But that is not the same
as lactogenesis.
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.
Not exact matches
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.
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).
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.
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 all.
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.»
Milk sodium concentration is a marker of tight junction closure between mammary epithelial cells; with the onset of secretory activation (stage II
lactogenesis) milk sodium concentrations decrease sharply
as potassium concentrations increase [14].