Episode 36: Establishing Your Milk Supply in the Immediate Posptartum

During the first three weeks after you have your baby your body is switching from a complete hormonal and functional emphasis on growing and nourishing an infant in your uterus. After your baby is born there's a transition to your body focusing on the hormones and function of lactation. And in those first three weeks, approximately, after you have your baby, you have an opportunity for you to build up your max capacity. After those first three weeks are up, your milk supply will only fluctuate within that max capacity. It's only in those first three weeks that you might have an opportunity to increase your supply.

What we mean by staying establishing your milk supply is doing everything that you need to do in those first three weeks after your baby is born to ensure that you're not inadvertently limiting the amount of milk that your body can make. 

Remember, everyone has a different max capacity of milk their body can make, and there are instances where some people's body will make an excess of milk and those folks don't have to worry about their milk supply as much, while some of us struggle to build enough of a supply for our infant's and every drop counts so the efforts we make in these first three weeks have a big impact. You just, unfortunately, will never know what your own experience is going to be until you get to that part of your journey (your breast size is not an indicator, at all!)

Here are some tips for establishing your milk supply:

1. Remove milk from your body often. Every 1-3 hours ensure you completely drain the milk from your breasts, via either latching your infant, hand expression, pumping, or a combination of the three. One method is to latch your infant for a while, then hand express or pump whatever milk remains in your body for a fully drained feeding.
2. Keep your infant skin to skin as much as possible.
3. Use nipple salve after each feeding / pumping.
4. Have compassion for yourself and your infant. Feeding an infant from your body can be a huge learning curve.

Watch the video for more details! (remember, closed captioning is available via clicking the [cc] symbol on the video interface.

Full Transcript:

[00:00:00] Hello, and welcome to your next episode of the free weekly Brave Journey Birth Preparation Videos, where I pick a topic related to birth and postpartum and we talk about it. Today we're talking about establishing your milk supply. In particular, the first three weeks after you have your baby is your opportunity to increase your milk supply to its max capacity.

After about the first three weeks, you have established a max capacity and then you are simply working within that max capacity. But those first three weeks, you have a little bit of an opportunity to increase your supply, to reach a max amount of milk that your body will create. So the topic of this video is how to establish your milk supply in those first days after you have your baby. I'm Cara Lee, I'm a birth doula and a childbirth educator, and let's get started.

[00:01:00]

So let's talk about establishing your milk supply. Again, your first three weeks after you have your baby, your body is switching from a complete hormonal and functional emphasis on growing and nourishing an infant through growing your placenta and nourishing your infant. After your baby is born there's a transition to your body, focusing on the hormones of lactation. And in those first three weeks, approximately, after you have your baby, this is an opportunity for you to build up your max capacity. After you've increased to a certain capacity. And after those first three weeks are up, your milk supply will only fluctuate within that, max capacity. It's only in those first three weeks that you might have an opportunity to increase your supply.

So establishing your milk supply, what we mean by staying establishing your milk supply is doing everything that you need to do in those first three weeks after your baby is born to ensure that you're not inadvertently limiting the amount of milk that your body can make.

So I'm going to give you some tips for how you can increase your [00:02:00] milk supply, or at least establish your milk supply. So one important concept for you to understand is that your body creates milk on a supply and demand basis. And what this means is the more that milk leaves your body, the more your body will make. The less milk that is leaving your body, the less milk your body will make. So your body responds. So not nursing for a while, not removing milk from your breast for a while. It's not going to save it up or make more for later. It will overall, if you're not removing milk regularly, it'll decrease the amount of milk that your body makes overall. So the more often your milk is being removed from your breasts, the more milk your body's going to make to replace it.

Now we each have our own individual max capacity and that's going to be individual to you. But this is about how do you get to your own individual max capacity to establish your milk supply. So with this supply and demand, what that means is the most important thing that you can do after your baby is born, is to regularly remove milk.

And you notice I'm not just saying regularly feed your [00:03:00] baby because it is true. Many infants are able to effectively remove milk through their latch on your breast. Occasionally there are infants for whom they're not adequately removing the milk from your breasts. So what you can do in addition is to feed your infant regularly and then either hand express or use a pump to fully drain your breasts.

So tip number one is to fully drain, remove all the milk from your breasts. At least every one to three hours. Now the tricky bit is I don't mean every one to three hours during the day. I mean, one to three hours, 24 hours a day. If you go more than four hours between feedings in this beginning time, your body may think that it needs to decrease the amount of milk that it's making.

And again, these are all generalizations. You never know what your experience is going to be like when you're feeding your baby. But generally you're going to want to feed every one to three hours, especially during these first couple of weeks, right after your baby is born. And you're going to want to remove all the milk from your breasts, every one to three hours.

Now let's think about this for a minute. So we can think about how hard this is. [00:04:00] If you're feeding every one to three hours and it takes your baby about 10 to 20 minutes to feed, or it takes you about 10 to 20 minutes to remove all the milk from your breast. That means you've got like 40 minutes between each feeding to eat, go to the bathroom, rest, take a shower. It's really constant.

Even if it's every three hours, if it takes 20 minutes to feed your infant, you're still only getting like two hours, two and a half hours in between each feeding to run an errand. And this is later on not immediate post partum you should be resting, but just to really conceptualize why this can be really hard on someone, a parent, when you're needing to nurse every one to three hours, it's a lot more frequent than you realize.

And I'm talking from personal experience too. But just keep that in mind. So number one, tip, remove milk regularly. This will help establish your milk supply. It will also help prevent clogged ducts. It will help prevent mastitis or infection. It just regularly moving milk through your breasts. Whether it's through the infant removing at themselves, a pump, or [00:05:00] hand expression that's just regularly emptying milk is your number one tip.

The next tip for the first three weeks to establish your milk supply, is to be skin to skin often. So take your baby out of their onesie, take off your blouse or unbutton it and place the baby here and cover them with a blanket. That skin to skin that oxytocin. That's a part of nursing. That those hormones of nursing include. And that snuggling is going to really be important for your body's milk production. So skin to skin, it's an important part of establishing your milk supply is keeping your infant on your body and skin to skin with you. That can definitely help you establish your milk supply, and also help you attend to your infant's hunger cues faster.

So I'll talk about this in a future video, but we're going to talk about what do newborn hunger cues look like and spoiler alert - when they're crying, they're, they're often over hungry. You have to be able to calm them down before they will be able to latch. So you want to feed them earlier. You want to look for those early hunger cues.

So spoiler alert. We'll talk about that in a future video. But so keeping skin to [00:06:00] skin the next tip. So first tip empty your breasts, every one to three hours for the first couple of weeks, it'll spread out over time. Next tip. Lots of skin to skin. Third tip apply nipple cream or a nipple salve to your nipples after every feeding, at least in the beginning.

Your nipples are growing adjusted to being wet and then dry. And you don't want them getting chapped. It's the same as your lips. If they're wet and dry, wet, and dry chapstick is going to help prevent or protect your skin. This is the same idea with nipples salve. So there's a gazillion different varieties out there. Go find some nipple salve, definitely apply it and it's safe for the infant. So you don't have to like wipe it off before your infant latches for the next feeding. And some people will use coconut oil. So just look into your options. But applying in nipple salve after each feeding can really help.

And then the fourth tip is have a ton of compassion for yourself and for your infant. This is a giant learning curve, and this seems really obvious from this standpoint, prenatally, but I'm telling you if during those first few weeks when feeding every one to three hours morning and night, day & [00:07:00] night, It can be really frustrating if it takes a while for your infant to latch.

It can be really frustrating if you are having it's awkward. How do you hold the baby? How do you hold the baby to your breast? What angle works for you and the baby? How do you get that good latch? It's really complicated and it's a learning curve. And sometimes you have to break the seal and relaunch a few times each feeding... give yourself compassion, give your infant some compassion and just recognize it is a giant learning curve.

So a little bit about nursing those first seven days. When the baby is first born, your body will begin creating cholesterol costumes, a thick, super fatty substance. It doesn't look like milk at all. And it just a very small amount is helpful for your infant. It helps their digestion begin and it helps. It's really good for them. After days, 2, 3, 4, your body will switch to, your "milk will come in" is the phrase that people use. So this is usually experienced as a fullness in the breasts where you're now making milk. That truly, that looks like milk, what you would expect milk to look like. And that doesn't happen [00:08:00] for 2, 3, 4 days or so after the baby's born.

So those first few days colostrum the super thick substance. And then your milk supply comes in. And that's when you start, when your infant feeding, it's going to become a little bit more typical. After the first week, you'll probably settle into an every two to three hours feeding schedule where your infant will kind of let you know when they're ready for their next feeding, but the first week it's really sporadic.

And you just want to make sure that your infant is, at least every one to three hours, and sometimes it's okay for them to just be at your breast a lot. That first week is just all about establishing your supply and healing from your birth. So just to give you an idea of that.

Okay. So those are your main tips feed often, and remove milk from your breasts often, lots of skin to skin apply a SAB or a cream tea to your nipple after each feeding to help keep your skin healthy and protect it from that drying effect of wet, dry, wet, dry. And then lastly have a lot of compassion for yourself and for your infant.

That's it for this week. I will see you next week.

[00:09:00]