When does milk come in? Is my baby getting enough? Should I pump for a better supply? These are common questions that newly breastfeeding mothers have – and we have answers!
When Does Breast Milk Come In
I’ve said it before, but I’m sometimes very grateful that I had Jack at a time where there wasn’t so much information being thrown at you from the Internet.
Sure, I was in some Baby Center boards for my birth month, but online breastfeeding groups didn’t really exist.
Although I think that these groups can be incredibly beneficial to mothers (I mean, I run one myself), I also think they can make mothers often feel like they aren’t producing enough. It can also make them overthink breastfeeding.
I’ve mentioned in the past how I really didn’t know much about breastfeeding before my first was born. I just figured I would do it. And fortunately, it went quite smoothly.
I didn’t know anything about my milk supply, or how to bring it in, or how things I was doing after birth might affect it!
Since then, I’ve learned a lot, and I have a passion for helping mothers learn about how to have a healthy breast milk supply from the start.
Table of contents
Myths about Milk Supply
First off, I want to clear the air on a couple of things:
- Pumping is not an indication of supply
- Average output with the pump – when done with breastfeeding – is .25-2 ounces per hour.
- Having an oversupply is not desirable. I know a lot of mothers who say they want to have an oversupply
- Pumping before you give birth will not affect how good of a supply you will have. In fact, unless medically necessary, you really shouldn’t pump before giving birth (at least not until you are full term), as it can put you into labor. If you are leaking colostrum, then you could use a milk saver to collect the milk
- Speaking of colostrum – some women leak it before they give birth, others do not. I did with my first but not with my second. This is not an indication of whether or not you will be able to breastfeed.
- Babies don’t need a lot of milk immediately after giving birth!
I’ll talk about this in a moment, but I don’t even recommend pumping (unless medically necessary) for the first month or so after giving birth. I think that it can make mothers stress out more than they need to, and in my opinion, stress can affect breast milk supply SO much.
When is Milk Supply Established
Secondly, I want to talk about the process of milk coming in. Breast milk production actually starts during pregnancy (this is colostrum), however, your mature milk won’t come in until after baby is born.
As soon as the placenta is dispelled from the body, this is a signal for your body to start producing breast milk. Whether or not you actually breastfeed or not, this is actually a hormonal process, and your milk will start to come in around day two (sometimes sooner, sometimes later).
Some people will say that there’s nothing you can do for your supply since this is a hormonally driven process. However, if milk isn’t being removed from the body, then the body will stop producing it. Research shows that mothers who nurse frequently after the baby is born have higher milk production on days 3 and 4.
After those first few days especially, there are quite a few things you can do to better your chances of having a good breast milk supply. So now is where I will be sharing things you can do to help your supply.
Always be aware of the signs of dehydration and that your infant isn’t getting enough. While cluster feeding is normal and the majority of mothers will produce enough milk, there are times where a baby will nurse and not be getting enough. Signs of an infant not getting enough include decrease urine and stool output, sunken in eyes, lethargy, inconsolable crying, and weight loss above 10%. Always work with a lactation consultant after giving birth! If you don’t have access to one in person, I highly recommend Lactation Link’s online consults.
How to Boost Milk Supply
1. Breastfeed as soon as possible
Barring any complications, if you want to breastfeed, do it as soon as possible. The sooner you can get your baby to nurse, the sooner your milk will come in. Latching frequently lets the body know that there is a baby ready and wanting to nurse.
In the past, it was common for mothers who had c-sections to not be able to nurse for a while after giving birth. Some hospitals still follow this protocol, but it’s becoming more and more common (thankfully) to let mom and baby be together immediately following the c-section.
If you are having a c-section, make sure you talk about this with your physician and let them know your desire to not be separated unless medically necessary.
2. Skin to Skin
My milk came in around day two with Oliver, and I believe it’s because we were constantly doing skin to skin. Unless I was sleeping, he was just inside my hospital robe. I loved it!
Skin to skin has been shown to be associated with increased milk production. It’s also a great way to encourage baby to nurse frequently. When they have that constant access to the breast, babies will often try to latch on their own. It’s really a cool thing!
I always liked little baby kimonos when I had Oliver. It made it easier to do skin to skin without taking off his clothes altogether.
3. Feed Frequently
Don’t worry about getting on some kind of feeding schedule initially – stop watching that clock. Breastfeeding is a supply and demand system, and if the baby wants to nurse frequently, it’s their way of telling the body to produce milk.
If baby wants to nurse every 30 minutes for a while, that’s generally just fine. We live in a society that pushes schedules, but I believe that this can be a big downfall in the beginning days of breastfeeding. If you are limiting how frequently baby can nurse, this can greatly impact your supply.
4. Avoid supplementing
Please don’t get me wrong – there are situations where supplementing (whether by formula or donor milk) is 100% necessary.
But in most situations, if you don’t need to supplement – don’t! If you don’t have to give milk from a bottle – don’t! I see a lot of moms who want to hand off the middle of the night feeds to their spouse or partner, but they don’t realize that they will need to pump in place of those feeds…which can be even more exhausting.
If you do have to supplement, make sure you are pumping in place of any feeds. If you are given the recommendation to supplement by your pediatrician, I would recommend working with an IBCLC to make sure you are doing it correctly. We were told to supplement by a pediatrician, and she said, “Don’t worry about pumping. Just have your husband give a bottle a couple times a day, and you’ll be fine!”
Fortunately, as soon as she left the room, the lactation nurse who was in the room quietly gave me advice that I credit for saving me from making some mistakes that would have affected my ability to nurse big time.
This is a great article to read about supplementing and what to do when you are given the recommendation to supplement.
5. Try not to pump
Some women believe that if they pump in addition to nursing, that will give them a great supply!
This belief comes from well-meaning friends – and even some medical professionals. However, when a mother is able to put the baby to the breast frequently, pumping in addition to nursing is not necessary or even recommended.
Pumping too much in the early days can lead to an oversupply. And while an oversupply may sound wonderful – it really is not. It can lead to mastitis, plugged ducts, a fast letdown (which can lead to infant refusal to nurse, reflux, etc.) I have worked with a lot of mothers with massive oversupplies, and their message is typically the same – avoid it at all costs.
There are some situations where pumping is necessary – if the baby isn’t able to latch or isn’t transferring well, if mom isn’t producing enough, mom has chosen to exclusively pump, etc. But in most situations, pumping after giving birth is not necessary for your supply.
As my IBCLC always would say, “For the first four weeks, put the pump away and enjoy your baby.”
**Many mothers want to pump because they feel so engorged. Pumping until you are empty to relieve engorgement can encourage an oversupply. If you are experiencing painful engorgement, try to hand express first until comfort. The best antidote for engorgement is to have baby nurse – if they will. If you are experiencing engorgement that just isn’t getting better, please contact an IBCLC for further help.**
6. Wake Baby Up
If baby isn’t eating at least every three hours, and they just want to sleep, make sure you wake them up. Ideally, baby should be eating every 2-3 hours, though it may be even closer together during those first few weeks.
With my youngest, we just let him sleep – and I think this may have contributed to some issues that we had. I ended up getting mastitis, which typically does cause a temporary drop in supply (which I experienced). My body wasn’t being stimulated as frequently as it needed to be, and not only did my son have some issues gaining weight (not entirely related to this, but it sure didn’t help), but it affected my milk supply.
It can be hard to wake a sleepy baby – but it’s important to remember that babies also don’t need to be WIDE awake to nurse. Many of them will latch will they are sleeping or drowsy.
7. Check Your Latch
An insufficient latch can make it so baby isn’t transferring milk well. And if the baby isn’t emptying the breast entirely, that will signal your body to stop producing that much milk.
If you are worried about your latch, definitely work with an IBCLC to make sure it’s correct and that baby is transferring well. This is my favorite latching video that I recommend to just about everyone!
8. Trust Yourself
Breastfeeding requires at least some faith in yourself. If you are constantly doubting yourself, it can be easy to convince yourself that you won’t ever produce enough milk.
While there are certain situations where all the trust in yourself won’t affect your milk positively, I do think that having a good attitude goes a long way. Try to avoid comparing yourself to other moms, keep an eye out for the signs of wellness (producing enough diapers, proper weight gain, generally content, normal awake and sleep time, etc.), and trust yourself!
And even if you are struggling with true low milk supply – just remember that you are doing great! And any amount of breast milk is great. There are many mothers who have struggled with low milk supply in the beginning who have gone on to successfully breastfeed with a good supply.
Signs Milk is Coming in
You might be getting anxious about if your milk supply is coming in or not – I totally get that! It can be a bit stressing. Here are a few signs that your mature milk might be coming in:
- Baby cluster feeding less
- Breasts feel fuller
- Milk starts to leak (and looks more white than yellow)
- Diapers are more frequent – stool starts to change from blackish to yellow
- Feeling extra emotional – right before my milk came in both times, I got extremely emotional. I don’t know if this happens with everyone, but it definitely happened with me!
Reasons for Delayed Milk Supply
While most mothers will start to produce milk between 48 and 72 hours after giving birth, there are situations where this may not be the case. Here are some scenarios that may cause milk to come in later (but these are not necessarily the kiss of death! My milk came in just fine with both my children and I had an epidural both times).
- First-time mothers may have their milk come in later
- Lots of IV fluids (this can also artificially inflate an infant’s birth weight)
- Blood loss
- Retained placenta
- Pain medications
- Health issues such as insulin resistance, PCOS, infertility, Type 1 diabetes, etc.
- Insufficient glandular tissue
- Certain medications