The Truth About Milk Supply
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If I had to name the number one question that I get from new mothers, it’s definitely about milk supply and how to make more milk! I did some internet research and while there are tons of posts about milk supply and pumping and cookies and tea, not one of them tells the basic facts. Here I lay out how milk supply works and answer some frequently asked questions about milk supply.
Your body starts making colostrum at around 20 weeks into your pregnancy. You’ll make colostrum until about 10 days after delivery. Your breastmilk will “come in” somewhere between days 3-5. This means that your breastmilk will be mixed with your colostrum and will appear thicker and more yellow until about day 10 after delivery. The volume of colostrum that you’re making in the early days is small, which coincides with the small size of the baby’s stomach. However, the colostrum is very concentrated. Once the milk comes in, the volume increases significantly.
- Colostrum from about 20 weeks pregnant until about 10 days after delivery
- Mature milk comes in somewhere around days 3-5 after delivery
- Colostrum and mature milk mixed until day 10, appearing thicker and more yellow than milk alone
- Volume of colostrum is very small, but highly concentrated
- Volume of mature milk much greater
Your milk supply is largely based on demand. In the first three days after delivery, before your milk comes in, frequent breastfeeding sends the message to your body that it should prepare to make lots of breastmilk. Think of it this way: You’re putting in the order now so that when the milk comes in, you’re making plenty.
Once the milk comes in, it’s the frequent stimulation and milk removal that keeps the supply going. This is achieved by the baby breastfeeding often and emptying (or mostly emptying) the breast at each feeding. If the baby is sucking but not removing any milk, or is too sleepy to even suck and therefore no stimulation is happening, your milk supply will be negatively affected. Whatever milk is removed from your breasts will be replaced. However, any milk left behind will send the message to your body that the milk is excess and that milk will be reduced. This is a good thing. You don’t want to be very full all of the time. Your goal should be that your breasts to fill up when it’s time for the baby to eat, and are softer by the end of the feeding.
- Supply is based on demand
- Early supply is determined by frequent stimulation in the early days
- Supply is maintained by frequent stimulation and milk removal
- Whatever milk is removed will be replaced
- Whatever milk is not removed will send the message to reduce the supply some
*All of the above is assuming you do not suffer from hormonal problems, untreated thyroid, infertility, have any sort of breast surgery that could impact your supply, or have underdeveloped breasts. While all of these could be a red flag, they do not necessarily guarantee you'll have supply problems. This is just a heads up that you should work closely with a lactation consultant. Don't assume anything. Find a lactation consultant and make a plan.
FAQ about milk supply:
Do I need to start pumping right away to help my milk come in?
No. The milk "coming in" is a hormonal process and you can't speed it up. The process starts when the placenta is delivered, but generally takes 3-5 days before the milk comes in for a first time mom. You body has to get rid of all of the excess progesterone from the placenta before the prolactin can take over. The process is usually quicker with subsequent babies. Pumping right away will ensure that your body is getting the message that you want lots of milk, but isn't necessary if the baby is breastfeeding well. Take advantage of the down time between feedings and rest. Don't add to your exhaustion by doing something that isn't necessary.
When should I pump to ensure that I’m making enough milk?
When your milk first comes in, you are making much more than you need. The goal in the first few weeks is to actually reduce the supply to what the baby needs. It may make you feel like you have superpowers when your breasts are bursting with milk and if you pump or express some milk, but this will quickly become uncomfortable or miserable. You want to make what your baby needs. You want your breasts to fill up when baby needs to feed and be softer at the end of the feeding. Remember this rule: whatever you take out your body will replace. If you are breastfeeding every three hours then pumping after every feeding, your body will think you're feeding twins and it'll keep giving you what you asked for. However, when you're feeling back to your old self and want a day of shopping, you will either be lugging your pump around, pumping every 3 hours after feeding baby, or will be miserably full and uncomfortable. Moral of the story: let your baby determine the supply and leave the pump for when you need to be away or are going back to work. If you're separated from your baby or baby is not feeding well, read here to learn about pumping.
How do I know if I’m making enough or have a low supply?
You cannot measure how much your baby takes at each feeding from the breast very easily or accurately. However, you can gauge his general milk intake by paying attention to a few things: diapers, mood, and weight. Once your milk comes in (days 3-5), your baby should have 5-6 wet diapers and 3-4 poop diapers in a 24-hour period. If he falls below this, have your breastfeeding evaluated by a lactation consultant. The baby should feed every 2-3 hours around the clock and be relatively content between feedings (might fuss to be held, but isn't hungry). If baby never seems satisfied, then have the feedings evaluated by a lactation consultant. Babies lose weight after delivery and don't start gaining until the milk comes in. After that, they typically gain 1/2-1 oz per day. They should be back to birth weight by 2 weeks of age. If baby's weight gain is slow or he is not back to birth weight by two weeks, have your feeding evaluated by a lactation consultant.
Do I need to drink Mother’s Milk Tea to have a good milk supply?
Mother's Milk Tea is an herbal tea consisting of herbs that anecdotally work to increase milk supply. There is no scientific literature verifying this. However, many mothers swear by it. Whether you choose to drink the tea, eat lactation cookies, or make a lactation smoothie, the most important thing to remember is that no supplement will increase milk supply without frequent stimulation and milk removal. That means, if you are not breastfeeding and/or pumping as often as your baby should be eating and/or are not effectively removing the milk from the breasts, no supplement in the world will increase your supply. The teas, cookies and smoothies are nutritional. They won't hurt, but they won't help without stimulation and milk removal.
What should I eat/ drink to increase my milk supply?
There are many foods and drinks that people swear by for milk supply. These anecdotally work to increase milk supply. There is no scientific literature verifying this. However, many mothers swear by it. Whether you choose to drink the tea, eat lactation cookies, or make a lactation smoothie, the most important thing to remember is that no supplement will increase milk supply without frequent stimulation and milk removal. That means, if you are not breastfeeding and/or pumping as often as your baby should be eating and/or are not effectively removing the milk from the breasts, no supplement in the world will increase your supply. The teas, cookies and smoothies are nutritional. They won't hurt, but they won't help without stimulation and milk removal.
How much water should I drink to have a good milk supply?
You should drink if you're thirsty. There is no set amount you need to drink for normal, everyday functioning and there is no set amount for producing milk, either. Remember, there is water in other beverages and the foods we eat, as well. Increasing your water intake has no impact on your milk supply unless you are drinking massive amounts of water, in which case it can decrease your supply. If you are drinking more water than your body can handle you may experience some edema. The edema that results in your breasts can reduce your supply. The moral: drink if you're thirsty. Breastfeeding tends to make you thirsty!