Stm when did milk come in?

Milk production generally begins around the midpoint of pregnancy, somewhere between weeks 16 and 22. At this stage your body is producing what's known as colostrum—a yellowish milk that's rich in calories and disease-fighting antibodies—which will serve as baby's first food after birth.

Here are signs that your milk is on its way, plus tips and tricks to avoid engorgement and other challenges that some breastfeeding moms experience when their milk first comes in after giving birth.

Your breast milk arrives in three different stages — and production actually starts before you even give birth!

Timing: Day one

Most women can begin breastfeeding immediately after giving birth, but the milky fluid that you produce in these early days is technically called colostrum. Colostrum is the first "milk" that your body produces and is packed with antibodies and white blood cells to help protect your baby from infections and illnesses during her first few days of life.

Colostrum contains a high concentration of carotenoids, which give it its signature golden yellow color (although sometimes it can be clear), and its thick, sticky consistency coats your baby’s intestinal system to help protect the sensitive and permeable lining of her stomach. Colostrum also acts as a laxative to help newborns pass the meconium, or first poop, from their system.

You actually start making colostrum while you're still pregnant — most women begin producing colostrum around week 14 to 16 of pregnancy, and some might notice leaking colostrum in the second or third trimesters.

Your body only produces tiny amounts of colostrum after giving birth. With frequent and effective milk removal through nursing or pumping, your supply will increase, and your colostrum will change to transitional milk over the next few days.

Timing: Three or four days postpartum

When new moms wonder when their milk will "come in," they're usually referring to transitional milk. Transitional milk appears between colostrum and mature milk, usually around the third or fourth day after giving birth.

Transitional milk takes on a more whitish color and is usually more abundant than colostrum. Transitional milk also contains more calories and is richer in fat content to help meet the needs of your rapidly growing newborn.

Some signs that your transitional milk is coming in include:

Timing: Between day 10 and 14 postpartum

After a few weeks, your transitional milk will become what's known as mature milk, which is thin and white (though sometimes bluish), and resembles watery skim milk. Mature milk contains all of the fat and nutrients your baby needs.

If your transitional milk seems like it's delayed, there could be a few possible causes. In most cases, delayed milk increase is due to infrequent or ineffective milk removal in the first few days after giving birth. This might be due to an improper latch, a baby who is having trouble nursing effectively, or if you're not nursing or pumping frequently enough.

In some cases, delayed milk increase might be due to hormonal imbalances, breast hypoplasia or another chronic issue that may contribute to low milk supply, such as maternal obesity and pregnancy-induced high blood pressure.

If you are experiencing low or no milk production beyond three to five days postpartum, talk to your OB/GYN or board-certified lactation consultant to identify the cause.

Engorgement — when your breasts swell and become hard and tender — is a normal and expected part of your breastfeeding journey, but this stage can be uncomfortable. In the first few days after giving birth, breast engorgement is caused by your transitional milk coming in, which can result in breasts becoming overly full (though it can also happen later on, such as if you wait too long between nursing or pumping sessions).

To relieve painful and uncomfortable breast engorgement when your milk comes in, try these strategies, which differ depending on whether or not you're hoping to breastfeed:

Milk production begins around the midpoint of pregnancy. For most mothers, milk will “come in” (increase in quantity and begin the change from colostrum to mature milk) between days 2 and 5.

Yes! Colostrum is being produced from about 16-22 weeks of pregnancy, although many mothers are not aware that the milk is there since it may not be leaking or easy to express. Colostrum is the early, concentrated milk that is full of nutrients and disease-fighting antibodies — it provides everything that your baby needs in the early days after birth. Your baby’s stomach is very small at birth, and the amounts of colostrum (transitioning gradually to mature breastmilk once your milk comes in) are perfect for baby’s needs. The average colostrum  intake by healthy babies increases from 2-10 mL per feeding in the first 24 hours to 30-60 mL (1-2 oz) per feed by the end of day 3 (ABM 2009).

Average Intake of Colostrum/Milk

References: ABM 2009, Mannel et al 2013, Mohrbacher 2010.

Milk production normally begins to increase (biochemically) between 30 and 40 hours after delivery of the placenta, but it may take a little while for the changes to become apparent to the mother. Milk “coming in” generally refers to the time when the mother notices increased breast fullness (and other signs) as milk production begins to kick into full gear– this usually occurs 2-3 days after birth, but in as many as 25% of mothers this may take longer than 3 days.

Signs that your milk is increasing may include:

Keep in mind that many women experience their milk coming in as a gradual change, rather than a sudden one. Research indicates that this timing is hormonally controlled – it does not require that baby be breastfeeding at all. However, mothers who breastfeed early and often (or express milk if breastfeeding is not going well) have higher milk production on days 3-4, and their infants lose less weight and have lower bilirubin levels (less jaundice).   Skin-to-skin contact with baby has also been associated with increased milk production. Milk production will begin to shut down if milk is not being removed by the time your milk is coming in.

When a mother’s milk does not undergo the expected increase in volume within 3 days of birth (72 hours postpartum) – this is called delayed onset of lactation (DOL).

Studies have shown that risk factors for delayed onset of lactation include:

Breastfeeding your newborn — what to expect in the early weeks @KellyMom.com

Increasing Low Milk Supply @KellyMom.com

How Does Milk Production Work? @KellyMom.com

ABM Clinical Protocol #3: Hospital guidelines for the use of supplementary feedings in the healthy term breastfed neonate, revised 2009. Breastfeed Med. 2009;4(3):175-82.

Chapman DJ, Pérez-escamilla R. Maternal perception of the onset of lactation is a valid, public health indicator of lactogenesis stage II. J Nutr. 2000;130(12):2972-80.

Hurst NM. Recognizing and treating delayed or failed lactogenesis II. J Midwifery Womens Health. 2007;52(6):588-94.

Lawrence RA, Lawrence RM. Breastfeeding, A Guide for the Medical Profession (7th ed.). Elsevier Health Sciences; 2011; 81, 84-85, 552.

Lind JN, Perrine CG, Li R. Relationship between Use of Labor Pain Medications and Delayed Onset of Lactation. J Hum Lact. 2014;30(2):167-73.