Insulin has a direct action on the mammary gland during breast development and is vital to the production and secretion of colostrum (lactogenesis I),
in lactogenesis II (when lots of milk arrives after the placenta is born, usually around day 2 or 3 postpartum), and continued lactation.
In lactogenesis, the mammary gland develops the capacity to secrete milk.
Not exact matches
A delayed onset of
lactogenesis (aka your milk hasn't «come
in») is unfortunately not uncommon.
Essentially, as long as the proper hormones are
in place, mom will start making colostrum about halfway through pregnancy (
Lactogenesis I) and her milk will increase
in volume (
Lactogenesis II) around 30 - 40 hours after birth.
Although biochemical markers indicate that
Lactogenesis II commences approximately 30 - 40 hours after birth, mothers do not typically begin feeling increased breast fullness (the sensation of milk «coming
in») until 50 - 73 hours (2 - 3 days) after birth.
A traumatic birth can delay on the onset of a mother's mature milk («milk coming
in»), known as
lactogenesis II, sometimes by several days.
Since mothers are generally sent home from the hospital before their milk comes
in, they should plan to seek help if their milk is not
in by 72 hours (the period defined as normal for the onset of
lactogenesis II).
So, Beth the first thing that you've mentioned when talking about low milk supply was that: «Sometimes it's just the birth and getting that kind of delayed
Lactogenesis — the delay of that fuller milk coming
in.»
As most Caesarean births are carried out via epidural, the epidural issues all apply, but
in addition there is the position and pain associated with the scar, delayed
lactogenesis (production of milk) and a perception amongst women and HCPs that Caesarean birth is a barrier to breastfeeding.
Some historical evidence suggests that,
in ancient times, first babies had particularly poor survival rates, and slow
lactogenesis following a first birth may have been a significant part of it.
Lactogenesis includes all processes necessary to transform the mammary gland from its undifferentiated state
in early pregnancy to its fully differentiated state sometime after pregnancy.
Cesarean births are associated with delayed
lactogenesis II (when the mature milk, «comes
in») which can contribute to excess weight loss
in the infant and the need for supplementation.
In my practice as an International Board Certified Lactation Consultant, after ruling out known causes of delayed lactogenesis such as underactive thyroid, postpartum hemorrhage, or retained placental fragments, and after applying the very best lactation management techniques, I have documented that only one in a thousand (0.1 %) of new mothers simply do not produce any breast milk at al
In my practice as an International Board Certified Lactation Consultant, after ruling out known causes of delayed
lactogenesis such as underactive thyroid, postpartum hemorrhage, or retained placental fragments, and after applying the very best lactation management techniques, I have documented that only one
in a thousand (0.1 %) of new mothers simply do not produce any breast milk at al
in a thousand (0.1 %) of new mothers simply do not produce any breast milk at all.
This is an important group to consider because combination feeding is common, for example,
in the first few days
in the hospital when
lactogenesis II is delayed while a mother's breast milk is becoming established, among mothers who have difficulty producing adequate milk and supplement their own milk with infant formula, or among mothers who are unable or choose not to pump breast milk when separated from their babies.
Engorgement occurs most of often three to five days after delivery, as a mother transitions from
Lactogenesis Stage I to Stage 2, commonly referred to as the milk «coming
in.»
Maternal perception of the milk «coming
in» is strongly correlated with biochemical and milk transfer indicators of stage II
lactogenesis (3 — 5).
However, for one of these studies, the relation between BMI and delayed
lactogenesis was no longer significant when parity was included
in the model (8).
Women who do not breastfeed at all
in the early postpartum will still experience
lactogenesis, but they are more likely to experience delayed OL (6).
Background: Delayed onset of
lactogenesis (OL) is most common
in primiparas and increases the risk of excess neonatal weight loss, formula supplementation, and early weaning.
Delayed
lactogenesis and excess neonatal weight loss are common across ethnic and socioeconomic categories of primiparous women
in northern California