Just like pregnancy and childbirth, nearly everyone has heard other women's stories about their experiences with breastfeeding. (It worked out beautifully for one, and went horribly for the other). A pregnant or newly postpartum woman can feel very overwhelmed by all of the information (or misinformation!) she's getting. Let's demystify the process by understanding the basics...Breast Development
Breast development begins early in pregnancy, but the mammary gland (the gland that actually produces milk) only becomes functional after delivery of the baby. Hormones such as estrogen, progesterone, and prolactin play a large role in breast growth and development during pregnancy. Throughout pregnancy breasts go through changes -- the size of the breast and the areola, the area surrounding the nipple, will become even darker. These are good signs that the woman's body is gearing up to produce milk and these hormones are working. Deep in the breast are clusters of tissue resembling grapes or broccoli florets. These are called alveoli, or milk-producing cells. After birth, when the baby latches on, compresses the ducts, and suckles correctly, a signal is sent to the brain to release oxytocin (which is the same hormone during childbirth which contracts the uterus to push the baby out). The oxytocin squeezes the alveoli and the milk comes down through the ducts and out of the nipple.
Milk production is based on supply and demand. Basically, the more frequently and effectively the baby nurses, the more milk will be made. During the first few days of lactation, the breast produces colostrum, which is the baby's first milk. It has a yellowish tint and it is thick, rich and filled with all essential nutrients and immunoglobulins. Keep in mind that it is only teaspoons worth, but it is all the baby needs at this stage. The baby will feed very frequently in the colostrum stage, but this is very normal and will only help to establish a good supply. Don't worry that the colostrum isn't enough. The baby's body will accept more volume as the mother's supply increases over the next few days. It's a gradual process. The baby's stomach is only the size of a marble on Day 1. By Day 3, it's grown to the size of a shooter marble and by Day 10, the size of a ping-pong ball. The baby's feeding patterns teaches the body how much to produce and milk supply will adjust to his or her demands.
Once the mother's milk "comes in," around days 3 or 4, the sensation is very different. The breasts feel much fuller and heavier. The milk changes from colostrum to transitional milk (a crossover between colostrum and mature milk) to mature milk. Mature milk consists of "foremilk," which is thin and watery like skim milk, and "hindmilk," which is thick and rich like cream. The foremilk contains lactose and the hindmilk contains the fat, so it is important that the mother completely finishes feeding from one breast before offering the other so that the baby gets the perfect balance of foremilk and hindmilk. The mother will feel her breasts welling up when it is time to feed and a release about 5 minutes into a feeding. This is called a milk ejection reflex, or "let-down." Many women start to notice their breasts leaking when their baby starts to cry (or even if another baby does!); when it's close to a time to feed; or they may even notice the other breast leaking while they're feeding. This is a normal physiologic response. Nursing pads can help to contain the leakage. There are many options for nursing pads: cloth (found in many maternity/baby care stores), disposable (Gerber, Curity, Medela, Lansinoh -- found in pharmacies and supermarkets), or reusable (Lily Padz -- found in maternity stores and online.) Keep in mind, however, many women do not leak at all. This is not a cause for concern as long as the mother is mindful of her milk supply, and that the baby is gaining weight and eliminating as expected.
When do I begin to breasfeed?
As soon as possible! Babies are eager to feed right after delivery. Ideally, a mother should attempt her first latch-on within the first hour after birth. This gets the whole process off to a great start. Babies are very alert and interested for the first 2 hours of life, so this is the perfect time to start.
What if I need a caesarean section?
Even if you have to deliver by c-section, the baby should still be able to feed as soon as you're settled in the recovery room.
What is normal? How do I know if my baby is getting enough milk?Here are some guidelines on how to tell the baby is getting enough milk.
What to expect the first few weeks after birth
It's interesting to watch a dog after it's given birth to puppies. It lies around for a few weeks and the puppies come to her to feed. This is how humans should treat themselves after giving birth. It doesn't matter how easy or difficult your labor and delivery was: It's a lot of work to birth a baby and it's essential that you take the time to recover and rest during this time. You need to eat well, drink well and rest.