When your milk comes in: what to expect

Co-written by Deja Ramos, a Certified Doula (DONA), ICCE, and Co-Founder of The Birth Companions and Anna Morales, Co-founder of Mila Support

Right after birth, your body makes a small amount of concentrated first milk called colostrum. The larger volume of milk “coming in” happens a few days later, and it can feel like a big, sometimes uncomfortable shift when it does. Here’s what to expect, timeline and all.

The general timeline

• Colostrum is available starting late in pregnancy and is what your baby will breastfeed on in the first couple of days. It’s low in volume but rich in antibodies and exactly what a newborn’s tiny stomach needs at first.

• Milk typically “comes in”, meaning a noticeably larger volume, around 2 to 4 days after birth, though it can take longer, especially in situations like retained placenta, or system-wide medical issues like sepsis. Other reasons milk may delay longer is limited contact with baby after delivery or inadequate feeding stimulus of breast in the first two days. 

• In the first weeks and months, your milk supply increases and begins to settle into a pattern that matches your baby’s needs. But breast milk remains dynamic throughout breastfeeding, changing as your baby grows and responding to their environment.

Engorgement: what to expect

• In the first week or two after birth, it’s common for your breasts to feel fuller, firmer, heavier, or a little lumpy as your milk volume increases. This is usually temporary.

• Frequent feeding, cold compresses between feeds, and hand-expressing a small amount of milk if you’re very uncomfortable can help. Avoid adding extra pumping unless your lactation consultant or care team recommends it, since removing more milk than baby needs can sometimes worsen oversupply and engorgement.

• Some fullness and discomfort is a normal part of your milk increasing. But if your breasts are so full that baby has trouble latching, address it right away. Hand-expressing a small amount before a feed can soften the areola enough to help baby latch.

When to check in

Your baby will typically see a pediatrician one or two times in the first week after birth. If your milk has not noticeably increased by then, or if your baby is losing more than 10% of their birth weight, your pediatrician may recommend supplementation and/or support from an IBCLC or lactation specialist.

Contact your provider promptly if engorgement comes with a fever, flu-like symptoms, or one area of intense redness and pain.

Sourced from: Cleveland Clinic, Academy of Breastfeeding Medicine.