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Breastfeeding 411

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Breast milk composition changes as your child grows and adapts to the specific nutritional needs of your child. In fact, milk composition changes during each feeding. It is important to understand the phases of breast milk production in the early weeks of lactation to prevent unnecessary supplementation and/or early weaning from common misconceptions.

Colostrum

  • Colostrum is present in breasts during pregnancy and will be your baby's first food.
  • In the first couple days of life, your baby will receive a small amount of colostrum (on average, about a teaspoon) at each feeding. Although this might not sound like a lot, it is the perfect amount for your newborn's small stomach which can also hold roughly a teaspoon each feeding session and is approximately the size of a shooter marble.
  • Colostrum is “high quality” milk rich in protein and low in fat and sugar and is referred to as “liquid gold”.
  • Colostrum is very thick and yellow in color.
  • Colostrum digests easily and rapidly and has many important functions:
    • The high levels of antibodies and immunoglobulins provide your baby with natural against immunity bacteria, viruses and environmental allergens.
    • Coats and protects your baby's digestive tract from invading microbes. (Think of a picture of Pepto-Bismol and how it shows the medicine coating the stomach)
    • Acts as a natural laxative to clear meconium (your baby's first stool) and to excrete bilirubin (which is the cause of neonatal jaundice).

Transitional Milk

  • Milk production usually increases within 3 to 4 days after birth and continues to increase in volume a bit each day, from approximately a tablespoon per feeding to 2 ounces per feeding (at 2 weeks of life). The onset of copious milk secretion is referred to as Lactogenesis II. Your baby's stomach size will also grow and will be approximately the size of a ping-pong ball, holding approximately an ounce of milk each feeding.
  • Transitional milk is present from approximately day 3 of life up until about 10-14 days of life.
  • Transitional milk still contains some colostrum and is high in fat, protein, lactose (sugar) and vitamins.
  • The milk begins turning more white in color and begins to thin.
  • Many moms refer to the onset of lactogenesis II as their "milk coming in". (Remember, milk has been in your breasts, it's just now that you are feeling the increased volume.)
Mature Milk
  • Mature milk is present from approximately day of life 14 and beyond.
  • Mature milk consists of foremilk and hindmilk. Colostrum is no longer present in mature milk.
  • Foremilk is low in fat content, high in lactose and is comprised of mostly water. It has a thin, watery consistency and is present at the beginning of the feeding session. Foremilk supports your baby's hydration demands and quenches thirst.
  • Hindmilk is present after several minutes of nursing. It is creamy, high in fat and necessary for adequate growth.
  • Both foremilk and hindmilk are necessary for adequate nutrition.
  • Your baby's stomach is now about the size of an extra-large chicken egg and can hold about 2 1/2 ounces of milk each feeding.
  • On average:
    • 750 mL of breast milk is produced each day from 1 month of age through 6 months of age. 
    • 2 1/2 ounces of breastmilk is consumed per feeding. (It is important to remember that each baby is unique and has his/her own feeding pattern. Some may take 3 ounces in 3 minutes, 5 ounces in 10 minutes or 2 ounces in 25 minutes.
In the first 3 days of life, milk production is regulated by hormones. The two hormones that play a significant role in breastmilk production are prolactin and oxytocin. Prolactin stimulates the milk cells to produce breast milk, while oxytocin produces muscle contractions which release breastmilk into the milk ducts (this is known as the milk-ejection or the let-down reflex). The milk-ejection sensation varies among women. Some women may experience tingling in the breast, fullness or leaking, while others may not even be aware that it has occurred. To get a visual picture of this process, think of the milk cells within the breasts as a cluster of grapes. Prolactin stimulates the production of milk in each milk cell (each grape) and oxytocin contracts or squeezes each cell (grape) to remove the milk. The milk travels down the duct system (stem of the grape cluster) and out from the nipple. The milk-ejection reflex is felt as the milk travels down the milk duct (stem of the grape cluster).

After the initial 3 days of life and once lactogenesis II has occurred (breastmilk volume has increased), milk removal and breast stimulation are essential for breast milk production and maintenance. This is better known as "Supply and Demand". In other words, the more milk that is removed, the more milk that is made. Your body will adjust to your baby's needs. During periods of rapid growth (known as growth spurts), your baby will feed more frequently. This signals your body to boost your milk production to satisfy his growth spurt. By feeding your baby on demand and allowing him to finish a breast before offering the next, you are ensuring that he gets both foremilk and hindmilk and allows for regulation of breastmilk production.

Be sure to get your rest, keep hydrated and eat nutritiously to help keep up your milk supply. If you feel as if your supply is dwindling or are having any kind of difficulty, reach out to a lactation consultant for assistance (find a lactation consultant here). Lactation consultants are a great resource for support and assistance.

Source:
Texas Department of State Health Services Nutritional Services and Texas Association of Local WIC Directors. Principles of Lactation Management. Attended May 2010.
Walker, M (2011). Breastfeeding Management for the Clinician (2 edition). Boston: Jones and Bartlett Publishers.

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