Pregnancy when does milk come in

When Does Breast Milk Come In? Stages & Signs

If you’re expecting baby’s arrival soon, or if you just recently gave birth, you may be wondering, “When does breast milk come in?” What you may not know is that our bodies like to be prepared for baby well before their arrival. Women start producing baby’s first food midway through pregnancy and continue on to make different types of breast milk over the course of those first couple weeks postpartum. Keep reading to learn about the types of breast milk a mother makes and how long it takes for milk to come in, plus what to do if your breast milk is delayed.

In this article:
When does breast milk come in during pregnancy?
When does breast milk come in after birth
Signs your milk is coming in
Why your milk might be delayed coming in
What to do if your milk is delayed

When Does Breast Milk Come in During Pregnancy?

If you’re pregnant, you may be making early breast milk and not even know it! Milk production generally begins around the midpoint of pregnancy, somewhere between weeks 16 and 22. At this stage your body is producing what’s known as colostrum—a yellowish milk that’s rich in calories and disease-fighting antibodies—which will serve as baby’s first food after birth. Some moms-to-be may even notice faint yellow or orange stains in their bra during the second or third trimester, a sign that their nipples are leaking colostrum. (If they never leak, that’s fine too.)

When Does Breast Milk Come in After Birth?

From the moment baby is born, your body is prepped and ready to deliver colostrum. This is true whether you delivered vaginally or via cesarean. “It’s a hormonal process, meaning that breast milk would come in regardless of whether baby ever breastfed or if Mom pumped in those first few days,” says Carrie Bruno, RN, IBCLC, a lactation consultant and founder of The Mama Coach.

As baby gets the hang of feeding and their needs evolve, your body will begin to cycle through the three stages of breast milk: colostrum, transitional milk and, finally, mature breast milk. Keep reading to learn more about each type of milk and how long it takes milk to come in.

Colostrum

Since your body starts producing colostrum during pregnancy, that first type of breast milk has already come in by the time baby is born. Your newborn will only get a few drops of colostrum at each of those first feedings, but it’ll give them plenty of nutrients. What it lacks in quantity, it makes up for in quality—which makes perfect sense, given that “when babies are born, their stomachs are small, like a marble!” Bruno explains. “This makes colostrum the perfect first milk” Colostrum also works as a laxative to help baby pass their first stool, known as meconium, and helps prep baby’s intestines for the arrival of mature breast milk.

Transitional milk

Transitional milk typically comes in two to five days after birth. This period is commonly referred to as “milk coming in”—as your body ramps up breast milk production to fill baby’s expanding belly, your breasts will start to feel full.

Transitional milk will look thinner and whiter than colostrum, according to Sherry Ross, MD, a women’s health expert and author of She-ology: The Definitive Guide to Women’s Intimate Health. It provides baby with more energy, Bruno adds, as it’s higher in fat and carbohydrates. Transitional milk can last for up to 10 to 14 days after birth.

Mature breast milk

Toward the end of the second week, moms can expect their mature breast milk to come in. Mature breast milk is the milk baby will continue to drink until Mom and baby want to wean. “Breastmilk composition changes throughout the breastfeeding relationship to match exactly what the baby needs,” Bruno says. “Breast milk contains two types of proteins: whey and casein. Over time, this ratio of casein and whey changes. Whey is high in immunoglobulins and easier to digest, whereas casein helps baby feel full longer. In the beginning, with colostrum, the ratio of whey to casein is 90:10, and after a month it’s 60:40. If Mom breastfeeds for over a year, it’s closer to 50:50.”

Signs Your Milk Is Coming In

So you now have a sense for when breast milk comes in—but what does it feel like when your milk comes in? Here are a couple common signs that your milk is in:

Your breasts become engorged

According to Bruno, the most common sign is a feeling of fullness and engorgement. “Breasts physically fill with milk, which can feel heavy and sore. Breasts can feel hard to the touch, warm and tingly,” she says. “Mom may also notice her breasts leaking in between feeds.”

Engorgement when milk comes in can be painful. Luckily, there are ways to help decrease the discomfort:

-Breastfeed often. One of the best things moms can do to help with engorgement is keep up a regular feeding or pumping schedule, Bruno says, as that will help empty the breasts and avoid clogged milk ducts. You can even massage your breasts while nursing

-Express by hand. “If moms are finding it hard to latch their baby due to the engorgement (sometimes breasts can feel so full the nipple flattens), it can be helpful to hand express for a few minutes to soften the breast, which will help the baby to latch easier,” she explains.

-Apply ice. “If mom is still sore after feeding, applying ice for a few minutes after feeding can provide some relief,” Bruno says.

-Apply heat. Ross also recommends using a warm compress or taking a warm shower in between feedings.

Baby starts gulping

Another telltale sign to look for when your milk comes in? Baby will start to take longer gulps. “Baby’s feeding patterns will change,” Bruno explains. “Mom will start to notice baby staying longer at the breast, and be able to hear audible swallows of milk.”

Moms may also see milk dribbling out of the corner of baby’s mouth. In fact, after the first few feedings of fast-flowing milk, baby may look the way you do after Thanksgiving dinner—full and sleepy, an expression moms humorously refer to as “milk drunk. ”

Why Your Milk Might Be Delayed Coming In

There are several reasons milk may be delayed coming in, and they could be related to your medical history, birth experience or something else entirely, like simply being a first-time mom. According to Bruno and Ross, some possible reasons include:

Having a c-section delivery
Traumatic birth
Excessive blood loss during birth
Postpartum hemorrhage
Premature birth
Maternal obesity
Diabetes
Thyroid abnormalities
Polycystic ovarian syndrome (PCOS)
Significant stress
If mom has an infection with fever
Retained placental tissue
If baby is unable to latch properly
Previous breast surgery (reductions or augmentation)

What to Do If Your Milk Is Delayed

You know when breast milk generally comes in and the signs look out for—but what happens if the milk just isn’t coming? Here, a few tips on how to get breast milk to come in if it’s a bit behind schedule.

Talk to a professional

First and foremost, Bruno recommends reaching out to your doctor or a lactation consultant to ensure there aren’t any medical reasons for the delay. Together, you can build a plan for how to help your milk come in. “Sometimes, while moms wait for their milk to come in, there is a need for supplementation,” she adds. “This should be decided in conjunction with your healthcare provider, as they can help a mom decide if their baby needs it and how much, and will help build a plan to get baby solely breastfeeding if that is what Mom decides.”

Stimulate your breasts around the clock

For how to get milk to come in faster, Bruno recommends stimulating your breasts every three hours, around the clock (even the middle of the night), either by breastfeeding or hand-expressing and pumping to help build up a supply. “Research shows that if Mom feeds baby frequently or hand-expresses and pumps, it does increase a woman’s milk supply,” she says. “Every mom is different. Just because it’s delayed doesn’t mean it isn’t coming.”

To ensure baby is getting enough milk, listen for big sucks and swallows during feedings, and look for an appropriate number of wet and dirty diapers.

Stay positive and try your best

Above all, both Bruno and Ross encourage moms to stay positive. “Breastfeeding is extremely challenging, and every woman experiences it differently,” Ross says. “Be patient, use your resources and know it does get better with time. It’s completely worth the effort for you and your baby.”

Bruno adds that breastfeeding “can feel like a roller coaster, which is hard to navigate after you have just run the marathon of birth!” To help reduce anxiety around potential challenges, she recommends reaching out to a lactation consultant even before birth. “This way a plan is in place,” she says. “And if you’re a new mom and feel like you’re struggling with breastfeeding, I would encourage you to find support. There are solutions to what you are moving through and you shouldn’t have to do it alone.”

About the experts:

Carrie Bruno, RN, IBCLC, graduated from nursing school at MacEwan University in Alberta, Canada in 2005. She worked as a labor and delivery nurse for 10 years before starting her own company, The Mama Coach in 2015. In the past six years, the Mama Coach has grown to a team of over 40 registered nurses that provide prenatal education, newborn support, lactation counselling, sleep coaching and allergy navigation.

Sherry A. Ross, MD, FACOG, is an ob-gyn with more than 25 years of experience and currently practices at Providence St. John’s Hospital in Santa Monica, California. She’s also the author of She-ology: The Definitive Guide to Women’s Intimate Health. Period.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.

When Does Breast Milk Come In & Signs It’s Coming

The look and feel of your colostrum, or early milk, is much different from your mature, later milk - which often comes in around 2 - 5 days after your baby's birth, though every mama’s timing is different.

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So, When Does Breast Milk Come In?

Though colostrum production begins as early as 16 weeks pregnant and should begin to be expressed right away after birth (with some moms even experiencing occasional leakage later in pregnancy), its look and composition differs significantly from your later breast milk. This is because colostrum, or your “first milk”, plays a much different role for your baby than your later breast milk, though both forms are incredibly important to your baby’s wellness and development. Though later breast milk may take some time to “come in” after delivery, your milk production has been in the works since early in your pregnancy, so don’t worry, mama – it’ll be here soon enough!

Moms shouldn’t expect to see large milk volumes in the first few days after birth, though most newborns lose weight during this time. Both of these things are normal and expected, and your colostrum is all your newborn needs until your later milk presents. With that in mind, your later milk – or the breast milk produced as your colostrum transitions to your mature milk – “comes in” about 2 – 5 days after your baby’s birth. “Coming in” refers to the significant increase in volume and changes in composition, though this popular term isn’t necessarily accurate. This is because your colostrum is breast milk and should be fed to your baby as soon as possible after birth. When your mature milk comes in later, however, it is accompanied by some very noticeable symptoms.

Signs Milk Is Coming In

Many women, even first-time moms, know exactly when their breast milk has come in, mainly due to common indicators like:

Breast engorgement, or the feeling of fullness, heaviness, and/or firmness.
Swelling of the breasts.
Breast milk leakage, particularly overnight.
Flattened nipples and/or skin tightening or firmness around the areolas.

This initial engorgement – and the occasional discomfort that may accompany the first time your milk comes in – will dissipate as your body adjusts to a regular nursing and pumping routine. If your breasts are frequently engorged after your milk comes in, this is a sign that your body is working hard to produce milk and you may not be fully emptying your breasts after a nursing session – be sure to have a breast pump and breast milk storage bags on hand, so you can fully empty your breasts after and between breastfeeding your little one. Your pumped breast milk can be stored in the refrigerator or freezer, so you can start a stockpile for your little one – which can be especially helpful if your partner or another person, such as a babysitter, needs to feed the baby. Just be sure to read up on the latest breast milk storage guidelines and use a helpful feeding and pumping log to ensure none of your precious liquid gold goes to waste!

What Else Should I Know?

Though your body’s breast milk production is kicked into high gear within 30 – 40 hours after you deliver the placenta, your later milk coming in is dictated by the hormonal changes taking place in your body during this time. Because every woman – and every pregnancy – is different, there is a range of days during which breast milk may come in. With that in mind, there is evidence that skin to skin contact, initiating breastfeeding within 30 – 60 minutes after birth, and continuing to nurse early and often (or pumping or hand expressing your colostrum to feed your baby, if there are latching challenges) can positively impact your breast milk production.

If your breasts are very engorged, it can be more difficult for your baby to latch properly. Try softening your breasts before a feeding, such as by taking a warm shower, applying a warm compress to each breast, and/or hand expressing a small volume of milk. You can also apply a cold compress – think a bag of frozen vegetables or an ice pack wrapped in a towel – to reduce swelling and discomfort. Prevent engorgement and reduce your risk of developing mastitis or encountering eventual breast milk supply issues by nursing or pumping frequently.

If you have questions about your breast milk coming in, concerns about supply, or are experiencing difficulties getting into a regular breast milk feeding routine, talk to a lactation consultant right away. The sooner you can address any issues you may be facing, the easier it will be to minimize impact on your future breast milk production. Remember, mama, it’s common to encounter early breast milk feeding challenges – especially if you’re a first-time mom – and it may take some time for your body and hormones to adjust. After all, you just did an amazing thing by welcoming your little one into the world! The most important thing to remember is to persevere and continue finding ways to ensure your baby receives all that great liquid gold that your body is making – whether by pumping, nursing, or a combination of both. As your milk comes in and you adapt to life with a newborn, you and your baby will eventually get into a regular feeding routine. Congratulations on your new bundle of joy – and be sure to enjoy this unique bonding time together!

Breast changes from the beginning of pregnancy to the end of breastfeeding

Medela's experts explain the changes that occur in the breast from the beginning of pregnancy to the end of breastfeeding, as well as tips for taking care of your breasts throughout this period.

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From the moment of conception, your body begins to prepare for the birth of your baby. This applies not only to the uterus - the anatomy of the breast also changes radically. This article will tell you what to expect in each trimester, during and after breastfeeding.

First trimester breast changes

Early in pregnancy, many women notice changes in their breasts. Moreover, often they become the first signs of pregnancy. Fluctuations in hormone levels and changes in the structure of the mammary glands can cause increased sensitivity and soreness of the nipples and breasts as early as the third or fourth week. For some pregnant women, breast tenderness persists until childbirth, but for most it goes away after the first trimester.

“Sometimes during pregnancy, breasts grow very quickly in the first weeks, and sometimes their size increases gradually,” says Dr. Jacqueline Kent, a leading lactation specialist at the University of Western Australia. “All women are different. For some, breast size may not change much until childbirth or even after them. In general, we can say that by the time the milk arrives, the breast will most likely become one and a half times larger than before pregnancy! ¹

As soon as your regular bras start to feel tight (usually around 12 weeks), it's time to buy a maternity bra. The most comfortable, according to many women, are seamless models with wide straps made of soft, breathable fabric. It is best to avoid underwired bras as they can put pressure on the developing milk ducts.

It is important to take your measurements correctly in order to find the right bra with a good fit. Take measurements every couple of months, as you may need a different size bra as your baby grows and your breasts get bigger.

Breast changes in the second trimester

From about the 15th week of pregnancy, newly formed cells that produce milk are activated in the breast, and by about the 22nd week, production begins. ¹ But don't worry - most of this milk will be absorbed by the body without going out, as pregnancy hormones prevent it from being overproduced or excreted.

“During the second trimester, you may notice that the nipples and areolas (the areas of skin around the nipples) become darker and larger,” says Dr. Daniel Prime, Medical Research Associate at Medela. tubercles - the so-called glands of Montgomery. They secrete oil that moisturizes the nipples and will protect them from inflammation and infection when you start to feed. Scientists believe that the smell of this fat is similar to the smell of amniotic fluid and helps the newborn baby find the nipple.” ²

Do not use harsh soap for breast hygiene and do not rub hard with a towel as this can damage this natural lubricant. Just wash your breasts with warm water and pat dry. And if someone tells you to pinch or rub your nipples to prepare them for breastfeeding, don't listen to them!

If you have flat or inverted nipples, your pregnancy is over 32 weeks, and your pregnancy is normal, you can try inserting special nipple formers* into your bra in consultation with your doctor. They help to gently pull out the nipples so that it is easier for the newborn to grasp them. Consult your healthcare professional or read our article on flat and inverted nipples to learn more.

If breast size increases dramatically during pregnancy, breast skin may itch and stretch marks may appear on it. A good moisturizer can help soothe itching. The appearance of stretch marks usually depends on genetics and skin type. If you have a predisposition to stretch marks, it is unlikely that you will be able to prevent them, but, fortunately, over time they will become lighter and less noticeable.

Breast changes in the third trimester

In the last trimester, you may again experience soreness and heaviness in your chest. A sleep bra will keep you comfortable at night, while a supportive sports bra will help you avoid soreness and ligament damage during exercise.

Don't forget to buy a pair of nursing bras one month before your baby is born. If possible, consult a specialist in the store or study the online guide to select the appropriate model and size. Every woman is different, but usually cups of a nursing bra are chosen one or two sizes larger than before pregnancy. The underbust girth may also increase as the ribcage expands to provide enough room for the baby. The sales assistant should choose the size of your bra, taking into account the appearance of milk after childbirth. Models with fasteners that can be unfastened with one hand make it easier to attach the baby to the breast.

Surprising but true: milk appears in the breast even before the baby is born. This is why your nipples may start to produce some colostrum (the first breast milk), which will be quite thick and sticky. Sometimes this happens as early as 14 weeks, but more often it still happens in late pregnancy. To avoid the appearance of stains and smudges on clothes, you can use special bra pads.

“If you have diabetes or have been diagnosed with gestational diabetes, your doctor may tell you to express some colostrum by hand and freeze it. A recent study showed that after the 36th week it is quite safe if the pregnancy does not have other complications, ³, says Dr. Prime, “Storing colostrum can come in very handy because babies with diabetic mothers are at higher risk of hypoglycemia (low blood sugar) and frequent colostrum feeding is the best remedy. . However, be prepared for the fact that there will be very little colostrum. You may only be able to express a few drops at first, and that’s perfectly fine.”

What happens to the breast after childbirth

Approximately two to four days after the baby is born (sometimes later if there was a caesarean section or a traumatic delivery), you will feel your breasts becoming heavier and firmer - this means that the milk has come. ⁴

“This breast fullness is not only due to excessive milk production – there is also an increase in the amount of blood circulating around the breast and the volume of lymphatic fluid,” explains Dr. Prime, “All this is the result of a gradual decrease in pregnancy hormone levels that began after the birth of a child and which allows the hormones responsible for the production of milk to enter into work.

During this period, you may experience soreness and discomfort in your breasts, a condition called breast swelling. This is quite common and usually resolves after a few days, during which time breastfeeding must continue. Read on for our tips on how to relieve swelling and discomfort, and if the problem persists, see a lactation consultant or healthcare provider.

What happens to the breast during lactation

For about the first three months of breastfeeding, your breasts are likely to fill up a lot before feeding. Over time, you may notice that your breasts become less full, but this does not mean at all that your milk production has decreased. If you are breastfeeding your baby exclusively and on demand, and at the same time he is growing well, then everything is in order with the amount of milk.

“Be prepared for the fact that after six months of breastfeeding, your breast size will begin to decrease,” Dr. Kent explains, “This is not a sign that your body is producing less milk. Most likely, the amount of adipose tissue in the breast simply decreased. By the time your baby is 15 months old, your breasts may be back to their pre-pregnancy size, but not smaller. However, whether you continue breastfeeding or not, you may still produce 100 to 300 ml of milk per day.”

This may be due to the start of more efficient milk production after six months of breastfeeding, which, according to Dr. Kent's research, may be the result of redistribution of breast tissue. ⁵

How your breasts change after you stop breastfeeding

When you finally stop breastfeeding—be it after three weeks, three months, or three years—the breast changes associated with lactation disappear. “After the complete cessation of breastfeeding, the breasts, as a rule, return to the size that they were before pregnancy. This usually happens in about three months, and for someone else while breastfeeding,” Dr. Kent explains, “If you get pregnant again, the whole process starts all over again. ”

Literature

1 Cox DB et al. Breast growth and the urinary excretion of lactose during human pregnancy and early lactation: endocrine relationship. Exp Physiol . 1999;84(2):421-434. - Cox D.B. et al., "Breast growth and urinary lactose excretion during pregnancy and lactation: an endocrine relationship." Exp Physiol. 1999;84(2):421-434.

2 Doucet S et al. The secretion of areolar (Montgomery’s) glands from lactating women elicits selective, unconditional responses in neonates.PLoS One . 2009;4(10): e 7579. - Doucet S. et al., "Papillary gland secretion (Montgomery's glands) in lactating women induces a selective unconditioned response in the newborn." PLOS One. 2009;4(10):e7579.

3 Forster DA et al. Advising women with diabetes in pregnancy to express breastmilk in late pregnancy (Diabetes and Antenatal Milk Expressing [DAME]): a multicentre, unblinded, randomized controlled trial. Lancet. 2017;389(10085):2204-2213. - Forster D.A. et al., "Women with Gestational Diabetes are Recommended to Express Milk Late in Pregnancy (Diabetes and Antenatal Pumping [ DAME ]): A Multicenter, Open, Randomized, Controlled Trial. Lancet (Lancet). 2017;389(10085):2204- 2213.

4 Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals, Geneva : World Health Organization ; 2009. AVAILABLE FROM : https://www.ncbi.nlm.nih.gov/NBKS/NBK148965/ - "POSTICION" POSTICION "POSTRISS" POSTRIMENT "POST textbook for students of medical and related professions. Geneva: World Health Organization, 2009. Article cited: https://www.ncbi.nlm.nih.gov/books/NBK148965/

5 Kent JC et al. Breast volume and milk production during extended lactation in women. Exp Physiol. 1999;84(2):435-447. - Kent J.S. et al., "Amount and production of breast milk during long-term lactation in women". Ex Physiol. 1999;84(2):435-447.

Read instructions before use. Consult a specialist about possible contraindications.

* RU № ФСЗ 2010/07352 dated 07/19/2010

When milk comes after childbirth

Several days pass from the moment of birth to the appearance of breast milk: for some mothers this process takes 1-2 days, others have to wait longer. How to understand when milk will come, and what to eat for a child while it is not?

What is colostrum?

Colostrum

Some women experience thick, yellowish breast discharge long before childbirth, others in the last days of pregnancy or immediately after childbirth, in rare cases it does not appear until 2-3 days later. It's colostrum, baby's first food.

Different women produce colostrum in different amounts – from a few drops to tens of milliliters per day. It may seem to you that this amount is not enough for the baby, and that supplementary feeding is required - do not panic, colostrum is very nutritious. It contains vitamins, easily digestible proteins, and a large number of immune factors: leukocytes, T-lymphocytes and antibodies, which provide the child with protection against bacteria and immunity in the first days of life.

transitional milk

Transitional milk

2-3 days after vaginal delivery and up to 6 days after caesarean section, colostrum is replaced by transitional milk. It is thinner and whiter, and contains significantly more fluid that the baby's kidneys are already able to process. You can feel the flow of milk by a slight tingling in the chest and a feeling of fullness.

After the appearance of milk, to maintain lactation, the child needs to be applied to the breast much more often, as a rule, once every two hours, but sometimes up to 20 times a day. At first, the breaks between feedings should be no more than 3.5-4 hours. To care for the nipples during breastfeeding, you can apply special creams and ointments containing dexpanthenol or other harmless caring components to them. They are safe for the baby and will help you prevent cracking and discomfort. If you feel that feeding is causing you a lot of pain, ask the staff to help you adjust the grip, most likely the problem is in it. Save our scheme to your phone and take it with you to the hospital.

If for some reason you are not in the same room as your baby, check with the staff for the feeding hours and express your milk by that time. Some maternity hospitals have powerful electric breast pumps for this (you just need to get your own disposable funnels and tubes), others may allow you to bring your own breast pump, and still others will have to be content with manual pumping - ask the nurse to show you how to do it correctly. In no case do not allow stagnation of milk in the breast, this can lead to the development of inflammation.