A baby smiles big and appears happy. The baby lies on a green blanket.
Your baby will appreciate all the steps you take to ensure a healthy, bountiful milk supply. (For Spectrum Health Beat)

There’s much to be aware of in the month of August. It’s national immunization month, national crayon collection month and national eye exam month.

Notice a pattern? It’s all about the kids gearing up for a return to school.

But there’s one another campaign worth mentioning. It has the littlest kids in mind.

August is breastfeeding awareness month, which gives us a great opportunity to look at the some of the particulars on breastfeeding.

Colostrum and milk

Some women may notice colostrum leaking at the end of their third trimester.

Colostrum is the first food that baby gets. It’s a wonderful food for your baby.

La Leche League, a great resource for breastfeeding information, identifies the beneficial properties of this special milk, which is thick and sticky and usually yellow to orange in color.

According to the organization’s website: “It is low in fat and high in carbohydrates, protein and antibodies to help keep your baby healthy. Colostrum is extremely easy to digest and is therefore the perfect first food for your baby.

It’s also low-volume but high in nutrition and it has a laxative effect that can help the baby pass early stools. This “aids in the excretion of excess bilirubin and helps prevent jaundice,” according to La Leche League’s website.

Bottom line: Colostrum is all your baby needs for the first several days.

When does your full-fledged milk come in? It typically takes three to four days.

When this happens, you’ll notice an engorgement of your breasts. You’ll feel your breasts getting heavier and fuller.

Your baby will also nurse a bit differently. You may hear your baby swallowing when breastfeeding. Sometimes you’ll leak milk. The milk also changes to a whiter color and it’s thicker than colostrum.

What can affect the timing of your milk coming in?

Medications and hormones are two big factors.


In the past, we’ve looked at medication options in labor.

A 2014 study in the Journal of Human Lactation looked at medications administered in labor and the delayed arrival of milk. (In this case, a delay is anything beyond 72 hours after delivery.)

The finding: About 1 in 4 women will experience delayed onset of breastmilk, but this ratio increases when medication is used in labor. It doesn’t matter if the delivery is vaginal or C-section—the use of pain medication is likely to delay the onset of breast milk.

It’s an interesting study. As a former labor and delivery nurse, and in talking to other nurses, I’ve noticed that sometimes a baby can struggle with breastfeeding if the mom had an epidural in delivery.

Now, this does not mean that the baby can’t breastfeed. It just means it may take a bit more time for the baby to learn to latch well and for the milk to come in.

There’s no question you can still breastfeed even if you’ve had medication. You simply need to know that the medication might possibly delay the arrival of milk.

Hormones and milk production

Research has shown that mothers produce milk between feedings because of elevated levels of prolactin. This hormone also surges during the actual breastfeeding, which produces even more milk.

But what affects the prolactin levels? Again, according to The Journal of Human Lactation, medication can potentially lower prolactin levels.

A few other things that can delay the onset of milk:

  • Traumatic or stressful birth (including C-section after long labor)
  • Abnormally high blood loss at delivery
  • Receiving large amounts of IV fluids during labor
  • A heavy baby born to a first-time mom
  • Diabetes or gestational diabetes
  • Mom with higher BMI
  • Formula given to baby after delivery

What can you do to help your milk come in more quickly?

One of the most important things you can do is remember that the medications you choose to receive in labor may affect breastfeeding.

You should also breastfeed often. Moms who feed their baby frequently in the first 48 to 72 hours can see a difference in milk production later. If your baby isn’t nursing often in the beginning, you can use a pump to stimulate milk production.

Some other tips that may help with milk production:

  • Start skin-to-skin contact after delivery and continue at home.
  • Consult a lactation consultant for assistance.
  • Take your baby to scheduled doctor appointments.