CG The Importance of Early Initiation of Milk Removal for a Strong Supply -

The Importance of Early Initiation of Milk Removal for a Strong Supply

Many new moms question how their bodies know how to make milk for their growing baby. The science behind this process, often called the supply and demand system, has been around for years, and newer research has recently been released:^1,2

Each mom/baby pair is unique, has their own experience, and often needs support to have a successful lactation experience;
Healthy babies will tell you through their hunger cues when they want to eat and will also tell you when they are full (satiety cues);
The best way to make more milk is to frequently remove milk.

How Does Lactation Occur?

The three stages of lactation (Stage 1 Lactogenesis, Stage 2 Lactogenesis, and Stage 3 Lactogenesis) are described below.^1,3,4,5

Lactation Stage	Definition	What Occurs
Stage 1 Lactogenesis	Begins around the 16th week (second trimester of pregnancy) and lasts until a few days after you give birth.	Estrogen and progesterone levels increase and your milk ducts grow in number and size. Breasts start to become fuller and larger. Your nipples will darken and your areolas become larger. Your Montgomery glands (small bumps on the areola) secrete oil to lubricate your nipple and provide a smell for your baby so they know how to locate the nipple. Your body begins to make colostrum (see below for more information regarding colostrum).
Stage 2 Lactogenesis	Starts about 2 to 3 days after giving birth. Milk production will increase. Often referred to as the “milk coming in” stage.	Once your baby and placenta are delivered, a sudden drop in your estrogen and progesterone levels cause the hormone prolactin to rise. When your baby breastfeeds at your breast or you use a pump, it prompts the release of two hormones from the pituitary gland; prolactin and oxytocin. Prolactin is the hormone responsible for prompting the alveoli in your breast to make milk. Oxytocin causes muscle contractions around the alveoli to push milk into your milk ducts so it can be released (known as the “letdown” reflex). Milk production will often increase dramatically at this stage. Breasts will feel full, larger, and may feel sore (if this worsens, it could be engorgement).
Stage 3 Lactogenesis	Describes the rest of the time you lactate Includes the Supply and Demand System	Lactation generally continues as long as milk is removed from your breast by the baby or by pumping. The more milk that is removed, the more milk your body makes to replace it. Frequent feeding or pumping will cause your body to make more milk.

Colostrum, Baby’s First Milk

Your breasts begin producing small amounts of a nutrient-rich milk called colostrum somewhere between 16 and 22 weeks of pregnancy. Colostrum can vary in color; it may be clear to a light yellow color. Colostrum is the best nourishment for your newborn’s first few days of life, and no other supplementation is needed. After the first few days (usually days 2 to 4), you make transitional milk and then by 14 days, you are making mature milk. Colostrum may be present in your milk for up to 6 weeks. Your baby’s belly capacity at birth is about a teaspoon and will steadily increase to 3 to 5 ounces by about 4 weeks. As your milk production starts to increase, you may experience firmer breasts and changes in the color and texture of your breast milk. These are normal and healthy signs your body is creating milk for your growing baby.⁶

To Make More Milk, Remove More Milk (Supply and Demand System)

Milk supply is dependent on good quality breast/nipple stimulation and frequent milk removal. Audible (distinct and clear) sucking and swallowing at the breast is a sign your baby is getting milk during a feeding. Having a good latch will also help with this process. It is often said that milk supply works on a supply/demand system, and this is true. As your body prepares for ample milk production after delivery, breast/nipple stimulation is required to activate milk production. Once the milk making process is underway, frequent milk removal is key to keep it going. In fact, a whey protein/polypeptide called FIL (Feedback Inhibitor of Lactation), builds up in the breast when milk is not frequently removed.¹ This is a local control system of milk production found independently within each breast. The role of FIL is to slow milk synthesis when the breast is full, and to speed up milk synthesis when the breast is less full (less FIL is present).

The FIL does just what its name indicates; it tells the breasts to reduce production.¹ This is why, during the first six weeks postpartum, it is essential to breastfeed or pump at least every 2-3 hours during the day and every 3-4 hours at night. Feed your baby from your breast whenever you can, trying to avoid bottles and pacifiers in the early weeks to avoid any disruption or missed hunger cues. Breastfeeding frequently, especially in the first hours, days, and weeks is the best way to increase your milk supply.⁶

What If I Have Questions?

If you are interested in learning more, this Aeroflow class expands on some of the topics discussed above:

Ultimate Breastfeeding Prep
Babywearing and Breastfeeding

To register for these classes, log into your portal or click here.

Want More Info?

For a directory of Aeroflow’s other Care Guides offering information on pregnancy, baby care, and more, browse our comprehensive list of titles:

https://www.hersourcehealth.com/aeroflow-care-guides/ ‎

References