I’m in the last month of my pregnancy and recently, I noticed that I’m leaking colostrum. That happened for about a week and stopped. Does this mean my milk flow will be better this time round? With my first child, I had very limited milk flow.
It is not unusual to start producing colostrum in the last trimester of pregnancy. Secretion of colostrum (Lactogenesis I) can start at around 16 weeks of pregnancy. This indicates that hormones in pregnancy (oestrogen and progesterone) have primed your breasts, making the ductal and glandular tissues grow in preparation to produce milk.
The next stage of milk production starts after your baby’s birth and delivery of the placenta. An interplay of hormonal changes and stimulation of the nipples results in Lactogenesis Stage II. This is when milk starts to “come in” and occurs at between 30 to 96 hours after delivery. This stage occurs earlier if a woman has breastfed before.
Regular baby’s suckling releases the hormone prolactin. The amount of mature milk, however, is not directly related to prolactin levels and is under local control. Generally, milk production increases when milk is removed from the breast more frequently and completely. This gives rise to the phrase “supply and demand”. This process works to fulfil a baby’s needs when baby feeds directly at the breasts, or when breast milk is regularly expressed.
However, there are other influences on milk production ranging from medical conditions such as breast hypoplasia, obesity, illness in the mother (diabetes mellitus, reduction mammoplasty, thyroid dysfunction) or interference with early milk removal, retained placenta, stress and pain.
As you have had a previous experience with insufficient milk, do inform your doctors and other health professionals familiar with breastfeeding and care of the newborn about it. Several factors that may reduce breast milk production can be overcome if anticipated and treated early. An example is to correctly manage initial third-day breast engorgement and to ensure proper latching at the breast in the first week of breastfeeding.
There is no need to worry if your colostrum has stopped leaking now. The appearance and subsequent “disappearance” of colostrum do not predict your eventual milk production. There is also no need for any special breast preparation now. Prepare yourself with the confidence that you will start breastfeeding your new baby and ask for help along the way if required.
Question answered by:
Dr Yvonne Ng Peng Mei
Senior Consultant and Lactation Consultant
Department of Neonatology
National University Hospital