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Your Breasts are Designed to Feed Your Baby

From the onset of puberty and right through the pregnancy, your breasts are being primed for breastfeeding.  From around the 16^th week of pregnancy, your breasts are producing milk that is available to your baby as soon as he is born.  It is produced in exactly the right amount for your newborns tiny stomach.  The delivery of the placenta triggers your body to start making more milk.  In the beginning, your milk supply is hormonally controlled and your breasts should fill up in the next 3 days regardless of stimulation or milk removal.  This is called lactogenesis II.  If your baby is not nursing well or often, you may become engorged.  Feeding your baby frequently from the very beginning is the only way to prevent engorgement and it will ensure a plentiful milk supply.

Early and Often

The hormone prolactin is responsible for milk production.  In order to work, prolactin needs receptor sites in the breasts.  It is believed that frequent milk removal in the first two weeks after birth, creates these prolactin receptor sites.  Keeping your baby with you and feeding him whenever he cues to feed, will not only insure a well hydrated, well fed baby, but it will mean a more abundant milk supply, when your baby is ready for it.  Studies have found that the more often a woman nurses on the baby's second day of life, the more milk she has at six weeks.  If for some reason your baby cannot breastfeed, frequent milk removal through hand expression or a hospital grade pump will get the same results.

Supply and Demand

Unlike lactogenesis II, the next step, lactogenesis III, is dependent on milk being removed from the breast.  At this point the breasts begin to work on the basis of supply and demand.    The best way to achieve the right milk supply is to follow your baby's cues.  Feed him whenever he wants and as long as he wants.  Let him come off the first side spontaneously before offering the second.  By following your baby's cues, your milk supply will calibrate to your baby's needs. For some women this means down regulating.  Most women find that by 3 to 4 weeks, their breasts feel less full and they are more comfortable.  If for some reason your baby is unable to remove milk from your breasts, you will need to pump to maintain your milk supply.  This is true for every stage of breastfeeding. 

Scheduling feeds, giving artificial baby milk instead of breastfeeding or as a top up, and trying to push off feeds with a pacifier can all cause the system to fail.  If you feel that you have either too little or too much milk for your baby, contact a lactation consultant for help.