What parents should know about breast milk production

Every breastfeeding experience is different. If you’re navigating yours or about to start breastfeeding, you might be wondering what you can expect. What breastmilk is made of, the amount of it your breasts make and even its color changes as your baby grows. Here’s what you should know about the stages of breast milk production, what’s normal and what’s not, and when to seek help.

Stage 1: colostrum

Breast milk production starts during pregnancy. Your breasts start making colostrum between 16-18 weeks of pregnancy. Colostrum, sometimes called liquid gold, is full of important nutrients and antibodies your newborn needs. What makes colostrum different from mature breast milk, said Dr. Carly Dulabon, director of Akron Children’s Breastfeeding Medicine, is that it’s produced in small but perfect amounts for your baby and packed with important factors.

“It’s really helpful for priming the baby’s gut, since they’ve never been exposed to anything in the world,” she explained.

Thanks to your newborn’s small belly, your breasts will only produce a few milliliters of colostrum at a time. Keep in mind that during this time, your baby will likely feed between 10 to 12 times per day or more. Your breasts will produce the most colostrum 2-3 days after your baby is born.

“A lot of people get worried they’re not producing enough during this time,” said Dr. Dulabon. “Just remember that your baby doesn’t need that much, and the amount you produce is supposed to be low.”

Stage 2: transitional milk

A few days after your baby’s birth, you might notice your breasts feeling full and painful. This is the transitional milk stage. In addition to your breasts being full and painful, Dr. Dulabon says you might notice it’s hard to get milk out. That’s because your breasts are so full. To help release the milk, you can try putting warm compresses on your breast right before emptying. You can also try briefly pumping or hand expressing your milk and making sure your baby has a correct latch.

If you do need to pump, it’s important to only do the minimal amount you need for comfort. Too much pumping early on could create oversupply, which can cause more pain and fullness.

What to watch for during this stage: If you have a delay in your milk coming in, it can be a sign of a poor latch. A cesarean section can delay your milk coming in. You can tell if you baby has a poor latch if it’s very painful, and your baby doesn’t remove milk from the breast well. If you’ve got a painful latch or a delay in your transitional milk, schedule an appointment with Akron Children’s Breastfeeding Medicine online.

Stage 3: mature milk

After your milk comes in, it slowly transitions to mature milk. This happens over a few weeks. If you pump, you might notice that your milk changes from looking thicker and yellowish to waterier. That’s nothing to worry about, Dr. Dulabon said.

“That happens because there’s just a little bit less fat, a little bit less protein, and a little bit more carbohydrates and water, which is perfect for a baby as they are growing,” she said.

You also might notice your milk has a blue tint. That’s also normal, Dr. Dulabon said.

What to watch for during this stage: If you have any pain during latching or pumping, that’s a sign to get checked.

“Most moms have some discomfort in those first few days. If you have pain that lasts beyond the typical couple of days – pain that is still there once your milk comes in or pain that is so bad that you are dreading every feeding – come see us,” Dr. Dulabon said.

If your baby is losing weight or gaining weight too slowly once your milk comes in, that’s another reason to make an appointment.

It’s best to reach out for help as soon as you notice something that concerns you, Dr. Dulabon said. It’s easier to correct things early than it is if you wait.

Other breastfeeding problems to watch for

If you notice any of these issues when breastfeeding, make an appointment:

It’s very painful when your baby latches: This means that the baby’s latch likely isn’t good. This can affect how much milk they get from your breast and can cause problems with weight gain for baby and breast fullness and pain for you as well as issues with supply.

“Starting nursing might be uncomfortable when your baby latches because of sore or cracked nipples,” said Dr. Dulabon. “But that pain should get better as they nurse. Any pain you can’t tolerate deserves an appointment.”

Hindmilk and foremilk imbalance is rare: Foremilk is the milk released at the beginning of a feed, and hindmilk is released later in the feed. A hindmilk/foremilk imbalance usually only happens if you’re pumping and have created a large oversupply, said Dr. Dulabon.

You’re pumping a lot of milk per breast: Pumping 3-4 ounces total is normal, noted Dr. Dulabon.

“A lot of social media videos show moms pouring out 30 or more ounces of breast milk each time they pump,” she said. “You don’t need that much, and your baby doesn’t either. It’s normal to produce 24-30 ounces of milk per day, depending on your baby’s needs.”

As your baby grows and starts to eat solid food, the amount of milk you produce will slowly go down. If you are concerned you’re making too much or too little milk, make an appointment.

You have a fever: If you have a fever and a red, painful swollen breast, you might have mastitis. Mastitis is an inflammation of the breast tissue, which is usually caused by an infection. You’re at risk for mastitis if your breasts make more milk than your baby can remove. Dr. Dulabon says you might get a fever when your milk comes in as part of a normal inflammatory response, but if it lasts for more than 2 days, see a doctor. If you have mastitis symptoms, see a doctor as soon as possible.

To lower your risk for mastitis, Dr. Dulabon recommends feeding your baby on demand and not trying to increase your supply with extra pumping sessions.

There’s blood in your milk: A little bit of blood is normal if you have a crack or wound on your nipple. If you have a lot of blood in your milk or you’re seeing blood in your milk all the time, get checked out.

Your breasts are so full you can’t feed your baby: Try putting ice packs on your breasts and taking an anti-inflammatory.