Milk production typically begins around the middle of your pregnancy. For more mothers, their milk will come in—meaning it will increase in quantity and begin the change from colostrum to mature milk—between two and five days.
Is there any milk present at birth? Absolutely! Colostrum, which is the early concentrated milk that’s chock-full of important nutrients and disease-fighting antibodies, is being produced from about 16-22 weeks of pregnancy. Many mothers aren’t aware that it’s there since it might not leak at all. This provides everything your baby needs in the early days after birth—your baby’s stomach is very small, so the amounts of colostrum produced at this time are perfect for their needs even if it doesn’t seem like much early on.
The average colostrum intake by healthy babies increases from 2-10 mL per feeding in the first 24 hours to 30-60 mL per feed by the end of day three.
When Will Your Milk Increase?
Milk production typically begins to increase between 30 and 40 hours after delivery of the placenta. It might take a little longer than this actually to notice the changes in your milk production. Your milk “coming in” generally refers to when you notice increased breast fullness or other signs, as milk production really gets going! This fullness occurs usually two to three days after giving birth, but as many as 25% of mothers it takes longer than three days.
Signs that your milk is coming in:
- Breast fullness, swelling, heaviness, warmth, engorgement, or tingling
- Leaking milk
- Changes in your baby’s feeding patterns, or their behavior at the breast
- Gradual changes in appearance—from thicker golden colostrum to thinner, white mature milk
Something important to remember is that a lot of women experience their milk coming in as a gradual change, rather than something sudden and super noticeable. Research has also shown that the timing of your milk coming in is completely hormonally controlled. That means your baby doesn’t have to be breastfeeding at all for your milk to come in. Skin-to-skin contact is associated with increased milk production.
Risk Factors that come with Delayed Onset of Lactation
When a mother’s milk does not undergo the expected increase in volume within three days of birth, it’s referred to as delayed onset of lactation or DOL. First-time mothers tend to have milk come in about a day later than mothers with more than one child.
Labor and delivery factors that can be affected by DOL:
- Pain medications during labor—regardless of your delivery method
- Large amounts of IV fluid during labor
- A stressful, exhausting, or traumatic vaginal birth
- A c-section
- A long pushing stage during birth (over one hour)
- Blood loss (more than 500 mL/1 pint)
- Retained placenta, or anything that affects placental function
What if My Milk Doesn’t Come In by Day 4?
If your milk doesn’t come in by day four after birth, here are some things you can try and/or look out for.
Optimize your breastfeeding management to make sure that your breast empties frequently and thoroughly. Skin-to-skin contact with your baby can also help with milk production.
Be sure to monitor your baby’s weight to make sure they’re getting enough milk. If your baby loses more than 7% of their birth weight, your breastfeeding should be evaluated. If your baby isn’t getting enough milk, it might be recommended that you try supplementation.
Schedule a visit with a local, board-certified lactation consultant. They can help you create a plan to increase your milk production, as well as monitor your baby’s progress.
If you’re struggling to breastfeed after a difficult start, remember that a lot of mothers are able to slowly bring in a full milk supply after a week or two—and sometimes even after many weeks!
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