Lactation: What You Can Do Against The Pain

When you have your first child, you start worrying about whether breastfeeding will go well in the days before delivery at the latest. For the body, a big change begins after birth, because now the child no longer has to be nourished in the womb, but the child must be cared for at the mother’s breast.

Here you will find answers to your questions about the milk supply.

These Are The Signs That You Are About To Give Birth

Soon you will be able to breastfeed your baby for the first time. Pay attention to the changes in your body that could be signs of birth. Signs that birth is near are:

  • Your belly is lowering.
  • You have frequent bowel movements.
  • Your baby comes to rest.
  • Discharge of the mucus plug that closes the entrance to the uterus.
  • Contractions come at more regular intervals.
  • Back pain and muscle twitching.

If your belly has lowered, it means that your baby has already moved into the birthing position. So it can start soon! The lowering of the abdomen is an important sign of birth. Regular contractions are also clear signs of birth.

When Does The Milk Supply Come In?

Milk usually comes in between the 2nd and 4th day after delivery. Your baby is well nourished until the onset of milk because until then it feeds on the nutrient-rich colostrum, which is a real calorie bomb.

In no case will your child go hungry until the milk comes in. Pre-milk differs from mature breast milk in color and consistency. It is yellowish and has a creamy to a thick consistency.

Throughout pregnancy, the breast prepares itself for the subsequent formation of milk. In some women, the breast releases colostrum from time to time during pregnancy, often as early as the first or second trimester.

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At this early stage, the release of foremilk is not an indication of birth. However, if the foremilk is released more around the term, it can be seen as a sign of birth.

How Does The Breast Develop Until Milk Is Let In?

Numerous processes in the body develop and change during the many months of pregnancy until milk is let in. The sex hormones progesterone and estrogen are particularly involved in these processes, as well as several other hormones.

These ensure the growth of the breasts and their optimal preparation for milk production. This process is called galactogenesis in medical language. The nipples, mammary glands, milk ducts, and milk sacs are already sufficiently developed from the second half of pregnancy onwards to enable mothers to breastfeed their babies even in the event of premature birth.

The hormone prolactin is responsible for the production of milk. During pregnancy, prolactin formation is inhibited by relatively high progesterone and estrogen levels.

After birth, progesterone and estrogen levels drop significantly, allowing prolactin to exert its full effect. The additional rejection of oxytocin facilitates milk let-down.

Oxytocin transmits the baby’s sucking stimulus to the milk ducts and enables them to contract. In the mother, the regular sucking of the baby, as well as its sight and smell, triggers the so-called milk-giving reflex.

The First Breastfeeding Attempts

Immediately after birth, your baby will be put to the breast. The first milk that your child drinks during the first breastfeeding attempts is the pre-milk. Midwives often refer to this first milk as first milk.

Colostrum is very high in calories and contains many nutrients, antibodies, and proteins. It provides the baby with everything it needs for the first two days of life. The natural sucking reflex ensures that milk production gets off to a good start.

If the baby is put to the breast regularly and sucks vigorously, more milk will be produced about 2 to 3 days after birth. This milk let-down feels different for every woman.

What Exactly Happens During The Milk Let Down?

A few days after delivery, transitional milk takes the place of the colostrum. There is a noticeable swelling of the breasts and nipples. These can become tense and even painful. Occasionally, the skin is red and warm. The body temperature may be slightly elevated.

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The term milk let-down is misleading. Two-thirds of the milk stasis is caused by lymphatic congestion in the glandular tissue and only one-third by the inflowing milk itself. Milk let-down is therefore mainly a swelling of the mammary glands.

Lactation is triggered by a drop in estrogen and progesterone levels after birth when the placenta is shed. The sudden hormonal change usually also depresses the mother’s mood.

Other consequences of the hormonal change include swelling of the mammary glands and an increase in breast volume and blood flow. In addition, the level of the hormone prolactin, which is responsible for milk production, increases.

The baby is also involved in boosting prolactin. Sucking stimulates not only prolactin release but also that of the “cuddle hormone” oxytocin. Through gentle contractions in the breast tissue, oxytocin supports milk transport in the breast.

What Symptoms Indicate That Milk Is Coming In?

  • Your breasts noticeably increase in size.
  • Your breasts become heavier.
  • Breast milk drips out of the breast from time to time.

The uncontrolled dripping of breast milk is completely normal and need not worry you. Sometimes you will observe this phenomenon even if you and your baby are already on a well-established breastfeeding team. You can simply collect the milk that drips out with nursing pads.

Your baby should now be emptying both breasts regularly. After breastfeeding, many nursing mothers feel a significant relaxation. During the first days of breastfeeding, your midwife will be happy to help you if you have any questions or problems.

It can take 4 to 8 weeks for a relaxed relationship between you and your child to develop. How much milk is produced depends on the demand from your baby. Breast milk is mature about 10 days after birth.

It consists of about 12% solid components and 88% water. The composition of the milk is optimally suited to the needs of your child. The quantity of milk also adapts to demand.

Possible Problems With Breastfeeding

Sometimes it takes longer for the milk to come in, for example, if your baby is still very sleepy from the painkillers at birth and therefore sucks poorly or not at all. In this case, milk production is not stimulated effectively enough.

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A Delayed Milk Supply Can Also Have The Following Causes:

Mother and baby are separated immediately after birth, for example, when urgent medical examinations have to be performed. This situation should be avoided if possible because it delays the breastfeeding reflex, which results in a delayed milk let-down.

Cesarean Section

The natural birth process with its physical subsequent processes gets confused. For mother and child to establish a harmonious breastfeeding relationship, the help of an experienced midwife or lactation consultant is required. In most cases, it is possible to trigger the milk-giving reflex.

Incorrect Latching On

You should ask an experienced midwife to show you how to breastfeed correctly.


Babies are quickly confused if the milk does not come from the nipple but a foreign teat and bottle.

Breastfeeding According To The Clock

Nowadays, breastfeeding on demand is recommended.

Extremely Engorged Breast

If the milk comes in very strongly, the breast can be so full that your baby cannot grasp the nipple. You should therefore express some milk with your hand before breastfeeding.

Pain During Milk Let-Down – How Can You Relieve It?

You should feed your baby regularly during lactation to have less discomfort during breastfeeding. If you feed your baby infrequently, less milk will be produced and the discomfort could worsen. So you can and should gently wake your baby when you feel the milk coming in and want to breastfeed.

Make sure that your baby has a good grip on the nipple. This is often very difficult with a full breast. You can try to relieve pressure from the breasts before breastfeeding by stroking or massaging them. Or you can use the breast pump for a short time. This softens the breast, which reduces the problems and makes it easier to empty.

Moist heat is also beneficial for breastfeeding. The breast tissue is more likely to give way, which promotes the flow of milk. For pain relief, you can use cooling compresses after breastfeeding. Be careful not to put the skin and breast tissue under unnecessary stress.

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A warm shower or washing with a warm washcloth is sufficient for the breast. For cooling, you should not try shock cooling with ice! A well-tried home remedy here is breast pads with curd cheese. In addition, a tight bra will alleviate the pain of milk let-down.

How To Prevent The Onset Of Milk

In the case of a stillbirth or miscarriage after the 16th week of pregnancy, the milk let-down is blocked by medication. However, other reasons speak against breastfeeding after birth.

This is the case, for example, with certain diseases or with mothers who use drugs. In these cases, milk let-down can be prevented by special prolactin secretion inhibitors.

What Are The Symptoms Of Mastitis?

In mastitis (inflammation of the breast), the breast is usually swollen and shows hardening in the inflamed area. A clear reddening of the skin is also often visible in the inflamed regions. The breast affected by the inflammation feels warmer. Pain on palpation of the inflamed areas is characteristic.

About half of the affected women have swollen lymph nodes under the armpit. These are usually painful. When mastitis occurs in the postpartum period, affected women are tired, fatigued, and often have a fever above 38 degrees.

Chills are also among the possible symptoms. Many infants refuse to drink at the breast because the milk secreted tastes salty and altered.

Usually, the upper breast area is inflamed on the outside. If treated too late, the inflammation may spread to the entire breast. In some cases, encapsulation is also possible. In this case, pus is accumulated in large quantities (abscess). The affected person can feel the abscesses as lumps.

Lymph Nodes In The Breast

Those lymph nodes that belong to the breast cannot normally be palpated. They enlarge only when there are pathological changes. Sometimes they can be painful and can be palpated, for example, swollen lymph nodes in the armpit.


Two to four days after delivery, milk let-down occurs. Sometimes the onset of milk is delayed. Until then, the very nutrient-rich colostrum provides sufficient nutrition for your baby. Nature has made excellent provisions for this. To ensure sufficient milk production, you should feed your baby regularly.

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