Preparing for Breastfeeding

One of the most significant changes a breastfeeding mother experiences is when her milk "comes in." With the expulsion of the placenta after a baby's birth, a drop in the hormones that maintained the pregnancy soon occurs and allows the hormone prolactin to begin to work. Prolactin "tells" the breasts it is time to begin producing large amounts of milk. A mother feels the result of prolactin when her milk comes in at three to five days postpartum.

You may notice that your breasts feel fuller, heavier, or warmer when your milk comes in. Some mothers find their breasts become uncomfortably engorged due to increased milk volume and tissue swelling. Then the breasts feel hard and tight; the areola and nipple may seem stretched and flat, making it difficult for a baby to latch-on. The most important thing to do when your milk first comes in is to move the milk out of your breasts by feeding your baby frequently. If your baby has difficulty latching on because of severe engorgement, consider the following:

• Soften the nipple and areola by expressing some milk and then let baby latch on.
• Breastfeed or express milk by hand or breast pump frequently (every one to two hours); your breasts should feel noticeably softer after breastfeeding or pumping.
• Apply cold packs or sandwich bags filled with ice or frozen vegetables to the breasts for 20 to 30 minutes after a feeding or pumping session. The application of cold packs has been shown to relieve the swelling that may interfere with milk flow. Some women do report improved milk flow if they also apply warm compresses to the breasts for a few minutes immediately before breastfeeding or milk expression, but there are no studies that support this as effective. Using heat for more than a few minutes could increase the amount of swelling.