Once a lady hears the news that she is pregnant and will be a mother soon, many thoughts cross her mind about pregnancy, birthing and finally about her journey to parenthood. As is true for most of us, moms-to-be are in nuclear families and they don’t have any experience of handling a baby post birth. This makes her nervous about the whole process and she is apprehensive whether or not she will be able to breastfeed the baby. She does not know when the milk will start and whether she will be able to produce a good quantity of milk. As a lactation consultant, I often come across mothers who have many questions related to breastfeeding and milk production, such as when will the milk production start, what does lactation delay look like, or will they produce enough colostrum?
It is important to understand that hormones play a major role in pregnancy and milk production. During pregnancy, hormonal activities increase, and this in turn causes the mammary glands to produce milk. However, this is all just preparation for breastfeeding. Mature milk production can start within three to five days of the baby being born.
Milk production starts during the midpoint of pregnancy, which is around 16-22 week of pregnancy. During the second trimester, your breasts begin to create colostrum. Colostrum is the first food your breasts produce for your baby. It is usually thick and yellowish and contains high amounts of proteins and antibodies to strengthen your baby’s immune system. Many mothers are not aware about this because it does not flow like mature milk. It might start with a few watery drops as this is the first milk.
Colostrum does not leak or produce for all pregnant mothers during pregnancy and for many, colostrum will start after the birthing process, which is absolutely normal. During pregnancy, mothers should not express or pump colostrum, as it might trigger the labor process. Mothers can use breast pads for comfort. If there is a good quantity of colostrum or a leaky colostrum, moms-to-be can express it by hand after 37 weeks of pregnancy and store it.
You may start producing breast milk months or weeks before your due delivery date. One of the first signs that your breasts have started producing milk is that they will become fuller and heavier, and they may even hurt sometimes. Immediately after birth, the mother will see transparent or yellowish color drops in the nipple area i.e. colostrum or liquid gold.
It is the first stage of milk production. It is thick, sticky, concentrated and very nutritious. Baby should suckle at breast within one hour of birth, this period is called golden hour. Colostrum is known as ‘liquid gold’, because it’s packed with protein, growth factors, white blood cells, and antibodies, especially immunoglobulin A (IgA) to fight off infections.
It’s very important for a baby’s health and immune system. In the first 24 hours after your baby is born, Mother will produce— on average — 1 ounce (30 milliliters) within 24 hours. On the second and third day, the mother will make approximately 2 ounces (60 milliliters) of colostrum. Some people’s breasts may leak during this colostrum phase, but this is normal. Within three to five days of delivery, your breasts go through a transition where mature milk gradually replaces colostrum. By the time your baby is around two weeks old, your breasts will only be producing mature breast milk.
Colostrum is replaced by transitional milk, which will start from day three to five until up to two weeks. Watery or yellowish milk will change into whitish milk. Transitional milk will be a combination of colostrum and mature milk. Frequent breastfeeding or regular milk expression will help with milk production and it also avoids engorgement. Transitional milk will be replaced by mature milk usually between 10 to 15 days. Its whitish milk with all nutrients and its production depends upon demand and supply principle.
Frequent nursing will stimulate mothers’ brains to release milk hormone, and accordingly, milk supply will be there.
Once the supply of breast milk settles down, it keeps on adjusting as per demand of the baby. For example, if a baby gets growth spurts, the baby will demand feed frequently and this might cause confusion to the mother that supply is not enough and the baby is hungry but in actuality, the baby is demanding the mother’s body. This way, the milk supply increases and settles down mostly within a week.
As per my clinical experience, many new mothers come with complaints of low milk supply and after assessment, most of the cases show stimulus to the mother’s body is missing, because of many reasons like preterm baby, medical condition of mother and baby, supplementation of formula, stress or postpartum depression etc.
For example if the mother is giving formula feed to the baby without trying for breastfeeding, that much demand or stimulus to the mother’s body will be missing and accordingly, her body will be producing less breast milk. If the baby is preterm and stability is not there, there might be ineffective or non-nutritive suckling by the baby on breast, which further reduces milk supply. Because of some external stress factors or postpartum depression of the mother, milk hormones might be affected.
If you have trouble with production even later on, in your newborn’s development, don’t give up! Breastfeeding takes a lot of diligent commitment, effort, and energy. Consult a lactation specialist or who will help you answer your questions and continually educate you about the ways your body is changing, as milk production increases. Early initiation at breast is a good start for good milk production. If a mother is not comfortable medically to feed her baby after birth, colostrum expression should be done within one hour of birth followed by frequent feeding or removal of milk.
An expecting couple should prepare themselves during pregnancy for breastfeeding. Antenatal classes can be of great help for proper guidance and support that will help them sail through this journey of breastfeeding.