When will my milk come in?

You’ve done it. You’ve successfully made it through labor and delivery, you have a beautiful new baby in your arms…now the big question: when will my milk come in? Breastfeeding moms everywhere know that feeling of anticipation as they wait for their body to adjust and produce the liquid gold that will give their little one the best start at life. If you're wondering when exactly you should expect to experience engorgement and an increase in milk supply, then read on--this blog post is here to guide you through what you can expect from day 1 up until your fully established lactation.

Stages of lactation 

Ok, let's start at the beginning if you have breasts your body has been preparing to breastfeed for YEARS even before you were pregnant. 

Even before pregnancy, your breasts contain all the parts needed for lactation. 

During pregnancy, your breasts may grow in size and become tender and sensitive. This is a really good sign! Your body is growing more glandular tissue which is the milk-making tissue needed to produce breastmilk for your baby. 

‍You already have milk

The first milk you make for your baby is called colostrum and your start producing this as early as 10-22 weeks gestation. This signals the first stage of milk production called “Lactatogensis 1.” So if you are pregnant and reading this, CONGRATS, you are already in stage 1! What an amazing body you have! For more information on colostrum and why it is so important for your baby head over to my complete guide to Hand Expression.  In Boob School, we also offer an entire workshop on hand expression to help you take full advantage of this amazing tool!

Typical time frame 

After your baby is born and your placenta is delivered, you experience a HUGE hormone shift. Your placenta had been secreting large amounts of progesterone which tell your breasts to “get ready,” but not to fully begin making milk yet. Once your progesterone levels dip drastically after the delivery of the placenta, you begin the 2nd stage of milk production “lactogenesis 2.”

Milk production really begins to increase between 30-40 hours after birth. This increase is gradual and most mothers notice an increase between the 2nd-4th day after birth. This is what is commonly known as “milk coming in.”  Moms will report breasts feeling fuller, heavier, and warmer and milk starts lightening in color.  The increase in milk volume is gradual even if you feel like it was abrupt. 

Delays in milk coming in 

Technically, when milk production takes longer than 72 hours to increase it is considered delayed. In the US, where most moms have some interventions in childbirth. it is very common to have moms not feel milk coming in until day 4-5.  Common reasons for a delay include the following. 

Long Difficult Delivery or Birth trauma 

• Research has shown an association between a stressful birth (either physically or emotionally) and a delay in milk production. Beck & Watson 2008. This may be due to higher cortisol levels which block oxytocin. 

Excess blood loss

• Mild to moderate hemorrhage can lead to delayed onset of milk production (Willis & Livingston 1995) 

C-sections 

• Several factors contribute to this including a longer delay between birth and the onset of feeding and less feedings in the first day of life. In general c-section baby’s do not get the squeeze of the vaginal birth and are born with a lot of amniotic fluid in their stomachs which can make them spitty and uninterested in feeding. 

First baby 

• First time mamas are more likely to have a slow or delayed onset of milk coming in. With each subsequent baby milk tends to come in quicker and in fuller volumes.

Gestational diabetes 

• Gestational diabetes can impact both development and function of breast tissue as well as delay the onset of your milk coming in.

Gestational hypertension

• Gestational hypertension is associated with lower rates of exclusive breastfeeding and shorter duration of breastfeeding. (Strapasson, Ferreira & Ramos 2018)

What you can do to help your milk come in sooner

The key to supporting your milk supply is the early and frequent removal of colostrum, which is your earliest milk. Even if your baby is not a great latcher, you can help your milk supply by using your hands to remove this colostrum which triggers your body to make MORE milk sooner.  For more information on hand expression check our guide here.

Signs your milk is coming in 

Remember the TRANSITION from colostrum to MATURE MILK takes place over 2-3 weeks and the milk you produce during this time is called transitional milk. It often appears more yellow than mature milk. 

• Your breasts may feel warmer 
• Your breasts may feel heavier 
• Your may notice increased veining on your breasts
• You may notice milk leaking from your nipples 
• You may notice baby swallowing more frequently at the breast 
• You may notice baby peeing more frequently 
• You may notice your baby poops becoming more frequent and changing in consistency or color to more yellow mustard color 
• You may notice your baby being more satisfied after a feeding this is often affectionately called “milk drunK” 
• Your baby will no longer be losing weight but gaining an average of 1 ounce per day

When nursing is going during the first week, milk volume should increase from an average of 37-56 ml on the first day to an average of 610 ml (20.6 ounces) on day 7. (Kent, Gardner & Geddes 2016) 

What to do if your milk is delayed

The first step is to reach out to an IBCLC to help determine the underlying cause to come up with a sustainable and tailored plan for you.  See our blog on low milk supply for why determining root cause is essential for managing low supply. 

The number one priority whenever there is a concern is about milk production is FEED THE BABY.  For some families, this may be offering a formula or donor milk supplement to the baby while at breast with a supplemental feeding system (SNS) or after via bottle or syringe.  A well nourished baby is going to breastfed better!  

If you are concerned that your baby is not feeding effectively at the breast, perhaps due to a poor latch, tongue tie, or being extra sleepy from jaundice, then you may need to pump to remove milk and encourage more milk production. 

This process of feeding the baby at the breast, pumping both breasts for 15 min and then offering the baby a bottle is called triple feeding. It should be a SHORT TERM INTERVENTION as it can be overwhelming and lead parents to burn out. 

The 3rd piece of the puzzle is to work on the latch.  If your baby can’t feed effectively at the breast, working with an IBCLC and having a functional oral assessment can help determine the underlying cause and come up with a game plan to help get you back on track.  I also have a FREE guide to latching with step by step guidance on getting a great latch. In Boob School, we also offer an entire workshop on latching and how to make it much less stressful and difficult so you can be latching comfortably from day one. 

What to remember

There are many signs and indications to show that your milk is coming in when breastfeeding, such as swelling and tenderness of the breasts, frequent pee and poops from the baby, and a baby who appears satisfied post feed. Some even report an increase in intense emotions or tearfulness when milk comes in.

Breastfeeding can be beautiful but the early days can be intense and overwhelming. 

Remember that if you need help with anything during this journey – reach out. There are many resources available from lactation consultants to boob school. Get the guidance and education on better breastfeeding practices you deserve today. Let’s strengthen our collective parenting communities to continuously learn ways of growing together as humans while raising our babies!

Cheering you on, always!

XOXO

Kelly

Boob School Founder and CEO

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