Almost all women worry about breastfeeding, especially when they are new milking women. Pregnancy and breastfeeding lead every woman to numerous physiological and emotional changes.
Colostrum is the special milk secreted during the initial days after delivery. It is secreted in small amounts, about 40 to 50 milliliters on the first day. But, it is sufficient to meet the infant's needs now. It is rich in white blood cells and antibodies, especially IgA, and it contains added protein, minerals, and fat-soluble vitamins (A, E, and K) than the milk that is secreted later. Colostrum provides immune protection and helps develop the infant's immune system. It is essential to feed every baby with colostrum milk and not other feeds at this time.
Milk secretion increases between two to four days after delivery, making the breasts feel full; the milk is said to have “come in.” After seven to 14 days, the breast milk is called transitional milk, and after two weeks, it is called mature milk. The concentration of all these types of milk varies according to the growing needs of the infants. That is why breast milk is considered the best source of nutrition for growing infants.
When Will My Milk Come In?
Milk “coming in” generally refers to when the mother first notices physiological changes in her breast, including increased breast fullness, tenderness, or heaviness when milk production begins.
The milk secretion begins even before delivery. Colostrum, the first milk secreted from the mother's breast, is formed when the mother is about four months pregnant. However, the breast milk's flow, volume, and composition are established when the milk starts “coming in.”
Usually, the milk will change in concentration and increase in volume even if the mother practices breastfeeding. However, the prolactin hormone starts the breast milk secretion postpartum, so the body will continue making milk irrespective of breastfeeding.
Mothers may notice their milk secretion increasing about three to four days after delivery and their breasts getting fuller, firmer, and heavier and will know signs milk is coming in. However, if they are a new mother and have had a difficult delivery, or if there are any other complications with the delivery, it may take time (a day or two) for the milk volume to increase. Also, with the second or later babies, milking women are more likely to experience milk production earlier. Though these time frames are variable for every woman, it may be earlier for some milking woman and later for others.
When Should I Start Breastfeeding?
It is important to start breastfeeding the baby as early as possible and feed the baby more often. Early and frequent breastfeeding increases prolactin activity and builds a proper milk supply in the breast. Hence, the more often mothers feed their babies, the better will be their milk supply.
Additionally, the early milk contains colostrum which is essential for the overall well-being of the baby as it provides protection against various infections and prevents many systemic conditions in later stages of life.
The American Academy of Pediatrics (AAP) recommends breastfeeding for the first six months of life and continuing breastfeeding until the mother and the baby desire it. Breastfeeding is beneficial for both the mother and the baby. It also reduces the chances of breast and ovarian cancer in breastfeeding mothers—skin-to-skin contact while breastfeeding builds an emotional bond between the mother and the newborn babies.
How Long Does It Take for Milk to Come In?
Milk production generally starts to increase between 30 to 40 hours after delivery of the placenta. But for some mothers, it may take some time for these changes to happen. Signs that the milk secretion is increasing may include the following:
Breast fullness, swelling, and heaviness.
Warmth (increase in temperature of the breast).
Tingling sensation in the breast.
Leaking milk from the breast.
Change in baby’s feeding patterns.
Concentration change in milk secretion. The milk changes from thicker golden colostrum to thinner and whiter mature milk.
What Should I Do if My Milk Does Not Come by Day Four?
The time of milk secretion is variable for all women, and the new mothers may get the milk secretion later than experienced mothers. However, if the mothers do not have milk secretion by day four, they may seek the help of their doctor or lactation specialist. Under such situations, they may consider the following:
Mothers may check for complete emptying of their breasts frequently and thoroughly.
Maintaining skin-to-skin contact with their baby can also help with milk production.
They should monitor their baby’s weight to ensure that they get enough milk. Breastfeeding needs to be evaluated if the baby loses more than seven percent of their birth weight.
If the baby is not getting enough milk, other supplements should be given after consultation with a doctor.
Mothers may seek help from a local board-certified lactation consultant to increase their milk production.
If the delay is due to other reasons, then the causative factors should be determined to increase the milk supply. For example, if retained placental fragments inhibit milk secretion, removing the placental fragments will increase milk production.
Tests for checking hormonal levels can be performed (thyroid, testosterone, prolactin).
Nursing takes time and practice for every mother. Breastfeeding can be initially challenging for a new parent, but at the same time, it can be rewarding for some. Little patience and some practice can help mothers achieve a successful breastfeeding experience with their babies. The earlier experience might be painful for many mothers. However, when the mothers learn the comfortable position for themselves and their baby, it becomes easier gradually. Mothers should maintain skin-to-skin contact with their babies and feed their babies as often as possible. This stimulates the milk supply in the breast. Mothers may seek help from an experienced mother or lactation specialist to learn the proper latching techniques.