Breastfeeding

The milk coming in

For some women, the milk coming in was not a memorable event. They experienced a smooth transition from the colostrum of the first breastfeed to their full milk supply, with little or no discomfort. Several of these women spoke of a night where the baby just fed constantly and then the milk seemed to be there the next day.

On the other hand, many women spoke in dramatic terms of the changes to their body and the milk coming in. They talked about their breasts as a “different landscape”, baseballs, melons and balloons. Their breasts became larger, firmer, very warm and sore. One woman said,

“I can remember the feelings and … wondering what was happening and being very aware of my breasts at this time, and the fact that they seemed to have grown and they seemed to have taken on a life of their own and they were dictating what was happening rather than me … It took me a few days to learn that actually my daughter, was in control, not me or my breasts, it was my daughter who was sort of dictating what was happening there”.

A few women talked about having to learn to attach their baby all over again when their full milk came in.

The women used a variety of methods to relieve the engorgement (excessive milk build up), including more frequent feeding, warm compresses, expressing, and chilled or frozen cabbage leaves*1 or gel pads (bought from the chemist and kept in the fridge) which they applied to their breast(s).
They spoke of difficulty getting the baby attached to the breast and how they expressed some breastmilk to soften the breast so that the baby could attach. However, one woman spoke of establishing a “vicious cycle” between expressing and becoming more engorged. Several women mentioned the feeling of “relief” when their baby eventually attached, withdrew their milk and softened their breasts*2.
Several women talked about their milk leaking and even spurting from their breast(s) in the early days (see Interviews 49 and 39 above). Leaking was often triggered by the sight or sound of their baby or by overfull breasts. Some used breast pads to catch the excess milk while others collected and stored it for later use (see 'Emotional and psychological aspects of breastfeeding'). 

Low milk supply
A number of women we talked with felt that they were not producing enough milk. For some it was a temporary problem, but in at least one case the pattern of low milk supply remained unchanged throughout the lactation period. Lizzie, a first time mum, experienced very low milk supply that remained unchanged despite all her efforts to increase it. Lizzie’s son was born tongue-tie but he latched well so she and the health visitor expected that once the tongue-tie was corrected, her milk supply would increase. But it didn’t.

For three months, Lizzie followed all the advice her midwife, health visitor, the breastfeeding consultant and the breastfeeding support group gave her: she breastfed on demand, used an electric pump after every breastfeeding session, ate certain foods and spices, but her low milk supply didn’t change. At the same time the message she got was to be patient and to persevere because the milk ‘would come’.

*Footnote 1: Cabbage leaves, kept cool and applied to the breast, are sometimes recommended as a home treatment for engorgement. Their effectiveness has not been scientifically proven.

Footnote 2: Women who are able to get their baby to attach well and breastfeed without restriction are less likely to have problems with engorgement. The importance of good attachment (skin contact) and effective milk removal (by any means if the breasts are over full) is the surest way to the establishment of satisfactory breastfeeding and an adequate milk supply.

Foonote 3:  In many countries women who have low milk supply are prescribed domperidone as it increases prolactin levels, and is considered compatible with breastfeeding. (Hale TW. Medications and mothers’ milk. 15th edition. Hale Publishing 2012)

Last reviewed September 2015.
Last updated September 2015.
 

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