Booby Traps Series: Could something about your birth have made your milk come in late?

This is the tenth in a series of posts on Booby Traps™, made possible by the generous support of Motherlove Herbal Company.

We’ve wrapped up our series on Booby Traps in pregnancy, and are launching into a series of posts of Booby Traps in birth today!

Do you remember when your mature milk came in?  It’s a pretty momentous and memorable event for many of us.

But if your mature milk was late in arriving (defined as no breast fullness at ≥ 72 hours after your baby’s birth), you probably remember this as a stressful time.  You may have worried that your baby was getting dehydrated or suffering from inadequate intake.  Your pediatrician may have told you that your that your baby needed to be supplemented with formula.

Having a delay in your milk coming in can set off a chain of events than can -but thankfully don’t always – lead to weaning before you want to.  For some of us, breastfeeding is over just as it should be beginning.

How?  When your milk is delayed in coming in you’re more likely – often of necessity – to be told to supplement with formula.  Supplementation, when done in a manner not friendly to breastfeeding, can cause milk supply problems and sometimes nipple confusion.  Milk supply problems can lead to weaning before we meet our breastfeeding goals.  Of course, sometimes supplementation is truly necessary (Rule One:  feed the baby), but when done without trying to protect your milk supply, it can be devastating.

Poor intake can also make your baby sleepy, which can make him or her a poor feeder – one who falls asleep at the breast early in the feeding.  And that in turn can make babies take in too little milk, which makes them even more sleepy.  It also puts babies at higher risk of jaundice, which in turn creates makes even sleepier.  See the vicious cycle you have to turn around to make breastfeeding work?

What many of us don’t know is that there are things about your birth experience which can make it more likely that your mature milk will take longer to come in.  And that’s where the Booby Traps come in.

First, there are a number of factors associated with late mature milk which are beyond our control (or very difficult to control) when we deliver.  They include diabetes, obesity, thyroid problems, hypertension, polycystic ovary syndrome (PCOS), preterm birth, and even our age at time of delivery.

But there are some factors related to birth which we can influence (though admittedly not control):  having a cesarean section, receiving a lot of IV fluids, having a prolonged second stage of labor (pushing longer than one hour), and having a lot of stress.  In short, the cascade of interventions that happens for so many of us may in fact result in a delay in our milk coming in.

How can we influence (though not always control) these factors and beat this Booby Trap?

Have a doula or other trained labor support person present.

Numerous studies show that having a doula present at your birth reduces your risk of a c-section, results in shorter labors with fewer complications, and reduces the use of pitocin, and reduces mothers’ requests for pain medications (these last two are often accompanied by IV fluids).  In short, having a doula or someone who can serve like one may prevent the cascade of interventions which can lead to a delay in your milk coming in.

Know your provider and your hospital’s stats.

Want to avoid a c-section?  Then, as Linda Smith, author of The Impact of Birthing Practices on Breastfeeding, said in an interview with me, “Don’t go where they do 90% of them!”   Check out your provider (OB/midwife) and your hospital’s rates of c-sections, inductions, and epidurals, and choose carefully.  Your support team will have a lot to do with your early start to breastfeeding.

Learn non-drug pain relief techniques.

You may or may not end up using pain medication, but the cascade of interventions often there.  So the less you can use of them the better.  Non-drug means of pain relief are the kinds of things you might learn in a childbirth class, but you may want to supplement what you learn there with extra reading or instruction.  Be sure that you and your partner know lots of laboring positions, massage techniques, acupressure points, visualization and breathing techniques, and about the use of water in a birthing tub or bathtub, for example.  And make sure that your providers are supportive of these things.

Remember:  If you do experience a delay in your milk coming in, all is not lost.  Be sure to ask for help from a lactation consultant (IBCLC) who should be able to help you navigate the road ahead.

Did any of you have a delay in your milk coming in?  What were the factors that could have contributed to the delay?

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20 Comments | Last revised on 06/03/2011

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