In pregnancy, the breasts may start to produce milk weeks or months before you are due to have your baby. Show
If your nipples are leaking, the substance is usually colostrum, which is the first milk your breasts make in preparation for feeding your baby. Leaking is normal and nothing to worry about. If it bothers you, you can try putting a tissue or an absorbent breast pad (sometimes called maternity breast pads, or nursing pads) in your bra to absorb the milk. Breast pads are available in some pharmacies and mother and baby shops. When to get helpIf the milk leaking from your breasts has blood in it, talk to your midwife or GP. After your baby is born and if you're breastfeeding, your breasts will probably leak milk. You can learn more about breastfeeding, including how to deal with common breastfeeding problems and expressing and storing breast milk. For many mamas-to-be, tender breasts are one of the earliest signs of pregnancy, signaling the many big and exciting changes to come. And that’s just the beginning! Your breasts will continue to change throughout your pregnancy. They’ll likely grow a bit bigger, the veins in them will probably become more noticeable, and your areolas might get darker. But what about breast milk? When does a pregnant woman start producing milk? And what is colostrum and how is it different from milk? Let’s take a look. In this article: 📝
When does lactation start?Lactation is the medical word for the process of producing breast milk, and it happens while your little one is still inside you. Most mamas will start producing milk between weeks 12 and 18 of their pregnancy. By then, your breasts are probably starting to feel a bit bigger than normal. This is because both the size and number of your milk glands is increasing. Your milk duct system will be fully developed at some point during your second trimester, so that you’re ready to feed your baby even if they arrive a little early. While you’re pregnant, usually during your last trimester, your breasts might start to leak. Don’t worry, mama, this is totally normal! It’s a good thing, in fact, it means that your body is getting ready to welcome your hungry baby into the world. You might notice that your breasts leak when your nipples are stimulated, such as when you have sex, or if they rub against your bra while you exercise. It’s also normal if your breasts don’t leak, by the way, so don’t fret if this isn’t something you experience. You’re just likely to have cleaner bras – win! If you do leak, you might notice that the liquid is yellow or orange. That’s because it isn’t mature breast milk, but rather something called colostrum. What is colostrum in pregnancy?Colostrum is your baby’s superfood. It’s full of protein and antibodies that do wonderful things for your little peanut, including providing them with excellent nutrition and helping to develop their immune systems. It can be clear, creamy, white, or even orange in color, and is usually thick and quite sticky. Colostrum is easy for babies to digest and is very good for their gut. It works as a laxative and helps them to clear their first poop, which is called meconium. When do pregnant women start lactating “proper” breast milk?When you feed your baby for the first time (what a thought!), you’ll be feeding them colostrum rather than mature breast milk for the first two to three days. For some mamas, it might take longer than this, so don’t worry if your body does its own thing. Every pregnancy, birth, mama, and baby is different. You might notice when your milk “comes in”, although this is usually a gradual change rather than something that happens quickly. Your breasts might start to feel fuller, heavier, or more swollen, and your baby might start to behave a little differently when they’re guzzling. Breastfeeding is an adventure all on its own and (we’ll say it again) everybody’s journey is unique. Now that you know a little bit more about where your breast milk comes from, you might want to find out more about the next steps. Milk production begins around the midpoint of pregnancy. For most mothers, milk will “come in” (increase in quantity and begin the change from colostrum to mature milk) between days 2 and 5. Is there milk in my breasts at birth?Yes! Colostrum is being produced from about 16-22 weeks of pregnancy, although many mothers are not aware that the milk is there since it may not be leaking or easy to express. Colostrum is the early, concentrated milk that is full of nutrients and disease-fighting antibodies — it provides everything that your baby needs in the early days after birth. Your baby’s stomach is very small at birth, and the amounts of colostrum (transitioning gradually to mature breastmilk once your milk comes in) are perfect for baby’s needs. The average colostrum intake by healthy babies increases from 2-10 mL per feeding in the first 24 hours to 30-60 mL (1-2 oz) per feed by the end of day 3 (ABM 2009). . Average Intake of Colostrum/Milk Baby’s AgePer FeedingPer 24 hoursDay 1 (0-24 hours)2-10 mL (<½– 2 tsp)30 mL (1 oz)Day 2 (24-48 hours)5-15 mL (1 tsp – ½ oz)Day 3 (48-72 hours)15-30 mL (½– 1 oz) by Day 730-60 mL (1-2 oz) 300-600 mL (10-20 oz)Weeks 2 & 360-90 mL (2-3 oz) 450-750 mL (15-25 oz)1-6 months90-120 mL (3-4 oz)750-1035 mL (25-35 oz)References: ABM 2009, Mannel et al 2013, Mohrbacher 2010.
When can I expect my milk to increase?Milk production normally begins to increase (biochemically) between 30 and 40 hours after delivery of the placenta, but it may take a little while for the changes to become apparent to the mother. Milk “coming in” generally refers to the time when the mother notices increased breast fullness (and other signs) as milk production begins to kick into full gear– this usually occurs 2-3 days after birth, but in as many as 25% of mothers this may take longer than 3 days. Signs that your milk is increasing may include:
Keep in mind that many women experience their milk coming in as a gradual change, rather than a sudden one. Research indicates that this timing is hormonally controlled – it does not require that baby be breastfeeding at all. However, mothers who breastfeed early and often (or express milk if breastfeeding is not going well) have higher milk production on days 3-4, and their infants lose less weight and have lower bilirubin levels (less jaundice). Skin-to-skin contact with baby has also been associated with increased milk production. Milk production will begin to shut down if milk is not being removed by the time your milk is coming in. Risk factors for delayed onset of lactationWhen a mother’s milk does not undergo the expected increase in volume within 3 days of birth (72 hours postpartum) – this is called delayed onset of lactation (DOL). Studies have shown that risk factors for delayed onset of lactation include:
What do I do if my milk does not come in by day 4?
References and more information:Breastfeeding your newborn — what to expect in the early weeks @KellyMom.com Increasing Low Milk Supply @KellyMom.com How Does Milk Production Work? @KellyMom.com
ABM [Academy of Breastfeeding Medicine] Clinical Protocol #3: Hospital guidelines for the use of supplementary feedings in the healthy term breastfed neonate, revised 2009. Breastfeed Med. 2009;4(3):175-82. Chapman DJ, Pérez-escamilla R. Maternal perception of the onset of lactation is a valid, public health indicator of lactogenesis stage II. J Nutr. 2000;130(12):2972-80. Hurst NM. Recognizing and treating delayed or failed lactogenesis II. J Midwifery Womens Health. 2007;52(6):588-94. Lawrence RA, Lawrence RM. Breastfeeding, A Guide for the Medical Profession (7th ed.). Elsevier Health Sciences; 2011; 81, 84-85, 552. Lind JN, Perrine CG, Li R. Relationship between Use of Labor Pain Medications and Delayed Onset of Lactation. J Hum Lact. 2014;30(2):167-73. Mannel R, Martens PJ, Walker M. Core Curriculum for Lactation Consultant Practice (3rd ed.). Jones & Bartlett Publishers; 2013; 289-291, 356, 594, 818. Mohrbacher N. Breastfeeding Answers Made Simple, A Guide for Helping Mothers. Hale Pub L P; 2010; 63, 70-74, 109, 409-413. Riordan J, Wambach K. Breastfeeding and Human Lactation (4th ed.). Jones and Bartlett Publishers; 2010; 267, 330-337, 346-347. |