Help! My Milk Hasn't Come In Yet

You’re three days post-partum, your days and nights are mixed up, and your formerly predictable world is completely turned upside down. And on top of everything, your milk hasn’t come in yet. What can you do to hold yourself together and make sure your baby is getting the nutrition he needs?

First of all – even though it seems impossible to do – relax. Your milk will come in eventually, and your baby needs the colostrum that your body produces in the meantime. And the more relaxed you can be, the better your body will be at producing milk.

What does it mean for your milk to “come in”? When your baby is first born, your breasts produce nutrient-rich colostrum, which is most often yellowish or clear. Even though the amount of colostrum is tiny, it will provide all of the nutrition and important antibodies your baby needs to stay well-nourished and healthy during those early days. You should nurse early and often (around the clock) when your baby is first born to help him get the hang of it and to make sure that your body is being properly stimulated to produce milk.

By about the third or fourth day postpartum, your breasts should begin producing regular breast milk. For some women, the process of the milk “coming in” is very dramatic but for others it is more gradual. You will know that your milk has come in when your breasts are significantly fuller, firmer, and heavier; and your nipples start leaking a whitish fluid. You may notice that your baby is nursing longer, because he’s getting better at it, and because there’s more for him to consume.

If you had a difficult delivery or a C-section, or if you have other health problems, your milk may take longer to come in – approximately four to five days, or even longer in some cases. However, if you get to four days postpartum and your milk still hasn’t come in, you should stay in close touch with your pediatrician to make sure that your little one is gaining weight properly.

To stimulate your milk production, make sure that you are nursing every two to three hours around the clock. Get as much rest as you possibly can, and drink plenty of fluids. Beyond that, you may want to rent a hospital-grade breast pump that you can use after each nursing session. The pump may give you the extra stimulation you need to begin producing milk.

Some doctors may insist that you begin to supplement with formula if your milk hasn’t come in by about Day 5. However, if you are committed to breastfeeding and do not want to begin using formula, you should seek qualified help from a lactation consultant. A lactation consultant will help you make sure that your baby is positioned and latching properly and may also recommend stimulants to help your body with milk production. Your hospital or doctor may be able to recommend someone for you, or you may find local support through the La Leche League, which works in support of breastfeeding mothers.

Last but not least, don’t let anyone try to steer you away from a path that feels right to you. Some mothers manage to hold out even though their milk is slow to come in; some mothers supplement with formula and continue to use it; and still others use formula as a bridge while their milk comes in, and then once they have milk they never use formula again. Be wary of anyone who tries to warn you of absolutes, such as, “If you give your baby formula, it will destroy your nursing relationship.” Your story is yours alone to write; you should let it unfold in the way that is best for you and your baby.