I am at a freestanding birth center, no labor meds, no inductions, low risk healthy deliveries, 99% of babies are nursing within 30 minutes.  We offer 24/7 phone support a 48-72 hour home visit and a weekly weight clinic as well as addition LC visits as needed.  In this ideal environment I still see lactogenesis II averaging 48-72 hours for multips and 72 hours for primips. I have very rarely seen it at 24 hours in a multip and never in a primip, although early onset does seem to be more common for tandem nursers.  We have had the odd cases where even with the perfect birth experience the milk didn't come in until 5-7 days.  I also see our hospital delivered families and don't see a huge difference in the timing of lactogenesis II, this may also be due to early initiation and excellent lactation help in the hospital.  Certainly I have seen a delay for the "trainwreck" deliveries, but not for the run of the mill intervention filled births.  These observations probably reflect the hormonal basis of lactogenesis II; unless something interferes with the declining progesterone level (retained placental fragments for one) the milk will come in around 72 hours.

Janie Akerlund RN IBCLC
Nurse-Midwifery Birth Center
541-484-5796 
 
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