From the Guidelines
It is completely normal for a first-time mother who is 3 days postpartum to be mainly producing drops of colostrum. According to the most recent study 1, colostrum is the first fluid produced by mammary glands immediately after birth, providing high concentrations of essential nutrients and immunologic factors. This production pattern is biologically appropriate and designed to match the newborn's tiny stomach capacity. Most mothers transition from colostrum to mature milk between days 2-5 postpartum, with some first-time mothers experiencing this transition closer to day 4 or 5, as supported by another study 1.
Key points to consider:
- Colostrum is extremely nutrient-dense and contains high levels of antibodies and immune factors that help protect the newborn 1.
- To support milk production, continue to breastfeed frequently (8-12 times per day), ensure proper latch, and maintain skin-to-skin contact with the baby.
- If concerned about the baby getting enough nutrition, monitor for adequate wet and dirty diapers and regular weight gain.
- The transition to mature milk, often called "milk coming in," is triggered by the drop in pregnancy hormones after delivery and usually involves noticeable breast fullness 1.
In terms of milk composition, human milk is most often differentiated into three categories: colostrum, transitional milk, and mature milk 1. As breastfeeding continues, the immunoglobulins and protein/nitrogen concentrations decrease, changing colostrum into transitional milk, present from day 7 to 14. At around 2 weeks postpartum, human milk changes from transitional to mature milk.
It's essential to note that maternal and child factors, as well as the interplay between both, play an important role in dictating the composition of milk 1. Variations over the course of lactation, the course of the day, and/or across feeds have not yet been studied for all milk components. However, the main source of energy in human milk is fat, and mature milk contains more energy than colostrum 1.
To ensure the best possible outcome for both the mother and the baby, it's crucial to prioritize breastfeeding support and education, as emphasized by the study 1. This includes implementing breastfeeding-supportive hospital practices, such as breastfeeding in the first hour after birth, exclusive breastfeeding, rooming-in, breastfeeding on demand, avoidance of pacifiers, and information on breastfeeding support after discharge.
From the Research
Normal Colostrum Production
- The production of drops of colostrum 3 days postpartum is a normal phenomenon, as colostrum is the first form of human milk and its volume can be minimal in the early postpartum period 2.
- Studies have shown that the volume of colostrum increases over time, with a significant increase in milk volume typically occurring around 30 hours postpartum, which is termed secretory activation 2.
Timing of Milk Coming In
- Secretory activation, or the onset of copious milk production, usually occurs between 30-40 hours postpartum, but can vary among women, with primiparous women (first-time mothers) tend to experience it later than multiparous women (women who have given birth before) 2.
- By day 3 postpartum, the composition of colostrum is changing, with decreases in some components and increases in others, such as insulin-like growth factors (IGF) II 3.
- The transition from colostrum to mature milk is associated with significant changes in the concentrations of various compounds, including sugars and polyols, which are completed by around the fourth postpartum day 4.
Factors Influencing Colostrum Production
- The yield and nutrient content of colostrum and milk can vary among women, with factors such as parity (number of times a woman has given birth) influencing the concentrations of some compounds in breast milk 4, 5.
- It's essential for mothers to be informed about the normal trajectory of human milk volume in the postpartum period to alleviate concerns about milk supply 2.