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Breast milk composition | What’s in your breast milk?

It’s full of nutrients that feed and protect your baby, but did you know breast milk composition varies over time? Find out what’s in breast milk and how it changes to meet your baby’s needs

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As your baby’s first food, you might expect your breast milk ingredients to include basic essential nutrients, such as carbohydrates, proteins and fats, as well as water to keep her hydrated, which it does.1 But breast milk is no ordinary food – it has more value than nutrition alone.

What’s breast milk made of?

Here are some of the other constituents of human milk present at every feed, many of which can’t be replicated:

  • Millions of live cells. These include immune-boosting white blood cells, as well as stem cells, which may help organs develop and heal. 2
  • More than 1,000 proteins3 that help your baby grow and develop, activate her immune system, and develop and protect neurons in her brain.
  • All that breast milk protein is made up of amino acids. There are more than 20 of these compounds in your milk. Some of them, called nucleotides, increase at night and scientists think they may induce sleep.4,5
  • Over 200 complex sugars called oligosaccharides6 that act as prebiotics, feeding ‘good bacteria’ in your baby’s gut. They also prevent infections entering her bloodstream and lower her risk of brain inflammation.
  • More than 40 enzymes.7 Enzymes are catalysts that speed up chemical reactions in the body. The ones in your milk have jobs such as aiding your baby’s digestion and immune system, as well as helping her absorb iron.
  • Growth factors that support healthy development. 1 These affect many parts of your baby’s body, including her intestines, blood vessels, nervous system, and her glands, which secrete hormones.
  • On the subject of hormones, your breast milk contains lots of them!7 These clever chemicals send messages between tissues and organs to ensure they work properly. Some help regulate your baby’s appetite and sleep patterns, and even aid the bond between you.
  • Vitamins and minerals – nutrients that support healthy growth and organ function, as well as help build your baby’s teeth and bones.1
  • Antibodies, also known as immunoglobulins. There are five basic forms of antibodies and all of them can be found in your milk.8 They protect your baby against illnesses and infections by neutralising bacteria and viruses.
  • You may have heard of long-chain fatty acids because they play a pivotal part in building your baby’s nervous system, as well as aid healthy brain and eye development. 9 And, you’ve guessed it, there are several of these in your milk too!
  • 1,400 microRNAs, which are thought to regulate gene expression, as well as help prevent or halt disease development, support your baby’s immune system, and play a role in remodelling the breast.10

While this is a long list, it’s only some of the ingredients in your breast milk – and scientists are still discovering more. Remarkably, the levels of these ingredients can fluctuate over time, depending on your baby’s age and needs.

Let’s start at the beginning…

The first few days: Colostrum

The early milk your breasts produce after your baby’s birth is called colostrum. This thick, sticky breast milk is often called ‘liquid gold’, not just because of its yellow or orangey colour, but because it’s so important for nourishing and protecting your vulnerable newborn.

At first you’ll produce very small amounts – just 40 to 50 ml (1.4 to 1. 8 fl oz) over 24 hours11 – but as your baby’s stomach is only the size of a marble, that’s all she needs. Colostrum is also very easy to digest. And what it lacks in quantity it makes up for in quality.

The composition of colostrum

Colostrum has the same ingredients that your later milk will have – it’s just that the amounts of these ingredients are different, as it’s tailored to your newborn’s needs.

For example, colostrum is sometimes referred to as a natural vaccination because its levels of antibodies and white blood cells are so high. Your first milk needs to contain these so it can protect your baby from infections and diseases after she leaves the safety of your womb.

Colostrum’s protective qualities are also important for your baby’s digestive system. Babies are born with a permeable gut lining, which colostrum coats and seals.12,13 This is particularly important if your baby is premature, as she’ll be more at risk from the dangerous gut condition necrotising enterocolitis (NEC). 13

It’s also rich in minerals and vitamins, with higher concentrations of vitamins A, E and K than mature breast milk. The percentage of protein in colostrum is higher too.1 Colostrum also acts like a laxative that helps your baby pass her first poo, meconium.14

The next couple of weeks: Transitional milk

During the first week of your baby’s life, around two to four days after delivery, your breast milk changes in quantity. You may feel your breasts become fuller and firmer – a change known as your milk ‘coming in’. On the third day, your baby will consume 300 to 400 ml (10.5 to 14 fl oz) of breast milk per 24 hours, and by the fifth day this increases to 500 to 800 ml (18 to 28 fl oz), so it’s not surprising your breasts may feel bigger!11

From day five to 14, your milk is called transitional milk.15 As the name suggests, it’s changing from colostrum to mature milk. It becomes creamier in colour and texture, and also higher in fat, calories and lactose (a natural sugar), making it the ideal food for your rapidly growing newborn.

But rest assured it’s still full of protective antibodies, live cells, ‘good’ bacteria and other bioactive ingredients to help keep her healthy.15

Four weeks onwards: Mature milk

By the time your baby is four weeks old, your breast milk will be fully mature. It’s rich in protein, sugar, vitamins and minerals, plus numerous bioactive components – such as hormones, growth factors, enzymes and live cells – to support your baby’s healthy growth and development.7

From four weeks, the nutritional content and levels of ingredients in mature milk generally remain fairly consistent. But the composition of your breast milk can still change from day to day and feed to feed.

For example, if you or your baby are ill, your body will make antibodies to fight that particular illness, which become part of your milk. And, remarkably, as your baby begins exploring the world and putting toys in her mouth, the level of protective bacteria-fighting enzymes in your milk rises. 16 This variation in breast milk composition shows how it adapts to your baby’s changing needs.

What are foremilk and hindmilk?

You may notice your milk seems thicker and creamier towards the end of a feed. This is because, as the feed progresses, the fat composition gradually increases due to the mechanics of milk moving through the breast. It’s often referred to as hindmilk, while the first more ‘watery’ milk is known as foremilk. These two names might lead you to think there’s a switch where foremilk becomes hindmilk, but there isn’t. The change is a gradual process.15 Both are essential parts of a completed feed, and rich in vitamins, minerals, protein and sugars.

Your milk’s fat content relates to how drained your breast is. Your breasts will be fuller at the start of some feeds (milk lower in fat) and more drained at the start of other feeds (milk higher in fat). So don’t worry too much about foremilk and hindmilk – over 24 hours your baby will end up consuming a similar amount of fat in total each day. 17

Breast milk composition after six months

You may be wondering what happens to your milk if you continue breastfeeding long-term. Can your body really keep producing such high-quality mature milk for months and months, or even years? The answer is, don’t underestimate your breasts!

While it’s true you’ll need to start introducing solids at six months to bolster your baby’s stores of certain nutrients, such as iron,18 your milk will still make up a large part of her diet.

For example, when your baby is seven months old she will still be getting 93% of her calories from breast milk. Even between 11 and 16 months, around half of her daily calorie intake will be from milk.19

So relax in the knowledge that you can both continue to enjoy the benefits of breastfeeding for many months to come.

References

1 Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatr Clin North Am. 2013;60(1):49-74.

2 Hassiotou F et al. Cells in human milk: state of the science. J Human Lact. 2013;29(2):171-182.

3 Beck KL, et al. Comparative proteomics of human and macaque milk reveals species-specific nutrition during postnatal development. J Proteome Res. 2015;14(5):2143-2157.

4 Zhang Z et al. Amino acid profiles in term and preterm human milk through lactation: a systematic review. Nutrients. 2013;5(12):4800-4821.

5 Sánchez CL et al. The possible role of human milk nucleotides as sleep inducers. Nutr Neurosci. 2009;12(1):2-8.

6 Moukarzel S, Bode L. Human milk oligosaccharides and the preterm infant: a journey in sickness and in health. Clin perinatol. 2017;44(1):193-207.

7 Hamosh M. Bioactive factors in human milk. Pediatric Clinics. 2001;48(1):69-86.

8 Brandtzaeg P. The mucosal immune system and its integration with the mammary glands. The J Pediatr. 2010;156(2):S8-15.

9 Uauy R et al. Essential fatty acids in early life: structural and functional role. Proc Nutr Soc. 2000;59(1):3-15.

10 Alsaweed M et al. Human milk cells and lipids conserve numerous known and novel miRNAs, some of which are differentially expressed during lactation. PLoS One. 2016;11(4):e0152610.

11 Neville MC et al. Studies in human lactation: milk volumes in lactating women during the onset of lactation and full lactation. Am J Clin Nutr. 1988;48(6):1375-1386.

12 Marchbank T et al. Pancreatic secretory trypsin inhibitor is a major motogenic and protective factor in human breast milk. Am J Physiol Gastrointest Liver Physiol. 2009;296(4):G697-703.

13 Herrmann K, Carroll K. An exclusively human milk diet reduces necrotizing enterocolitis. Breast Med. 2014;9(4):184-190.

14 Lawrence RA, Lawrence RM. Breastfeeding: A guide for the medical profession; 2011. 1114 p.

15 Martin CR et al. Review of infant feeding: key features of breast milk and infant formula. Nutrients. 2016;8(5):279.

16 Montagne P et al. Changes in lactoferrin and lysozyme levels in human milk during the first twelve weeks of lactation. InBioactive components of human milk 2001 (pp. 241-247). Springer, Boston, MA.

17 Kent JC, et al. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics. 2006;117(3):e387-395.

18 Kuo AA et al. Introduction of solid food to young infants. Matern child health J. 2011;15(8):1185-1194.

19 Dewey KG et al. Breast milk volume and composition during late lactation (7-20 months). J Pediatr Gastroenterol Nutr. 1984;3(5):713-720.

How to increase breast milk supply

How to increase breast milk supply | Pregnancy Birth and Baby beginning of content

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The best way to establish a healthy supply of breast milk is to start early, breastfeed frequently and make sure your baby is latching on correctly.

Some women have low supply, particularly during the early weeks of breastfeeding. This is the main reason some mothers start weaning or move to formula feeding. However, it's rare for a mother to produce less milk than her baby needs.

What are some reasons for a low supply?

There are many different reasons why some women have low supply including:

  • delays in breastfeeding after delivery or separations of mother and baby such as if the baby needs to be admitted to the special care nursery or if the mother is unwell after delivery
  • poor attachment to the breast, which can be caused by flat or inverted nipples, a tongue or lip tie, a sleepy baby because of jaundice, or a difficult or prolonged delivery
  • if the mother is unwell due to problems like mastitis, retained placental tissue or large blood loss after the baby is born
  • scheduled or timed feeding, rather than feeding baby on demand
  • taking an oral contraceptive pill that contains oestrogen
  • formula feeding as well as breastfeeding
  • skipping breast feeds and offering a supplement formula feed but not expressing breast milk at that time to ensure that supply continues to meet baby's demand
  • long-term use of dummies or nipple shields
  • smoking

Breast milk supply can be low if the woman has medical problems such as polycystic ovarian syndrome, hypothyroidism, diabetes and pre-diabetes, or takes some blood pressure medications and cold and flu preparations, or has taken the contraceptive pill or has been infertile.

In some women, breast or nipple surgery makes breastfeeding difficult. In a few women, the breasts did not change during puberty and early pregnancy in a way that makes breastfeeding easier.

Typical baby behaviour

Some health professionals and mothers have an unrealistic expectation of how the baby will behave and might be concerned that what is normal baby behaviour could indicate low supply.

If your baby is having a good number of wet nappies each day, low supply is not a likely cause.

Some issues with breastfeeding include:

  • wanting to be fed often — breast milk is digested in about 1.5 to 2 hours, whereas formula takes longer to digest
  • being more fussy in the evening; you might produce less milk at this time and your baby will request fewer feeds or will 'cluster feed' (feed frequently at certain times of the day)
  • liking to suck even if they have had a good breastfeed — sucking comforts them
  • wanting lots of cuddles and skin to skin contact — this makes them feel secure and ensures that baby's needs are being met
  • wanting to feed more frequently, which will happen when a baby is having a growth spurt — increased feeding will increase your supply
  • reduced amount of sucking time at the breast — this often happens after 2 or 3 months as your baby becomes more efficient at the breast

What is normal for mum?

Although breastfeeding is different for every woman, the following do not mean that you have a low supply:

  • your breasts suddenly seem softer — this is normal as your milk supply adjusts to your baby's needs
  • your breasts do not leak milk, stop leaking or only leak a little
  • you don’t feel a 'let-down' when milk pushes out of the breast
  • you are unable to pump very much with an electric pump — remember the baby is much more efficient and will always get more than a pump
  • how much you pump decreases over time

How do I know that baby is getting enough milk?

Always look at the whole picture to ensure that baby's growth and development is with normal limits. The baby is getting enough milk if they:

  • go through 6 to 8 wet nappies in a 24-hour period including at least a few dirty nappies
  • wake for feeds by themselves and feed vigorously at the breast
  • have 8 to 12 breastfeeds in 24 hours
  • pass a soft yellow stool
  • settle and sleep fairly well after most feeds
  • is back to birth weight in about 2 weeks
  • gain on average 150g or more every week for the first 3 months

If your supply is low

Milk supply is considered to be low if you are not producing enough milk to meet your baby's normal growth and development needs.

Low milk supply is usually a temporary situation that will improve with appropriate breastfeeding support and management. Making more milk is all about supply and demand — the more milk is removed from the breast, the more milk is made. The less milk removed, the less made.

How to increase your supply

The following may help increase your breastmilk supply:

  • ensure that baby is attaching well and removing milk efficiently from the breast
  • be prepared to feed your baby more frequently — breastfeed on demand every 2-3 hours at least 8 times in 24 hours
  • switch your baby from one breast to the other; offer each breast twice
  • ensure your breasts are emptied well at each feed or pumping session; you can express after breastfeeds to make sure
  • do not go longer than 5 hours without milk removal — your baby at the breast sucking is the most effective way to do this, but otherwise use a hand or electric pump
  • when your baby is feeding, compress your breast to aid milk flow as this will also encourage more effective sucking
  • make sure you are drinking a lot of water, eating a healthy balanced diet and not missing any meals
  • also ensure you are resting as much as possible between feeds

Other options that can help with a low supply include:

  • a supplemental nursing system or 'supply line'
  • herbal and pharmacological remedies that are known to increase milk supply (galactogogues)

Some cultures use food or herbs to increase breast milk supply but many of these have not been formally studied. Domperidone is a prescription medicine that can increase the hormone prolactin, which can help stimulate breast milk production. Your doctor may discuss if this medicine is right for you. The main way to increase breast milk supply is through breastfeeding or expressing milk more than you currently do.

If you think you have low milk supply, talk to your doctor, lactation consultant, breastfeeding counsellor or child health nurse. You can call Pregnancy Birth and Baby on 1800 882 436 for advice and support.

Sources:
Australian Breastfeeding Association (Increasing supply), Karitane (Breastfeeding), Royal Women's Hospital (Low milk supply)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: October 2021


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