The Breastmilk Guide - Milk coming in…what to expect & when!

Congratulations! You've successfully navigated through labor and delivery, welcoming your precious bundle of joy into the world.

Now, one of the foremost questions on your mind might be: when will my breast milk come in?

For countless breastfeeding mothers, this moment is eagerly awaited, marking the beginning of nourishing their newborn with nature's perfect food. If you're curious about the timeline for your milk's arrival and how to manage potential delays, this guide is here to provide insights from day one until your lactation is fully established.

Phases of Lactation

Let's start at the beginning: your body has been preparing for breastfeeding for years, long before pregnancy. Even prior to conception, your breasts possess all the necessary components for lactation. Throughout pregnancy, you may notice changes in your breasts, such as increased size and heightened sensitivity – positive indicators that your body is gearing up for milk production. This growth signifies the development of glandular tissue essential for generating breast milk.

Early Milk Production

Did you know that your body begins producing the first milk, known as colostrum, as early as 10-22 weeks into pregnancy? This marks the onset of the first stage of milk production, termed "Lactogenesis 1". If you're currently expecting, congratulations, you're already in stage one! Colostrum, often referred to as "liquid gold," is packed with essential nutrients crucial for your baby's early development. For further insights into colostrum and its significance, refer to our comprehensive guide on Hand Expression or check out my YouTube channel for a video on hand expression.

Expected Timeline

Following childbirth and the delivery of the placenta, your body undergoes a significant hormonal shift. While the placenta previously signaled the preparation phase with the secretion of progesterone, it's the rapid decline in progesterone levels post-placental delivery that initiates the second stage of milk production, known as "Lactogenesis 2." Typically, milk production begins to ramp up between 30-40 hours after birth, with noticeable increases occurring around the 2nd-4th day post-delivery – commonly referred to as "milk coming in." Many mothers report sensations of fullness, heaviness, and warmth in their breasts, accompanied by a lightening in the color of their milk. Despite feeling sudden, this uptick in milk volume is gradual.

Factors Affecting Milk Arrival

Instances of delayed milk production, defined as taking longer than 72 hours to increase, are not uncommon, especially in regions like the US where childbirth interventions are prevalent. Various factors contribute to these delays:

1. Prolonged or difficult labor

2. Excessive blood loss during childbirth

3. Cesarean sections, which may result in delayed initiation of feeding and reduced feeding frequency in the early postnatal period

4. Primiparity (being a first-time mother)

5. Gestational diabetes or hypertension

Promoting Timely Milk Production

Efficient milk supply hinges on early and frequent colostrum removal, stimulating your body to produce more milk sooner. Even if latching proves challenging, manual expression of colostrum can kickstart milk production. Refer to our hand expression guide for detailed instructions.

Recognizing Milk Arrival

Transitioning from colostrum to mature milk occurs over 2-3 weeks, during which you may notice the following signs:

- Increased warmth and heaviness in the breasts

- Enhanced veining on the breasts

- Leakage of milk from nipples

- Increased frequency of baby swallowing at the breast

- More frequent urination and changes in stool consistency and color in the baby

- Baby exhibiting contentment post-feeding, often referred to as being "milk drunk"

- Baby's weight stabilizing and then increasing gradually

For effective nursing during the first week, milk volume should rise from an average of 37-56 ml on the first day to around 610 ml (20.6 ounces) by day 7.

Addressing Delayed Milk Production

If you experience delayed milk production, consulting with an International Board Certified Lactation Consultant (IBCLC) is crucial for identifying underlying causes and devising a personalized plan. Remember, feeding the baby remains the top priority. Supplemental feeding with formula or donor milk, alongside techniques like triple feeding (breastfeeding, pumping, and supplemental feeding), may be necessary short-term interventions.

Improving Latch

Improving latch quality is paramount for effective breastfeeding. Seek assistance from an IBCLC for a functional oral assessment and personalized strategies. Our Boob School offers resources and workshops on latching to alleviate stress and ensure comfortable breastfeeding from day one.

Final Thoughts

The journey of breastfeeding is a beautiful yet intense experience, especially in its early stages. Remember, support is readily available, from lactation consultants to educational platforms like Boob School. Let's cultivate strong parenting communities and empower ourselves with knowledge to nurture our babies effectively.

With unwavering support. 

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