Delayed Lactogenesis II: Why Your Milk May Take Longer to ‘Come In’
My birth plan went out the window with my second child. Everything that could possibly make milk take longer to transition, did.
I thought for sure it would be easier the second time — because it’s supposed to be, right? But instead, my milk actually took longer to “come in.” Here’s why:
Emergency C-section in the middle of the night
Various medications and fluids
Birth trauma
Limited skin-to-skin because of a NICU stay
Fewer attempts at breastfeeding in those early hours
Looking back, I wish I could have given that exhausted, discouraged version of myself a pep talk. Because delayed lactogenesis II (that’s the fancy name for when your milk transitions from colostrum to more mature milk later than expected) is not your fault — and it happens more often than you’d think.
What Is Lactogenesis II?
Lactogenesis II is the technical term for the big shift when milk production ramps up — usually between 48 and 72 hours after birth. This is when your breasts start to feel fuller, and you notice more volume compared to the drops of colostrum in the beginning.
But here’s the thing: colostrum is milk. Your body actually starts producing it in your second trimester. So when people say, “my milk hasn’t come in yet,” what they really mean is that lactogenesis II hasn’t taken place.
What Can Delay Lactogenesis II?
Several circumstances can slow down this transition:
Cesarean birth
Birth complications or trauma
Excess IV fluids during labor
Certain medications
Separation from baby / NICU stay
Stress, pain, or limited breastfeeding in the early hours
Sometimes one factor is at play, sometimes it’s a combination. But none of these mean your body won’t make milk—they just mean the timeline may look different.
How to Prepare for a Smoother Transition
While you can’t control every birth outcome (trust me, I tried), there are ways to prepare during pregnancy and set yourself up for a smoother start:
Learn hand expression ahead of time — even practicing during pregnancy can build confidence and help you get colostrum to your baby if direct breastfeeding is delayed.
Talk with your care team about your feeding goals so they can support early skin-to-skin, rooming-in, and breastfeeding-friendly practices when possible.
Line up lactation support before baby arrives—knowing who you’ll call if milk seems delayed can ease stress in the moment.
Manage expectations—knowing that 2–5 days is normal for milk to transition can help reduce anxiety if it doesn’t happen right away.
How to Help Speed It Along
If lactogenesis II feels delayed, here are ways to encourage things to move along:
Skin-to-skin contact as often as possible, even if baby is in the NICU.
Frequent stimulation—nurse or hand express every 2–3 hours.
Use hand expression in the early days to get every drop of colostrum to your baby and signal your body to make more.
Double pump if separated from baby—aim for 8 sessions in 24 hours to mimic a newborn’s feeding pattern.
Prioritize rest and hydration—your body heals and produces more effectively when you’re supported, too.
Seek reassurance from a lactation consultant—an IBCLC can help troubleshoot and tailor a plan to your situation.
The Pep Talk I Needed
If you’re sitting there waiting for milk to “come in” and worrying it won’t—you are not alone. Your body is already working, even if the timeline isn’t what you expected. Delayed lactogenesis II can feel discouraging, but with support and patience, it does not mean the end of breastfeeding.
My own journey was rocky at the start, but we went on to have a long and fulfilling breastfeeding relationship. If I could go back, I’d tell myself: hang in there, you’re doing beautifully, and this is just the beginning.
