Frequently Asked Questions About Milk Production
by Kelly
Bonyata
Reprinted with permission
How
Does Milk Production Change Over the Course of Lactation?
For the first
few days, up to and including the point at which mom's milk "comes
in," milk production does not depend upon milk being removed
from the breast. After those first few days, it is necessary for
milk to be regularly removed from the breast (via baby or pump)
to continue milk production. The breasts will begin to shut down
milk production within several days if milk is not regularly and
effectively removed.
During the
early weeks, assuming nursing is going well, a mom will often
have more milk than baby needs. Many moms also experience varying
degrees of leaking and/or breast fullness/engorgement in the early
weeks -- this is not the norm for the entire breastfeeding experience
but simply a period of adjustment as mom's body determines and
adjusts to the amount of milk her baby (or babies) actually needs.
After the
first 6 weeks to 3 months (or sometimes later - this varies for
different mothers), the high baseline prolactin level that is
the norm in the early weeks gradually decreases to the lower baseline
that is the norm for later lactation. Around this time, mom's
breasts may feel less full, leaking may decrease or stop, let-down
may become less noticeable, and pumping output may decrease. These
are all normal changes and, on their own, do not mean that milk
supply has decreased.
I'm
Confused about Foremilk and Hindmilk — How Does This Work?
Foremilk is
the milk (typically lower in fat) available at the beginning of
a feeding; hindmilk is milk at the end of a feeding, which has
a higher fat content than the foremilk at that feeding. There
is no sharp distinction between foremilk and hindmilk –
the change is very gradual. Research from Peter Hartmann's group
tells us that fat content of the milk is primarily determined
by the emptiness of the breast -- the less milk in the breast,
the higher the fat content. Click
here to read more...
What
Happens Between Feedings?
Milk is produced
at all times, not just between feedings. Between feedings, milk
collects in mom's breasts. Volume of milk stored in the breast
is greater when there has been a greater amount of time between
feeds. The amount of milk that can be stored in the breast between
feedings (milk storage capacity) varies significantly from mom
to mom and is not determined by breast size (although breast size
can limit storage capacity). For most women there is not a lot
of storage room. Although mothers with both low and high milk
storage capacities produce enough milk for their babies, mothers
with a greater milk storage capacity may be able to go longer
between feedings without impacting milk supply and baby's growth.
Do
Breasts Need Time to Refill?
Many
people mistakenly think of a mother's milk supply as being like
"flesh-covered bottles" that are completely emptied
and then need time to refill before baby nurses again. This
is simply not how we understand milk production to function.
First of all,
milk is being produced at all times, so the breast is never empty.
Research has shown that babies do not take all the milk available
from the breast - the amount that baby drinks depends upon his
appetite. The amount of milk removed from the breast varies from
feed to feed, but averages around 75-80% of the available milk.
Trying to completely empty a breast is like trying to empty a
river -- it's impossible, since more milk will keep flowing in
while milk is being removed. Research also
tells us that the emptier the breast, the faster the breast makes
milk. So when baby removes a large percentage of milk from the
breast, milk production will speed up in response.
Rather than thinking of nursing or pumping as "pouring milk
out of a container" think of it as flipping on the "high
speed production" switch!
Yet another analogy: Imagine you are using a straw to drink from
a glass of water. As you drink, a friend is very slowly pouring
water into your glass. The emptier the glass, the faster your
friend pours the water. Would you be able to drink all the water
in your glass?
Waiting a
set amount of time to nurse your baby (under the mistaken belief
that breasts need time to "refill") is actually counterproductive.
Consistently delaying nursing will lead to decreased milk supply
over time because milk production slows when milk accumulates
in the breast.
