Breast Milk: When does production begin

New Delhi

Most moms-to-be in nuclear families don't have any experience of handling a baby post birth. This makes them nervous about the whole process and apprehensive about whether or not she will be able to breastfeed the baby. 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, will I 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.

Before Birth

Milk production starts during the midpoint of pregnancy that 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 as few watery drops as this is first milk that's called "colostrum".

Colostrum does not leak and not all pregnant mothers produce it during pregnancy, for many colostrum starts after the birthing process. This is absolutely normal. During the pregnancy a mother-to-be should not express or pump colostrum as it might trigger the labor process. Mothers can use a breast pad just for comfort. If there is good quantity of colostrum or leaky colostrum, one can express it with hand after 37 weeks of pregnancy and store it.

After Birth

You may start producing breast milk months or weeks before your due date of delivery. 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 the birth, a mother will see a transparent or yellowish colour of drops at 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. The baby should suckle at the breast with in 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 the baby's health and immune system. In the first 24 hours after your baby is born, a mother will produce�on an average - 1 ounce (30 milliliters) within 24 hours. On the second and third day, she will make approximately 2 ounces (60 milliliters) of colostrum. Some people's breasts may leak during this colostrum phase. 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 3-5 up to 2 weeks. Watery or yellowish milk will change in to whitish milk. The breast will feel warm and full. Transitional milk will be combination of colostrum and mature milk. Frequent breastfeeding or regular milk expression will help with milk production and also o avoid engorgement. Transitional milk will be replaced by mature milk usually between 10 to 15 days. It's a whitish milk packed with nutrients and its production depends upon the demand and supply principle. Frequent nursing will stimulus mothers brain to release milk hormone and accordingly milk supply will be there.

Once supply of breastmilk settles down it keeps on adjusting as per demand of the baby, for example if the baby gets growth spurts baby it will demand frequent feeding and this might cause confusion in the mother that her supply is not enough and the baby is hungry; but actually the baby is expressing its demand to the mother's body so that the milk supply increases and settles down mostly within a week.

Stay Committed!

As per my clinical experience many new mothers complain of low milk supply and after assessment most of the cases the demand or stimulus to mothers body is missing. This can be because of many reasons like preterm baby, medical condition of the mother and baby, supplementation of formula, stress or postpartum depression etc. For example if a mother is giving formula feed to the baby without trying to breastfeed, that demand or stimulus to the mother's body will be missing and accordingly her body will produce less breastmilk.

If baby is preterm and cheeks stability is not there, there might be ineffective or non nutritive suckling by the baby on the breast which further reduces the milk supply. Because of some external stress factors or postpartum depression milk hormones can be affected and a mother might face low milk production.

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 the breast is good start for good milk production. If you are not comfortable medically to feed your baby after birth, colostrum expression should be done within one hour of the birth followed by frequent feeding or removal of milk.

An expecting couple should prepare themselves during pregnancy for breastfeeding. Antenatal classes are great help which help in proper guidance and support that will help them sail through this journey of breastfeeding.