during pregnancy can avert this risk.

2. Traumatic birthing: Slow dilation causing long labor, extended pushing period, and birthing tools, such as forceps and vacuum pumps, make the birthing process stressful and traumatic. Under stress, the body produces hormones, such as cortisol, that cause delayed lactation onset (8).

3. Cesarean delivery: Emergency cesarean delivery (C-section)  can be stressful to mothers and babies. The same is true for planned C-sections, as well. Use of anelgesics or pain killers, such as epidurals, and extended separation of babies and  mothers due to premature birth can also cause dips in breast milk production (9) (10) (11).

4. Excessive IV fluid use: Intravenous fluid (IV) use during birthing is done in certain circumstances (12). Large amounts of IV fluids given to a woman in labor can cause breast engorgement due to water retention (13). Until breast engorgement subsides, milk production can be affected.

5. Excess blood loss: Postpartum hemorrhage is a condition where a mother loses large amounts of blood, i.e., more than 1000ml, postpartum. Excess blood loss can reduce milk production by altering breastfeeding hormone (prolactin) production. Stress and fatigue due to blood loss can also delay lactogenesis (14).

6. Retained placental fragments: After delivery, when the placenta is delivered, progesterone levels in the body drop. However, progesterone levels may stay high if placental fragments are present. This can cause delayed lactation onset, affecting milk production and supply.

Below are some other reasons that a low milk supply may occur.

7. Certain health conditions: Health issues, such as diabetes, poly cystic ovarian syndrome (PCOS), gestational ovarian cysts, and thyroid conditions, can interfere in breast milk production. The hormonal imbalances that occu rin these conditions alterbreast milk production and supply.

Thus, it is good to maintain pre- and post-pregnancy weight and follow your medications for your health conditions diligently.

8. Medications and herbs: The use of certain medications, such as estrogen-based hormonal birth control pills, can slow milk production. Likewise, certain herbs, such as oregano, parsley, can also affect milk supply (15). If you are breastfeeding and intend to use any herb or are on any medication, consult a lactation consultant to be sure it is safe to use while breastfeeding.

9. Formula supplementation: When mothers have little to no milk supply, they sometimes resort formula supplementation. In some cases formula replaces breastfeeding. Since breast milk production is a demand and supply process, milk production may decline when the baby breastfeeds less due to formula intake

10. Smoking and alcohol use: Research shows that smoking and tobacco use effect  milk composition and production. Alcohol has similar effects on milk production (16) (17).

In addition, poor latch, breast surgery, prolonged bed rest, and insufficient glandular tissue are some other reasons that mothers may have low  breast milk production. Knowing the risk factors for low milk production can help you find possible solutions for having no milk after delivery.

Tips To Maintain A Healthy Breast Milk Supply

If you have no or low milk supply after delivery, don’t get stressed. Remember, breast milk production is a demand (milk removal) and supply mechanism. The more you breastfeed or empty your breast, the more milk your breasts produce.

Here are some tips that can help you make more milk: (1) (18) (19).

1. Milk expression and pumping: Whether hand expression or pumping, try to empty your breasts every couple of hours. No matter how low your  milk supply, frequent expression and pumping can stimulate your breasts to produce milk. For pumping, you can opt for a hospital-grade breast pump with enhanced suction. Alternatively, you can try power-pumping, where you add frequent, short pumping sessions into certain times of the day..

2. Breast massage: Breastmassage is a technique of massaging breasts in a specific way that can help increase milk flow. Massaging your breasts for five to ten minutes between feeds can stimulate the breast for increased milk production. Research demonstrates that breast massage combined with breast pumping can increase breast milk volume (20) (21)..

3. Frequent breastfeeding: Besides massaging and pumping, you should aim to  breastfeed around 12 times a day for around 15 to 20 minutes per session. During each feeding session, switch breasts and nurse your baby at least once on each side. Your baby should fully empty each breast. Ensure your baby is latched to your nipple properly and sucking and swallowing while feeding .Additionally, have as much skin-to-skin contact as possible with your baby both while breastfeeding and between sessions. .

4. Hot shower and heat pads: Applying heat on breasts can trigger milk flow. Take a hot shower or apply heat pads or warm compresses on your breasts before feeding or pumping to increase milk flow and production.

5. Relaxation: Fatigue is one of the reasons for a low milk supply. Thus, relaxing and giving yourself time to rest can boost your milk supply. Choosing relaxation techniques is a personal choice. Options include listening to soothing music or imagining yourself feeding your baby to relax and boost breastfeeding hormones.

6. Sound sleep: Taking care of a baby often leaves a mother sleepless and stressed. Persistent stress and less sleep cause cortisol levels to rise, hampering milk production and supply. Thus, it is vital to rest adequately, sleep soundly, and stay stress-free as much as possible.  Having others help you with your baby is essential for being able to rest and sleep.

7. Healthy lifestyle: Eating nutritious food, drinking healthy fluids, and plenty of water help to increase milk production and supply. Make sure to eat a well-balanced, healthy diet consisting of a wide variety of nutrient-rich foods. Additionally, indulge in some physical activity whenever your doctor allows you to do so after delivery. Exercising helps maintain a healthy weight and releases endorphins that keep you stress-free and happy, a prerequisite to a healthy milk supply.

8. Galactagogues: Galactagogues are substances, such as herbs, that can help breastfeeding mothers enhance their breast milk production. You can consult a certified lactation specialist and discuss using galactagogues to enhance your milk production. They can guide you as to whether or not galactagogues will be useful in your situation and, if they will, what specific foods you should take and in what quantities.

Additionally, you may consult your pediatrician about formula or donor milk’s use for your  baby until your  breast milk supply improves. Supplementaton can ensure your baby gets adequate nutrition for their growth and development.

Breast milk is the primary source of nourishment for babies. However, sometimes there’s insufficient milk supply or no breast milk supply after delivery due to the delayed onset of lactation. Remember, delayed milk doesn’t mean you will not have milk at all. Consult a lactation consultant to help determine the cause and create a solution.