Tuesday, August 9, 2011

How do I know my milk has come in when breastfeeding?

Around 3-5 days after a baby is born, a mom feels fullness in her breasts typically described as her “milk coming in”. This isn’t an entirely accurate description. As I discussed in my previous post entitled “How do I start?” a woman begins making colostrum around 16-18 weeks of pregnancy. Colostrum is the first milk a mother produces and the first milk a baby receives after birth. It is commonly believed that a mother only has a limited amount of colostrum and once the baby consumes that, they just have to go hungry until her milk “comes in”. Colostrum actually continues to be produced at the same time as the mature milk begins to be produced. A woman doesn’t have colostrum one day and mature milk the next day. The conversion of colostrum to mature milk is a gradual process.
The production of mature milk is actually triggered by the delivery of the placenta. The placenta regulates the hormones of pregnancy. When the placenta is delivered there is an immediate drop in Progesterone which allows Prolactin to begin working to produce milk. This is why it takes approximately 3-5 days for a mother to feel like her milk has “come in”.
Engorgement is a common concern for new mothers. Breast fullness, including tenderness and sensitivity is normal but, if milk is not removed, this leads to engorgement. Prevention is the best medicine for engorgement. Ideally, baby latches on correctly and feeds on-demand from the first hours of life and around the clock without restriction. Frequent and effective removal of milk is the key to preventing engorgement. True engorgement is excessive swelling and pain and the baby is unable to latch on. Please seek help from a Professional Lactation Consultant if you are in this situation.
The first two weeks of a baby’s life are crucial to a mother’s milk production. The more frequently a baby breastfeeds during the first two weeks, the better milk supply the mother will have. It is tempting to want to skip nighttime feedings so a mother can get more sleep, but nighttime feedings are critical to milk production due to hormone levels being higher during the night.
By Alicia Fonder, RN, CLC, LCCE, CHBE

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