Am I producing breastmilk yet?
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When working at the hospital I find that there are some questions that I get asked regularly and my answer starts to feel like a memorized speech. Since these are clearly common concerns among new moms, I’m beginning this new series of posts based on those frequently asked questions and the answers I give.
What moms want to know:
The Deets: 1 day old baby. First time mom. Has been breastfeeding, but is concerned that she’s not producing milk yet.
Mom: My baby is getting nothing, should I give formula?
Lactitioner: What makes you think your baby is getting nothing?
Mom: My breasts don’t feel full, I’m not leaking, when I squeeze nothing comes out.
Lactitioner: On days 1-3 you are making colostrum. You’ve been making since you were about 20 weeks pregnant. Your breasts don’t feel full yet and you’re not leaking yet because the amount of colostrum is small, but it’s super concentrated. It’s all the baby needs for his tiny tummy in the first few days of life. As for not seeing anything when you squeeze, most moms just try to squeeze the nipple like a tube of toothpaste and expect colostrum to come out. That’s not how it works. You have to do massage and compression further back on the breast and sort of milk it forward. Just squeezing the nipple closes off the milk ducts so nothing will come out. (Read here about hand expression to learn more about this.)
Mom: What can I do to make my milk come in? Should I be pumping or drinking more water?
Lactitioner: There is nothing you can do to make your milk come in any faster. It is a hormonal process that has to take place and in a first time mom, the milk generally doesn’t come before 72 hours after delivery. If the baby is breastfeeding every 2-3 hours, there is no reason you need to pump. As long as you are stimulating, your body will deliver your milk. Pumping would just add to your exhaustion because it’s one more thing to do in between breastfeeding every 2-3 hours. As for drinking water, you should be drinking to keep yourself hydrated. However, drinking lots of water will not bring in your milk any faster nor will it increase your milk supply. (Read here to learn more about milk supply.)
Mom: How do I know if my baby is getting anything?
Lactitioner: Baby should be breastfeeding every 2-3 hours around the clock. Baby may skip a feeding or two in the first 24-hours during recovery sleep, or sometimes after the circumcision, though.
If baby is doing these things, he’s getting your colostrum:
- Sucking actively at the breast during the feeding with some pauses
- Making long jaw movements that wiggle the ear which indicate swallowing (or you hear it!)
- Baby is content between feedings
- Baby is having appropriate diaper output (1 wet, 1 stool on day 1; 2 wet, 2 stool on day 2; 3 wet, 3 stool on day 3; etc.)
If those things are not happening, you may need to work closely with the lactation consultant to improve positioning and/or latch, confirm the presence of swallowing, begin hand expressing or pumping, or supplement if needed. (Read here to learn more about supplementing.)
This is a common concern that I see, particularly among first time mothers, and it makes sense to wonder about these things. A large number of mothers don’t realize that their milk isn’t just there when the baby is born and that it takes 3-5 days to show up. Obviously if you are not feeling fullness or seeing milk, you may wonder what the heck is happening. I share these common concerns so that you are educated, prepared, and don’t feel silly for not knowing how it all works.