Colostrum is the nutrient-rich milk called 'pre-milk,' which your baby will receive for the first few days after birth. This thick, yellowish milk contains powerful immune-boosting properties. Colostrum is produced in tiny amounts and is packed with everything your baby needs during those first few days.
On day one, a newborn baby only requires about 2 -10ml of colostrum per feeding! No wonder it is referred to as 'liquid gold.' By day three, mothers produce between 15 and 30ml of milk.
It is best to breastfeed as early as possible after birth and as often as possible during those first few days to encourage the onset of mature milk. A baby is usually quite alert immediately after a natural birth, which makes the first hour following birth the best time to initiate breastfeeding.
Newborn babies have the innate ability to find the breast (while lying on the mother’s chest) and latch all by themselves!
When Will My Milk Come In?
Your breasts may start to produce colostrum during pregnancy, weeks or even months before your baby is due, although most mothers only notice this 'pre-milk' after the birth of their babies.
Most mothers will transition from producing colostrum to 'mature milk' on day 3. Some first-time mothers may only notice mature milk coming in on day 4.
When does milk 'come in' after a c-section? C-section births generally result in a delayed onset of milk - between days 4 and 6.
It is rare, but it is important to note that some mothers have such bad supply issues that their milk supplies never fully 'come in'. Factors that may be detrimental to establishing a supply are mentioned below.
Why Am I Feeling so Emotional?
You can expect some baby blues just as your mature milk comes in. This is normal and due to all the hormone fluctuations in your system. During this time, you might feel unusually weepy and particularly emotional; this should only last for a day or two. If you still feel this way two weeks in, it's best to talk to your lactation consultant. It would be a good idea to continue to take your prenatal vitamins for a few months after giving birth. Know that breastfeeding will help to prevent postpartum depression.
What Is a Let-Down?
A let-down is also known as the milk-ejection reflex. It is when the milk is ejected from the breast. It is perfectly okay if you never feel a let-down, but most mothers will experience a tingling feeling in their breasts and nipples when the breast milk starts to flow.
A let-down usually occurs a few seconds or minutes after your baby has started nursing, although you may have more than one let-down during a feeding session. It can also happen when a mother hears her baby cry (or any baby, for that matter) or sees her baby. A let-down occurs due to the hormone Oxytocin, AKA the 'love hormone.' Oxytocin causes the breast muscles to contract, squeezing the milk out. Some mothers also experience uterine cramping while nursing. This is nothing to be concerned about and is just your body’s way of getting your uterus back to its original size. Learn more about how breastfeeding shrinks your uterus.
How Will I Know That My Baby Is Hungry?
It is best to breastfeed your baby before they start crying. Newborn babies, and especially preterm babies, sometimes need to be woken for feedings every 2 - 3 hours.
I'm Worried About My Baby's Latch!
If your baby is not latched on well and milk transfer is insufficient, it could result in a low milk supply and very sore, broken nipples. It’s a vicious cycle because the more painful your nipples are, the less time you are likely to keep your baby at the breast. Less time at the breast equals less milk. Your baby must have the best latch possible. See latching on help here.
Deep Latching Technique
Adequate Milk Transfer
How Do I Know If My Baby Is Receiving Enough Milk?
Keep an eye out for any signs of dehydration, such as dry mouth, a sunken fontanel (soft spot on top of the skull), and a decrease in wet diapers. Breastfed babies sometimes lose some weight after birth but should regain their weight by day 10.
Signs to look out for - is my baby getting enough milk while nursing?
Signs That Your Milk Has Come In
- Your breasts feel fuller, warmer, engorged, and heavy.
- Your breasts may leak milk.
- Your milk has changed from a yellowish liquid to white milk. Mature breast milk looks much like cow’s milk, with a blueish tinge.
- Your baby's feeding pattern starts to change.
Changes can come gradually or suddenly, and it really is different from one mother to another. Milk production will diminish if no milk is removed during this time.
Factors That May Cause Delayed Milk Onset Include:
- A C-section birth.
- First-time breastfeeding mothers will usually have their milk 'come in' on day four instead of three.
- Pain medications given during delivery may delay the onset of mature milk. This includes large amounts of IV fluids given.
- Any other medications.
- A traumatic birth. Especially if the mother had to push for longer than one hour.
- If more than 500ml of blood was lost during childbirth.
- A retained placenta. Heavy bleeding and abdominal cramping are symptoms of a retained placenta. Even small pieces of retained placenta could cause supply issues.
- Premature birth.
- Hypoplastic breasts (underdeveloped, therefore, insufficient glandular tissue)
- Any previous breast surgery.
- Nipple abnormalities such as flat or inverted nipples.
- Other issues include diabetes, PCOS, thyroid issues, and hypertension.
What to Do If Your Milk Onset Is Delayed
- You and your baby must be comfortable while nursing. Please try different breastfeeding positions until you find something that works for the two of you.
- It is recommended to avoid the use of artificial nipples and pacifiers until your breast milk is well established. Giving your baby a bottle or pacifier reduces the time spent at the breast and could, therefore, diminish milk supply and cause nipple preference (when your baby prefers the bottle over the breast).
- If your baby is struggling to latch, you can use breast massage and hand expression to remove extra colostrum during the first few days. To avoid nipple confusion, it is best to finger-feed or syringe-feed the colostrum to your baby. Just place a few drops of milk on your finger and have your baby suck on it. Pumping can be done too, but hand expression is generally more gentle on tender nipples. Pumping should not replace your baby's time at the breast but should be done after or between feedings. The extra stimulation should cause your mature milk to 'come in' faster.
- Skin-to-skin contact has many benefits, including the promotion of breast milk production.
- Keep an eye on your baby's weight.
- If supplementation is necessary, a mother should consider using a supplementary nursing system.
- Get help! Talk to your lactation consultant. She can assess the situation and advise accordingly.
- Have your hormone levels checked, namely: thyroid, testosterone, and prolactin levels.
- Don't become too discouraged. A challenging start does not necessarily mean you will always struggle with breastfeeding. It might take a few weeks to build a full supply, but it is possible for most.
Please get in touch with your local la Leche league or lactation consultant if you have any concerns. They can assess the situation and advise accordingly. Be sure to contact them if:
- You are experiencing pain while nursing.
- Your baby is not staying awake at the breast to nurse.
- Your baby seems to still be hungry after feedings.
- Your baby is not gaining weight.
- Your baby is not producing enough wet or soiled diapers.