Milk let-down: what you need to know

Colostrum production begins at birth, or even towards the end of pregnancy. It is a thick, yellowish liquid that is particularly rich in micronutrients. It meets your baby's needs before your milk supply is established. It is the golden milk for your newborn's health. 

The milk coming in, or milk let-down, is therefore the transition from colostrum to more mature, richer milk — high in lactose — which signals the start of breastfeeding.

Almost all women — with very rare exceptions — whether they gave birth vaginally or by caesarean section, and whether or not they have chosen to breastfeed, will experience their milk coming in.

This milk coming in is triggered by the drop in oestrogen and progesterone levels after birth. This in turn stimulates the production of another hormone, prolactin — which is what enables lactation.

Milk usually comes in between the 3rd and 4th day postpartum. In some cases, it may be delayed until the 5th or 6th day. If this is the case for you, don't hesitate to ask a lactation consultant or midwife for support.

This varies from one mother to the next. Some mothers notice their breasts becoming fuller after birth, and also more tense than during pregnancy. Others feel nothing in particular. In reality, there is no "milk coming in" as such. It is the baby's suckling (or sometimes simply hearing them cry) that triggers the production of oxytocin, which in turn stimulates the milk ejection reflex from the breast.

Pain during the milk let-down doesn't have to be inevitable! The main remedy for engorgement is simple: it's your baby. The more time they spend at the breast, the more regularly they feed. This way, your breasts will be properly drained and therefore less painful.

If your baby struggles to latch because your breast is too firm, help them by shaping the nipple. They will then be able to latch and feed more easily. You can also try softening the breast with a gentle massage.

You can also try various traditional home remedies to relieve discomfort if your breasts or nipples become painful.

Cold compresses

Apply for around twenty minutes in your bra a breastfeeding pad cold, or towels placed in the freezer. This will help improve drainage, reduce engorgement, and reduce swelling.

A warm shower

Taking a warm shower or wrapping the breast in a warm towel can help in particular.

Green cabbage leaves

Use green cabbage leaves, pressing them well beforehand to release their anti-inflammatory and analgesic properties, and place them on your chest for around twenty minutes.

Expressing milk 

You can also express your milk by hand by placing your fingers on either side of the breast and pressing inwards (towards your ribs), then squeezing to draw out the milk. The technique takes a little practice to get right. Ask a breastfeeding-specialist midwife to show you the correct technique.

To encourage a good start to breastfeeding, let your baby feed without watching the clock.

Encouraging contact

First and foremost, it is important to have your newborn skin-to-skin in the first hour after birth. Let your baby instinctively find their way to the breast. They will be naturally guided towards the nipples, which carry the same scent as the amniotic fluid.

Feeding on demand

It is important to breastfeed your baby on demand in order to establish a good milk supply. Your baby knows how to regulate their own feeding. There is no need to wait a set amount of time (3–4 hours) between feeds — feed as often as your baby shows the need, especially in the first few weeks.

Feeding frequently 

Frequent feeds (every 1–2 hours) in the first days of breastfeeding are normal, and they signal to your body to produce milk. It is simply a matter of supply and demand: the more your baby feeds, the more they stimulate your body's milk production. Your baby's need to feed can be intense during the first few weeks. As well as wanting nourishment, your baby loves being close to you for reassurance and to adjust to their new environment.

A tip: let your baby feed for as long as they want. For some babies, feeds last 20 minutes, but others may take longer. Wait until they release the breast before offering the second one. At the next feed, you can start with the second breast. On average, your baby may feed between 8 and 12 times in 24 hours during the first few weeks (this is just an average — some babies feed much more).

Don't panic about feeding marathons

If you feel that your baby is constantly at the breast, this is not necessarily a sign of insufficient milk production or poor latch. If they are wetting 5 to 7 nappies a day, they are getting enough nourishment for their health.

Feeding "marathons" are common between 2–3 weeks, 6 weeks and 3 months, and correspond to growth periods during which your milk supply needs to adapt to your baby's needs. The best thing to do is to let your baby feed without watching the clock.

Surrounding yourself with experts and supportive people

If in doubt, don't hesitate to ask an IBCLC to check your baby's latch after birth and how they are taking the breast. 

Your baby should have a good mouthful of your nipple as well as a large part of the areola (the pigmented area surrounding the nipple). They should not be chewing, or appear to be struggling to stay latched. Sore breasts (breastfeeding nipple cracks) can also be signs of a poor latch. An IBCLC will be able to identify any potential tongue-tie issues (when your baby does not have good tongue mobility and the tongue is too tightly attached to the palate).

To prepare well for breastfeeding, make sure you also gather information during your pregnancy and surround yourself with people who are knowledgeable and positive about breastfeeding (midwives, friends who have breastfed and had a good experience). This will help you feel more relaxed. Don't hesitate to contact your local La Leche League, or to explore the many resources available on their website.

Resting and taking care of yourself

Calm is equally important. Milk let-down is not purely a mechanical response. Stress can block the production of oxytocin, which plays a key role in the milk ejection reflex. Take care of yourself: limit visitors, especially in the first few days, let yourself be looked after and stay in bed with your baby. Drink enough water (but only when you're thirsty — drinking more will not increase your milk supply) to avoid dehydration. And nourish yourself well.

Be mindful of taking breastfeeding supplement containing galactagogue foods right after birth. Except in very rare cases and on the advice of healthcare professionals, you do not need it to support your milk coming in. So in the early days, avoid the well-known breastfeeding herbal tea, as this can lead to engorgement and then a breastfeeding mastitis.