Can Retained Placenta Cause Low Milk Supply?

Posted on April 01, 2026

Introduction
The Science of Milk Production
What is Retained Placenta?
How Retained Placenta Blocks Milk Supply
Signs and Symptoms of Retained Placenta
The Impact of Postpartum Hemorrhage
What to Do if You Suspect Retained Placenta
Rebuilding Your Milk Supply
Dealing with the Emotional Toll
Working with a Lactation Professional
The Long-Term Outlook
Summary
FAQ

Introduction

The days following your baby’s birth are often a blur of snuggles, diaper changes, and the anticipation of your milk "coming in." For most parents, this transition happens naturally within the first few days. But for some, the expected increase in milk volume never seems to arrive, or it feels significantly delayed. If you are pumping or nursing frequently and seeing very little output, it is natural to feel frustrated and worried about your baby’s nutrition.

At Milky Mama, we know that breastfeeding is a biological process that usually works beautifully, but sometimes a physical roadblock gets in the way. One of the most hidden and misunderstood roadblocks is a retained placenta. This occurs when small pieces of the placenta stay inside the uterus after birth. These tiny fragments can send confusing hormonal signals to your body, effectively telling it that you are still pregnant rather than ready to nurse.

If you want a broader overview of supply concerns while you read, our guide on low milk supply is a helpful place to start. This article will explore how retained placenta affects your milk supply, the symptoms you should watch for, and how you can support your body’s recovery. We will break down the science of your hormones and provide actionable steps to help you reach your breastfeeding goals. Understanding the biological link between your uterus and your breasts is the first step toward finding a solution.

The Science of Milk Production

To understand how a retained placenta interferes with your supply, we first need to look at how milk is made. During pregnancy, your breasts undergo significant changes to prepare for feeding your baby. However, you do not produce large volumes of mature milk while you are still pregnant. This is because of your hormones.

The Role of Progesterone

Throughout pregnancy, the placenta produces high levels of a hormone called progesterone. Progesterone is essential for maintaining a healthy pregnancy. However, it has a secondary job: it acts as a biological brake on milk production.

Progesterone prevents the "milk-making" hormone, prolactin, from fully doing its job. It binds to the receptors in your milk-making cells (lactocytes), effectively keeping the system in a "standby" mode. While you may produce colostrum (the thick, nutrient-rich first milk) during pregnancy, the transition to high-volume mature milk cannot happen as long as progesterone levels remain high.

Lactogenesis II: The Transition

The birth of your baby is only half of the trigger for milk production. The second half is the delivery of the placenta. Once the placenta detaches from the uterine wall and leaves your body, your progesterone levels plummet.

This sudden drop in progesterone is the green light for your body. It allows prolactin to take over, signaling the start of Lactogenesis II. This is the clinical term for the stage when your milk volume increases significantly, usually occurring between two to five days after birth. If the placenta is not fully removed, this signal is muffled or missed entirely.

What is Retained Placenta?

Retained placenta is a condition where the placenta—or parts of it—stays inside the uterus for too long after the baby is born. In a typical birth, the placenta is delivered within 30 minutes of the baby. Doctors and midwives usually inspect the placenta to ensure it is "intact," meaning no pieces are missing.

However, even with a careful inspection, small fragments can sometimes remain attached to the uterine wall. These are known as retained placental fragments (RPF). Even a piece as small as a thumbnail can be enough to disrupt the delicate hormonal balance required for lactation.

Types of Retained Placenta

There are several reasons why the placenta might stay behind. Understanding these can help you discuss your history with a healthcare provider:

Placenta Adherens: This is the most common type. It happens when the uterus does not contract enough to push the placenta out, leaving it loosely attached.
Trapped Placenta: This occurs when the placenta detaches from the uterus but becomes trapped behind a closing cervix.
Placenta Accreta: This is a more serious condition where the placenta grows too deeply into the uterine wall. This makes it very difficult for the placenta to separate cleanly during birth.

How Retained Placenta Blocks Milk Supply

The connection between your uterus and your milk supply is purely hormonal. If fragments of the placenta remain, those fragments continue to secrete progesterone and estrogen into your bloodstream.

Because your body still detects these "pregnancy hormones," it doesn't realize that the pregnancy has ended. The biological "switch" that should turn on full-scale milk production stays in the "off" position. This can lead to several outcomes:

Delayed Milk: Your milk may not "come in" until much later than the typical five-day window.
Low Milk Volume: You may only produce very small amounts of colostrum or milk, regardless of how often you nurse or pump.
Failure of Lactogenesis II: In some cases, the transition to mature milk never happens at all until the fragments are removed.

Key Takeaway: The delivery of the placenta is the hormonal "on switch" for milk production. If any piece remains, the switch may stay off, preventing your milk from coming in.

Signs and Symptoms of Retained Placenta

While low milk supply is a significant indicator, it is rarely the only sign that something is wrong. If you suspect you have retained fragments, you should look for other physical symptoms.

Abnormal Bleeding

It is normal to have vaginal bleeding (lochia) after birth. However, if you have retained placenta, the bleeding may be heavier than expected. Watch for:

Bleeding that gets heavier after it had started to taper off.
Passing large blood clots (larger than a golf ball).
Bright red bleeding that persists beyond the first week.

Physical Discomfort and Infection

Retained tissue can cause the uterus to stay enlarged or become infected. Symptoms include:

Foul-smelling vaginal discharge.
Fever or chills.
Persistent, sharp pelvic or abdominal pain.
A general feeling of being unwell (flu-like symptoms).

Delayed Lactogenesis

If it is day five or six and you have felt no change in your breast fullness, and your baby is not having enough wet or dirty diapers, this is a red flag. While there are many causes for low supply, a complete lack of milk transition combined with heavy bleeding is a strong indicator of retained fragments.

The Impact of Postpartum Hemorrhage

Retained placenta is one of the leading causes of postpartum hemorrhage (excessive bleeding after birth). Heavy blood loss can have its own separate impact on your milk supply, creating a double challenge for new parents.

Anemia and Fatigue

Losing a significant amount of blood can lead to anemia (low iron). Iron is essential for energy and the proper functioning of your cells. When you are severely anemic, your body may prioritize healing itself over producing milk. The extreme fatigue caused by blood loss can also make it difficult to maintain a demanding nursing or pumping schedule.

Sheehan’s Syndrome

In very rare cases of extreme blood loss, the pituitary gland in the brain can be damaged due to a lack of oxygen. This is known as Sheehan’s Syndrome. Since the pituitary gland is responsible for releasing prolactin (the milk-making hormone) and oxytocin (the hormone that helps milk flow), any damage to it can cause a permanent or severe low milk supply. If you experienced a traumatic birth with significant blood loss and are making no milk at all, this is a topic to discuss with an endocrinologist.

What to Do if You Suspect Retained Placenta

If your milk has not come in and you are experiencing heavy bleeding or pain, your first step should always be to contact your healthcare provider. You do not have to navigate this alone.

If you need individualized lactation support while you wait for answers, our breastfeeding help page is a good next step. A doctor or midwife will typically use an ultrasound to look inside the uterus. This imaging can identify if there are fragments of tissue remaining. In some cases, blood tests may be ordered to check your progesterone levels. If your progesterone is still high several days after birth, it is a clear sign that placental tissue is still present.

Treatment Options

If fragments are found, they must be removed to protect your health and restore your hormone balance.

Manual Removal: A provider may be able to remove the fragments during a physical exam.
D&C (Dilation and Curettage): This is a minor surgical procedure where a doctor clears the lining of the uterus.
Medication: In some cases, medication may be used to help the uterus contract and expel the remaining tissue.

Once the fragments are removed, your progesterone levels will drop rapidly. For many parents, this leads to a sudden and noticeable increase in milk production within 24 to 48 hours.

Rebuilding Your Milk Supply

The good news is that for most parents, the low supply caused by a retained placenta is temporary. Once the biological roadblock is removed, your body is usually ready to get to work. However, you may need to give your supply a "jumpstart" to make up for the lost time.

Frequent Milk Removal

Milk production operates on a system of supply and demand. The more often you remove milk, the more milk your body will make. If your supply was low for several days or weeks, you may need to nurse or pump more frequently than usual.

For more practical guidance on pumping patterns, see our article on how long to pump to increase your milk supply.

Aim for 8 to 12 sessions in a 24-hour period.
Use a hospital-grade pump if your baby is not yet latching effectively.
Practice "power pumping" once a day to mimic a baby’s growth spurt.

Skin-to-Skin Contact

Spending time skin-to-skin with your baby releases oxytocin. This hormone is responsible for the "let-down reflex," which is the process of the milk moving from the back of the breast to the nipple. Skin-to-skin also helps regulate your baby's temperature and encourages them to nurse more often, which naturally boosts your supply.

You can read more about this in our guide on skin-to-skin contact and milk supply.

Nutritional Support and Hydration

Your body needs extra calories and plenty of water to produce milk, especially when you are recovering from a medical complication. Focus on nutrient-dense foods like oats, flaxseed, and healthy fats.

At Milky Mama, we offer a variety of products designed to support your lactation journey. Our Pumpin' Punch drink mix is a delicious way to stay hydrated while consuming ingredients that support milk production. For a convenient snack, our Emergency Lactation Brownies are a favorite among our community. They contain targeted ingredients like brewer's yeast and oats that may help support a healthy supply as you recover.

Dealing with the Emotional Toll

Struggling with milk supply due to a medical issue like a retained placenta can be emotionally draining. You may feel like your body has "failed" you or feel guilty that you cannot feed your baby the way you planned.

It is important to remember that this was a physical, hormonal complication. It was not caused by anything you did or didn't do. Healing your body is the priority. Every drop of milk you provide is valuable, and if you need to supplement while you recover, that is a valid and responsible choice for your baby's health.

What to do next:

Contact your OB-GYN or midwife for an ultrasound if you have heavy bleeding or no milk.

Rent a hospital-grade pump to keep your "demand" high while waiting for treatment.

Consult with an International Board Certified Lactation Consultant (IBCLC) to create a plan for rebuilding your supply.

Focus on rest and hydration to help your body heal from the physical stress.

Working with a Lactation Professional

While a doctor handles the medical side of a retained placenta, an IBCLC is your best ally for the breastfeeding side. A lactation consultant can help you:

Monitor your baby's weight gain and intake.
Suggest specific pumping schedules to boost supply.
Help with latching issues that may have developed while supply was low.
Advise on the use of herbal supplements or "galactagogues"—substances that can support milk production.

If you are looking for a structured learning option, our Breastfeeding 101 course can also help you build confidence and skills. Our team at Milky Mama includes certified experts who understand these challenges. We believe that every parent deserves compassionate, expert-led support. Whether through our online classes or our community groups, you don't have to figure this out in isolation.

The Long-Term Outlook

For many parents, once the retained placenta is removed, they go on to have a successful and long-term breastfeeding relationship. The human body is incredibly resilient. Even if your milk didn't come in until day ten or day fourteen, it is often possible to reach a full supply with consistency and support.

If your pumping routine is carrying most of the workload, our Pumping Queen supplement may be a relevant option to explore. However, every person's recovery is different. If your blood loss was severe or if you have other underlying health conditions like PCOS or thyroid issues, your path might look a little different. The goal is always a healthy baby and a healthy, happy parent.

Summary

A retained placenta is a serious but treatable cause of low milk supply. By keeping progesterone levels high, it prevents the body from transitioning into full milk production. If you notice a lack of milk combined with abnormal bleeding, fever, or pain, seek medical help immediately. Once the fragments are removed, you can use frequent milk removal, skin-to-skin contact, and nourishing support to help your supply flourish.

Progesterone must drop for milk to increase.
Small fragments can cause big supply issues.
Medical intervention is necessary to remove the tissue.
Recovery is possible with time, demand, and support.

"Your worth as a parent is not measured in ounces. You are doing an amazing job navigating a difficult challenge, and support is available to help you reach your goals."

If you are looking for extra support as you rebuild your supply, we invite you to explore our range of lactation treats and supplements. From our Lady Leche supplement to our lactation treats collection, we are here to provide the nourishment you need during this transition.

This product is not intended to diagnose, treat, cure, or prevent any disease. Consult with your healthcare provider for medical advice. If you suspect you have a retained placenta or are experiencing a medical emergency, contact your doctor or visit an emergency room immediately.

FAQ

How long after removing the placenta fragments will my milk come in?

For many people, the hormonal shift happens quite quickly once the fragments are removed. You may notice an increase in breast fullness and milk volume within 24 to 48 hours after the procedure. However, if it has been several weeks since your birth, it may take a few days of frequent nursing or pumping to signal your body to increase production.

Can a very small piece of placenta really stop my milk from coming in?

Yes, even a very small fragment of placental tissue can continue to produce enough progesterone to interfere with the prolactin receptors in your breasts. While some parents may still produce some milk with fragments present, it often prevents the "surge" of milk typically seen in the first week. Removing even tiny pieces can be the key to unlocking your supply.

Is low milk supply the only symptom of a retained placenta?

While low milk supply is a common sign, it is usually accompanied by other symptoms like heavy or prolonged vaginal bleeding, passing large clots, or pelvic pain. Some people also experience fever or foul-smelling discharge if the retained tissue causes an infection. If you have low supply but no other symptoms, it is still worth discussing with a professional to rule out other causes.

Can I still breastfeed if I need surgery to remove placental fragments?

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