Milk production
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During pregnancy, in response to changing hormones, a woman's breasts begin to prepare for breastfeeding. Glandular tissue develops and the breasts increase in size. The first milk - which may appear clear to bright yellow in color - is called colostrum. This may start to leak from the nipples as early as 20 weeks in your pregnancy.
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Following birth, colostrum provides all the fluid and nutrition a healthy baby requires. It also aids in the prevention of infection and disease of newborn babies. Over the next few days colostrum gradually changes and increases in volume, this is when we often say the milk is 'coming in'. During this time, there is often more milk produced than required and the breasts become full and may be uncomfortable. This is common and will settle. Good feeding practices (see information below) will help the milk supply adjust to meet your baby's needs. By about two weeks the milk has become whiter and thinner in appearance and continues to increase in volume to meet the needs of your growing baby.
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Continued milk production is dependent upon the frequent stimulation and emptying of your breasts, either by breastfeeding or expressing. During breastfeeding or expressing a hormone called 'oxytocin' is released which pushes the milk through the ducts to the nipple openings. This action is called the 'let-down' reflex. It takes approximately 60 seconds and is felt by some women as a tingling sensation or fullness in the breasts; some women do not feel any sensation but may notice milk leaking from the other breast or that the baby has changed to a regular suck and swallow action.
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Good feeding practices
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The following points are a guide to initiating and establishing breastfeeding.
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When your baby is newly born:
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- Feed your baby soon after birth, preferably within the first hour
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- Place undressed baby directly onto your chest (skin-to-skin)
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- Ensure your baby is well attached to the breast
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- Before the milk 'comes in' many babies may feed up to 12 times in 24 hours
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- Ideally, you and your baby should remain together so baby can breastfeed according to need throughout the day and night
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- If your baby is having difficulty attaching to the breast, hand express and give colostrum to your baby
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- Breastfeeding is a learned skill and assistance is often required. Don't be afraid to ask for help
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- Avoid the use of dummies, teats and infant formula unless you are advised to do so by a medical professional.
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Establishing your breastfeeding:
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- To prepare for breastfeeding, find the most comfortable position, either sitting or lying
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- Ensure your baby is well attached to the breast
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- Babies need to breastfeed more than six times in 24 hours
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- When feeding at the breast, ensure your baby is both sucking and swallowing
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- Encourage your baby to stay awake and actively sucking whilst feeding at the breast. Feeding skin-to-skin and gentle stroking are effective
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- With each feed, allow your baby to finish feeding from the first breast before offering the second. The breast can be gently massaged to ensure it is well drained
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- If your baby is having difficulty attaching or feeding effectively at the breast it is important to express the breastmilk and give it to your baby at every feed
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- Try to eat a well balanced diet and maintain an adequate fluid intake (up to eight glasses of water per day
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- There is no need to give infant formula or any other fluids to baby unless you have been advised to do so by a medical professional.
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Signs your baby is receiving enough milk:
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- Baby settles between most feeds
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- Wet nappies increase in number after the milk 'comes in', then expect at least six - eight soaked cloth nappies or four - five heavy disposable nappies in 24 hours
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- During the first few days your baby's stools change from a black meconium to a soft mustard yellow appearance. Most babies will have at least one bowel action per day in the first three months of life
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- Your baby starts to gain weight after an initial weight loss and will regain birth weight by around two weeks of age. In the first three months of your baby's life there is an average weight gain of 150 grams or more per week. This may fluctuate but there should be steady progress on the growth chart in relation to your baby's weight, length and head circumference.
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Where to get more information
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Breastfeeding Service
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Royal Women's Hospital
Level 4
Cnr Grattan St & Flemington Rd
Parkville VIC 3052
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Tel: (03) 8345 2400
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Women's Health Information Centre (WHIC)
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Royal Women's Hospital
Ground floor
Parkville VIC 3052
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Tel: (03) 8345 3045 or 1800 442 007 (rural callers)
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Australian Breastfeeding Association
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Tel: 1800 mum 2 mum (1800 686 2 686) Breastfeeding Helpline
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Web: http://www.breastfeeding.asn.au
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Maternal & Child Health Line (24 hours)
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Tel: 13 22 29
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 This fact sheet is available for download as PDFs in: English, Arabic, Chinese, Turkish, Vietnamese.
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Disclaimer
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The Royal Women’s Hospital does not accept any liability to any person for the information or advice (or use of such information or advice) which is provided in this fact sheet or incorporated into it by reference. We provide this information on the understanding that all persons accessing it take responsibility for assessing its relevance and accuracy. Women are encouraged to discuss their health needs with a health practitioner. If you have concerns about your health, you should seek advice from your health care provider or if you require urgent care you should go to the nearest Emergency Dept.
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Last updated Jan 2008
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