The milk coming in

For some women, the milk coming in was not a memorable event. They experienced a smooth transition from the colostrum of the first breastfeed to their full milk supply, with little or no discomfort. Several of these women spoke of a night where the baby just fed constantly and then the milk seemed to be there the next day.

On the third night in hospital she had a special night of skin-to-skin contact with her baby and constant feeding. Her milk came in the next day but she hardly noticed it.

She fed her son frequently after her caesarean section and does not remember her milk coming in. She kept a record of his feeding patterns but would not do that again.

On the other hand, many women spoke in dramatic terms of the changes to their body and the milk coming in. They talked about their breasts as a “different landscape”, baseballs, melons and balloons. Their breasts became larger, firmer, very warm and sore. One woman said,

“I can remember the feelings and … wondering what was happening and being very aware of my breasts at this time, and the fact that they seemed to have grown and they seemed to have taken on a life of their own and they were dictating what was happening rather than me … It took me a few days to learn that actually my daughter, was in control, not me or my breasts, it was my daughter who was sort of dictating what was happening there”.

A few women talked about having to learn to attach their baby all over again when their full milk came in.

She learned to attach her baby when she had colostrum but then they both had to learn again on their own at home when her full milk came in.

The women used a variety of methods to relieve the engorgement, including more frequent feeding, warm compresses, expressing, and chilled or frozen cabbage leaves*1 or gel pads (bought from the chemist and kept in the fridge) which they applied to their breast(s). They spoke of difficulty getting the baby attached to the breast and how they expressed some breastmilk to soften the breast so that the baby could attach. However, one woman spoke of establishing a “vicious cycle” between expressing and becoming more engorged. Several women mentioned the feeling of “relief” when their baby eventually attached, withdrew their milk and softened their breasts*2.

The first time she had engorgement she expressed and had an abundant milk supply, the second time she did not, her baby was not interested in feeding and she had a poor supply.

Her baby fed frequently one night and then the milk came in. She had to take extra care with attaching him and with her own position.

She describes the difference between the pain of engorgement and the pain of sore nipples. She used cabbage leaves to relieve the engorgement in her breasts.

She had several ways to relieve engorgement, including feeding the baby, having a hot shower, massaging her breasts and hand expressing some milk.

Several women talked about their milk leaking and even spurting from their breast(s) in the early days (see Interviews 49 and 39 above). Leaking was often triggered by the sight or sound of their baby or by overfull breasts. Some used breast pads to catch the excess milk while others collected and stored it for later use (see 'Emotional and psychological aspects of breastfeeding - Interview 37'). 

*Footnote 1: Cabbage leaves, kept cool and applied to the breast, are sometimes recommended as a home treatment for engorgement. Their effectiveness has not been scientifically proven.

Footnote 2: Women who are able to get their baby to attach well and breastfeed without restriction are less likely to have problems with engorgement. The importance of good attachment (skin contact) and effective milk removal (by any means if the breasts are over full) is the surest way to the establishment of satisfactory breastfeeding and an adequate milk supply.