Your milk coming in (known as lactogenesis II for those in the trade!) occurs between about day 3-5 after you have given birth. Right, some myth busters first of all:
- Your milk coming in will happen whether you have chosen to breastfeed or not
- Your milk with come in regardless of your mode of delivery
Lactogenesis II is triggered by the delivery of the placenta. That’s right. So, the type of delivery you had is basically nothing to do with whether you had a lovely water birth, a traumatic forceps, an elective caesarean or a full on emergency caesarean; though many people will tell you otherwise. It is the sudden change in hormones that tells your brain – “hey, this baby has arrived – get to work!”
However, there are some things you can do which seem to speed the process up:
- Be in close contact with your baby, spend plenty of time having skin to skin – this gets all those lovely hormones going
- Feed frequently. If your baby isn’t demanding – then offer!
- Make sure feeds are effective – they should not hurt
You have been making colostrum since about 12-16 weeks of pregnancy, so I promise you it is there. It can be very hard to express, as it is thick – like wallpaper paste! But your baby can definitely get it out, as long as he is attached properly. Bear in mind that a one day old baby has a tummy the size of a marble. By day three it is the size of a small bouncy ball, and by a week – roughly the size of a large ping pong ball. Your baby genuinely does not need any more milk than you are producing – which will be drops.
You have more than enough milk making cells in your breasts, but your body has no idea whether you have had one, two, three or more babies. It needs you (or more accurately, your baby) to tell it how many of those milk-making cells it needs. I like to think of the breast as having ‘switches’ to turn on milk-making cells. What we now know is that the first few days are critical for calibrating the breast to produce the right amount of milk for your baby or babies. Every time your baby feeds, he is ‘turning on’ those switches. The more switches he turns on, the higher your eventual milk capability. If you feed infrequently, or supplement with formula, you will not turn on as many milk making cells and it will be much harder later on to reverse this situation. We don’t yet know at what point these milk making cells stop being responsive to stimulation, but it seems to be in the first 2-3 weeks. So, think of the first two weeks as a process that will set up the milk factory. It is much easier to work on settling your baby, spacing out feeds and generally getting some sleep if your milk supply is set up nice and high.
Babies can seem to be getting ‘desperate’ for more milk by about day 3 or 4 if your milk hasn’t come in yet. In fact, many wise midwives know of the 'day-2' phenomenon. Beware the second night I always tell mothers! That peaceful baby can turn into a milk monster in a matter of hours and it can be very hard to hold your nerve and resist supplementing at this point. Add into the mix your well-meaning partner, mum, interfering friend and anyone else giving their two-pence worth and you can be a woman on the edge!
Try to remember that breastfeeding is about more than food! Think about how often you put something to eat or drink into your mouth - it it always every 2-3 hours? Is it only because you're hungry or thirsty? NO! We eat for comfort, celebration, commiseration. We eat when we're hot or cold, when we're lonely or scared or nervous. You've just given birth to a tiny human who is really quite similar to you actually! Your body nurtured that baby through pregnancy and it can carry on now. This isn't a design fault.
My advice – get yourself a drink and snack, scoop up your baby, slink off to your bedroom, and – in the nicest possible way – ignore the lot of them. This is a process that is as old as time, and is unlikely to go wrong for you. I have yet to meet a woman who wasn’t genuinely scared that she would be one of the few women for whom their milk just doesn’t come in. Most women fear this. In fact, this is a primal response isn’t it? We have such a strong need to feed our babies.
Supplementing at this critical point will basically tell your body that it doesn’t really need to worry about bringing in a full milk supply. This is because your baby will suckle less at the breast, and those milk-making cells will not get the message to get going. Eventually, to save energy and waste, any unused milk making cells just die away (until the next pregnancy).
So, assuming at this point that you have been feeding frequently and effectively, how do you know when that long awaited milk has come in? Well, you may feel that your breast is a little fuller. Your baby may be able to last a little longer between feeds. You may hear audible swallows – they sound like very gentle, quiet ‘thup, thup’ noises.
Is that it? Well, no. Actually, your milk doesn’t all just come in at once. The whole point is that milk gradually increases day by day until about day 14. This gradually stretches that tiny tummy.
Congratulations - great things are happening. Your body is amazing!