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Expert Q&A

	By Ann Calandro BSN, RNC, IBCLC Lactation Consultant

I have a friend who had her baby and three days later her milk still hasn't come in. I know that sometimes it takes up to seven days for that to happen. She mentioned to me that her mom never had her milk come in, and she is wondering if that is going to happen to her, too. She does have colostrum. How common is it for a woman NOT to produce breastmilk?

Most mothers have a big increase in milk somewhere between two and seven days after giving birth. Usually it happens about the third day, but sometimes it takes longer. It is estimated that about 1 percent of women are unable to produce milk. Some articles have said that up to 5 percent do not produce milk, but that number is disputed by most lactation consultants. I was working with a mom today whose milk is just beginning to come in, and it is the fifth day. It is important to continue nursing, and if the baby is not nursing well, also use a double electric pump to help the milk increase. The baby needs to be closely monitored, because the baby could get dehydrated if mom's milk is delayed, and may need some supplementation until the milk does increase.

It is possible that if your friend's mother did not get milk due to insufficient milk ducts, the same could happen to her. But in years past, many women were given a ""dry-up"" shot on the delivery table, sometimes without their knowledge, and the reason they never got milk is because of the shot. Hopefully things will improve for your friend, with proper assistance and persistence. If her milk does not increase as expected, consider these two options: check by ultrasound for a piece of retained placenta, which may keep her milk from increasing, and check for a low thyroid level, which may also be the culprit.

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