What to Expect When your Milk “Comes In”

It’s common to hear new moms talk about their milk “coming in”, but this phrase gives the impression that there isn’t any milk in the breast at the time of delivery, which is in fact a myth.  During pregnancy, the mother’s body begins to produce the first milk called colostrum.  This milk is available and ready for the baby as soon as the birth of the placenta is complete, which signals to the body that it’s time to ramp up production and make copious amounts of milk to feed the newborn baby.  No matter how early a baby is born, there will always be milk ready in the breast.

Colostrum is thick, sticky and somewhat yellow in color. It is packed with powerful nutrients and antibodies to protect the newborn and give him/her exactly what is needed in the early days after birth.  Colostrum is measured in teaspoons which is why it comes out in small drops, as that is all a tiny newborn stomach needs.  

Three to four days after birth, breastmilk begins to transition from colostrum to mature milk.  This is when the breasts start to feel heavy and full and larger amounts of milk can be expressed.  Mature milk is measured in ounces, to accommodate the growing belly size of the baby.  

Signs breastmilk is starting to transition to mature milk:

• Mom will experience breast fullness and possibly some discomfort 

• Audible swallows will be heard after the first few minutes that baby is nursing 

• Visible jaw drops will be seen when baby swallows

• Infant stool changes- baby’s poop will go from meconium (dark black tar-like poop) to a greenish color and then finally to a loose, yellow  color over the course of a few days

• Possible latching difficulties if breasts are really engorged 

Comfort Measures for Mom:

• Apply cool packs to breasts for 15 minutes on 15 minutes off after nursing

• Avoid heat on the breasts (warm packs, warm shower running on breasts)

• Hand express a small amount of milk to relieve discomfort (only if you must, as too much extra stimulation will cue the breasts to make more milk)

If baby is having difficulties latching due to engorged breasts you can try doing reverse pressure softening. Place your pointer finger and middle finger flat on either side of the nipple then press in towards the chest cavity for a few seconds to move some milk away from the nipple and allow more room for baby to latch on. 

The breast discomfort that comes with your body beginning to make mature milk can last a couple of days.  During this time it is crucial to nurse on demand, or at least every 2-3 hours, around the clock to ensure your body knows it’s time to make plenty of milk to feed your baby.  Avoid tight clothing and bras so there isn’t any added pressure on the breasts which can put you at risk for clogged ducts and mastitis. 

If you aren’t noticing these changes in the days following birth it’s important to reach out to a lactation professional for support and a thorough assessment as soon as possible.