Lactation Support
Lactation is a dynamic process that begins during pregnancy and continues through the postpartum period, involving a complex cycle of hormonal regulation that stimulates milk production, milk flow, and feel-good hormones. Of course, it takes two to breastfeed — baby's successful latch and sucking not only promote milk production but also help maintain supply through frequent feedings. Along with the functional aspects of lactation, new mothers may experience a range of emotional and physical challenges, from soreness and milk leakage to potential feelings of isolation or dysphoria. To support successful feeding, understanding how lactation affects both body and mind is essential. Various strategies, including targeted nutrition, effective pumping, physical therapy — and seeking professional help to address any challenges — can make a real difference in the journey. By focusing on a balanced diet and staying hydrated, both mom and baby can get the nutrients they need during this crucial time.
While we at Chiyo are passionate about nutritional solutions, please note that this information is for educational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Lactation is more than just a way to feed your baby — it’s a meaningful part of the postpartum journey that offers benefits (and challenges!) for both you and your little one. As a new mother, you might find yourself navigating a whirlwind of changes. If breastfeeding is part of your plan, it can become a bonding experience that nourishes your baby and supports your own recovery. This is an intricate process that goes beyond providing essential nutrients; it’s about building a connection, boosting your baby's immune system, even impacting your own mental wellbeing. By understanding the underlying mechanisms, you can start to embrace this natural, empowering phase of motherhood and make the most of these formative days with your newborn.
Explore this guide to discover the science and strategies to enhance your lactation experience. From colostrum — to confidence.
Lactation 101
Lactation is a natural process that evolves as you and your baby undergo changes throughout postpartum and pregnancy.
It Starts with Pregnancy
During pregnancy, hormones released by the placenta (such as Lactogen and Progesterone) and the anterior pituitary gland (such as Prolactin) stimulate the growth of glandular tissue and prepare specialized cells within the breast for milk production. This is when you might notice your breasts becoming fuller and more sensitive as the tissue grows, and the breasts prepare for lactation. At this point, however, high levels of progesterone will be preventing milk release — although the breasts are technically capable of milk production by mid-pregnancy. [1,2]
Baby’s Here! Hello Colostrum
After the baby is born, placental progesterone leaves the body during birth, which lowers progesterone levels and allows milk to start flowing. [3] Initially, breasts make colostrum, a thicker liquid rich in immune cells and antibodies essential for your baby's first few days. Colostrum can be frozen and stored for later use during the baby’s first year, to help their immune system fight illness or infection. It is low in fat but helps coat your baby's gastrointestinal tract to stimulate their digestion and bowel movements. [4] Happy tummy, happy mom.
What’s in Breast Milk?
Within a few days postpartum, your breasts will start producing transitional milk that bridges the phases between colostrum and mature milk, which is a much higher-fat liquid. [2] Your body starts producing mature milk about 10-15 days after birth and will continue to do so until lactation ceases (this varies for every person with the capacity to lactate). [4] Mature milk is made of several essential nutrients such as fat, lactose, vitamins, micronutrients, and proteins. [5]
Fat
High-fat content for your baby is important to support their vitamin absorption and stimulate brain development — and it’s the primary source of caloric energy for the infant. During the course of a feeding, fat content changes. When milk is sitting in the breast, fat is highly concentrated in the glands where the milk is produced, instead of the lactation ducts. [3] As the baby begins to feed, the milk in the ducts will be lower in fat content, though as feeding goes on, this fat will move from the glands to the ducts for your baby to consume.
Vitamins
Vitamins are also important to baby development and are directly related to the mother’s vitamin intake. Vitamins A, D, E, and K are all vital to infant health and are fat-soluble, while water-soluble vitamins like Vitamin C, niacin, riboflavin, and pantothenic acid are also very important. Your doctor or lactation consultant may recommend prenatal vitamins to ensure that both you and baby are getting the nutrients you need. [4,5]
Lactose
Lactose is the primary carbohydrate in human milk and accounts for 40% of your baby's caloric intake through breast milk or formula. It supports the defense against unhealthy bacteria in your baby's gut and helps improve their absorption of calcium, magnesium, and phosphorus, all of which are essential micronutrients for development. [4] There is also a growing body of research about the human milk microbiome, an ecosystem of microorganisms that is rich in probiotics and antibodies which help promote infant gut health and make them more resilient to infections. [6]
Human Milk Oligosaccharides
Human Milk Oligosaccharides (HMOs) are the third most abundant component in breast milk and contribute to the development of baby’s microbiome. Unlike lactose, which is found in all dairy products, HMOs are not. Due to their benefits, HMOs have also been added to some probiotic powders for infants on formula. [25]
Protein
Proteins in breastmilk are divided into two types (whey and casein) which make up 60% and 40% of protein composition respectively. This balance eases digestion for the baby, because casein proteins are more difficult to break down. An important protein called Secretory IgA contributes to the baby's gastrointestinal immune system and helps protect the newborn from disease, infection, and possible allergies. [4,5]
The Lactation Process
From Latch to Letdown
The baby has a very important role in breastfeeding, and it all starts with latch. Receptors in the mother’s nipple sense the baby’s suckling and send signals up to the hypothalamus in the brain. [7] When this signal reaches the brain, the production of more prolactin and oxytocin is triggered. Prolactin stimulates specialized cells to produce milk, while oxytocin stimulates the cells that contract and push the milk into the lactation ducts for the baby's consumption. This process is called milk letdown — and it can even be triggered by the sounds of a baby crying! This auditory stimulus can reduce the hypothalamus to produce more prolactin and oxytocin, even without a baby causing physical stimulation of the breast. [3]
Lactation Timeline
- Soon after delivery: progesterone decreases, and more and more milk can be produced
- First week postpartum: baby’s stomach grows. Since the baby still has a small stomach and is only ingesting low-fat colostrum, it is typically to see a small decrease in the baby’s weight, but this is gained back within the second week as mature milk starts to be ingested.
- The first few weeks: Feedings in the early weeks are about every 1-2 hours, or about 8-12 times a day.
- The first few months: The early months of breastfeeding are driven by prolactin via the milk letdown process. After a few months, however, the process becomes more need-based, and milk is produced only to replace what is taken by the infant. [8]
Frequent Feeding
To establish a long-term supply of breastmilk, it is important to allow the baby to empty the breasts frequently. This creates a deficit that stimulates glandular tissue to make more milk, so that the breasts are always full — establishing a pattern where a sufficient amount of milk is produced after each feeding.
After a successful feeding, the breasts will feel soft and empty, and baby will be calm. [9]
How Lactation Impacts Your Body
Changes in Breast Tissue
When breastfeeding, you might experience some physical changes beyond expected breast growth and tenderness. Milk leakage is a common part of the milk letdown process, due to the release of oxytocin which can be tied to external factors like hearing baby cry.
First-time breastfeeders might experience some soreness during the first weeks — lactation is a totally new sensation and your body will need some time to adjust! [10]
Dry skin and cracked nipples are other potential challenges that can result from improper latch, frequent feedings, and exposure to harsh soaps or creams. Treatments may include using lanolin-based ointments, getting support from a professional to ensure a proper latch, and keeping the nipples clean and dry to promote healing and prevent further irritation. If these problem persist, it's important to reach out to your provider or lactation consultant. [11]
Mental Health Effects
Benefits
The release of oxytocin during breastfeeding can help mothers feel less stressed and heighten your focus on your new baby. It also supports a feeling of attachment with your newborn.
Some studies even suggest that oxytocin levels at this time can help fight symptoms of postpartum depression.
Challenges
On the other hand, breastfeeding can feel very isolating for some, and related challenges can create anxiety and stress for new moms.
Influxes of hormones can lead some women to feel intense dysphoria immediately after breastfeeding, a phenomenon called dysphoric milk ejection reflex (D-MER). This is characterized by feelings of intense uneasiness, frustration, and unhappiness. Some might dread these feelings, causing further anxiety and stress around feedings. [11,12]
Stress around breastfeeding, producing enough milk, and sleep deprivation can all impact milk supply and overall wellbeing.
Mental Health Support
If you are experiencing anxiety around breastfeeding, try adopting lifestyle changes like deep-breathing exercises, taking walks outside, and leaning on your support system. It’s essential to take breaks for yourself — and don’t feel guilty if breastfeeding is not going the way you expected. If mental health changes worsen, seek out professional care. [13]
Social and Workplace Challenges
Breastfeeding can be difficult physically, mentally, and socially. Unsupportive work policies and a lack of parental leave have been cited as issues by new parents across the country.
Cultural norms around breastfeeding might make women less inclined to breastfeed in public — which could lead to breast pain when holding off feeding or pumping. [14]
It is essential for everyone, not just new parents, to create environments that support and protect breastfeeding. This can be done through breastfeeding-friendly work practices as well as educating yourself on the rights you have around breastfeeding in the workplace. Every state is different, so it is important to educate yourself and communicate with your employer if you feel that workplace policies are in violation of your rights.
In public, there are no laws outlawing breastfeeding, but some women may feel uncomfortable doing so. It might make you more comfortable to wear shirts that allow for easier access to your breasts, or to have a blanket on hand to give you some more privacy. Some new breastfeeders recommend practicing breastfeeding in front of a mirror or in front of close family to build confidence in doing it in more public settings [15].
Weaning
Weaning is a general term for your baby transitioning from being fully breast-fed to stopping nursing altogether. Weaning timelines can depend on several physical and cultural factors, and it happens naturally for many babies. The Academy of Pediatrics recommends this timeline as a guide:
- Exclusively breastfeed for the first 6 months
- After 6 months, continue to breastfeed, but slowly introduce solid foods (to start the weaning process)
- After 1 year, continue to breastfeed as long as you and your baby are comfortable. There is no scientific evidence suggesting that it is harmful to breastfeed an older child.
A baby's readiness to wean might be shown in subtle changes — like less frequent nursing sessions or losing interest in nursing — although the signals differ for every baby. If your baby starts to wean before the 1-year mark, you should consult your care provider because formula may be needed to supplement their nutritional needs.
For your physical health, it is important to wean slowly and gradually, because weaning suddenly can cause your breasts to become sore and engorged. [16]
Holistic Strategies
Tips on Pumping
Pumping is a common practice and can help start your baby on bottle feedings. When away from your baby, pump as often as you would feed in order to empty your breasts and allow them to fill back up. Hand expression can be a good option to relieve some of the pressure in your breasts if no pump is available. [17] There are many different pumps available, so talk to a lactation consultant about what will work best for you.
The main types of pumps are manual and electric. Electric pumps are motorized and noisier, whereas manual pumps use a handheld pump that relies on suction. There are also several other factors to consider including suction strength, ease of cleaning, and portability, which will take some trial and error to learn which pumps work best for you [18]. Here is a list of some top pumps on the market and their key features.
Physical Therapy
Physical therapy can also be an important part of pregnancy and postpartum for many. After childbirth, some of the muscles in your body will need to be retrained. Physical therapy can help support this process as well as improve posture and reduce joint pain.
For C-section recovery, physical therapy can help to teach scar management techniques and improve abdominal tissue strength and flexibility.
For lactation-related pain, lymphatic massages can be helpful to relieve some soreness. However, it’s important to be delicate with this sensitive area.
Talk to your primary care provider about pelvic, breast, and/or abdominal pain to see what might be suitable for you. [3, 19]
Lactation Consultants
Lactation consultants can be an important part of the motherhood journey, and you can start working with them at any stage of pregnancy or postpartum. These professionals can offer general education and support, like proper positioning for you and your baby, and they can help address common issues like clogged ducts, low supply, and dry nipples — as well as infant lip/tongue-tie, which plays a role in feeding and latching and can slow the baby’s weight gain. A lactation consultant can help make breastfeeding the best experience possible for you and baby, creating a feeding schedule that works for you both.
Many hospitals have lactation consultants who will visit you after labor, but it is important to confirm this beforehand as well as check with your insurance on what is covered [20].
Lactation is a learning curve and everyone has a different experience. Consulting a professional can answer your lactation questions and help you feel more confident in your breastfeeding experience.
Essential Nutrition
Eating for two doesn’t end once baby is born! Maintaining a balanced diet is essential to produce nutritious breastmilk.
Omega-3 fatty acids are crucial for breastfeeding — specifically DHA, which can only be obtained through diet or supplementation. Increasing consumption of foods rich in omega-3s, or continuing prenatal DHA supplementation, can support this process. [26]
Protein-rich meals are crucial to support overall postpartum wellbeing, and lactation in particular. Opt for lean meats, eggs, beans, lentils, and low-mercury seafood like salmon, trout, tilapia, and shrimp.
Eating a diverse assortment of nutrient-dense foods will impact the taste of your breast milk, expanding your baby’s palette which may help with the transition to solid foods down the road. [21, 22]
Snacks!
It is important to eat enough food to fuel both your body AND your baby’s, which means eating an extra 330-400 calories a day. Frequent snacks can help women to meet this increased calorie demand, replenishing energy levels with nutrient-rich bites throughout the day.
Low-sugar snacks like nuts, yogurt, and whole-grain crackers can provide the necessary calories and offer important vitamins and minerals that support both milk production and overall health. These snacks help maintain steady energy levels and prevent fatigue, without the sugar crash.
Pro-tip: focus on snacks that you can eat with one hand, so you can refuel while breastfeeding!
Galactagogues For Milk Production
Galactagogues are foods that can support milk production. Some common galactagogues include:
- Oats: High in fiber and known to have lactogenic properties.
- Garlic: Small amounts can potentially increase milk production.
- Carrots: Rich in beta-carotene, which is beneficial during lactation.
- Fennel and Fenugreek seeds: Often used as herbal supplements to boost milk supply.
- Leafy greens: Such as spinach and kale, high in calcium, iron, and folate.
- Nuts and Seeds: Especially almonds and sesame seeds, which are high in calcium.
- Legumes: Beans and lentils are rich in protein and fiber.
- Papaya: Unripe papaya is considered beneficial in some cultures.
- Whole grains: Besides oats, other whole grains like brown rice and quinoa can be beneficial.
- Dates: High in calcium and fiber, and have certain phytochemicals that may support lactation. [23, 24]
Adjusting to Your Dietary Needs
If you are on a vegetarian or vegan diet, it is especially important to choose foods rich in iron, protein, and calcium. Lentils, leafy vegetables, peas, and dried fruits are great sources of iron, and supplementing this with citrus fruits can help your body absorb the iron. For protein, eat lots of lentils, seeds, nuts, and grains if you are not able to eat eggs or dairy products. Calcium can also be found in soy products as well as dark green vegetables, juices, and cereals. Diet restrictions can be supplemented with vitamins such as B-12, which is found only in animal products, as well as omega-3 and vitamin D. These are important for both your wellbeing and your baby's health. [21, 22]
Water, Water, Water!
It is also important to remain hydrated when breastfeeding — drink when you are thirsty and if your urine appears dark. Drink a large glass of water each time you breastfeed to replenish what is lost through breast milk. And remember, electrolytes like sodium, potassium, chloride, calcium, phosphate, and magnesium are essential to aid hydration and absorption of minerals and water into our cells, and a balanced diet should provide these needed electrolytes. Be careful with too many sugary drinks and caffeine as they can dehydrate your body. [22]
Conclusion
For women who choose to breastfeed, understanding and supporting lactation is crucial for the wellbeing of both mother and baby. By addressing issues early, seeking expert advice, and adopting practical strategies, mothers can navigate this vital phase with confidence.
Prioritizing your nutrition during this phase is about being empowered to make the choices that are right for you and your baby. Anyone hungry?
FAQs
How soon after birth should I start breastfeeding?
Ideally, breastfeeding should begin within the first hour after birth. Starting early helps to stimulate milk production and establishes a strong breastfeeding routine. [8]
How often should I breastfeed my baby?
Newborns typically need to breastfeed 8-12 times a day, roughly every 1-3 hours. Frequent feedings help ensure that baby gets enough milk, and also supports your milk supply. [8]
How can I manage nipple soreness while breastfeeding?
Nipple soreness is common in the early weeks for women who are breastfeeding, and this can be managed by ensuring a correct latch, using lanolin cream or nipple shields to soothe discomfort, and allowing nipples to air-dry between feedings. For nipple pain, breast seashells are a natural option (they're literally seashells) — just wear them in your nursing bra, and wash them in the sink once a day with gentle soap. Seeking guidance from a lactation consultant can help you learn personalized strategies to improve latch and alleviate soreness. [11]
How can I tell if my baby is getting enough milk?
Signs your baby is getting enough milk include regular wet and dirty diapers, steady weight gain, and visible contentment after feedings. Your baby’s growth and developmental milestones are also good indicators.
What are galactagogues?
Galactagogues are foods believed to increase milk production. Maintaining frequent breastfeeding or pumping routines are other ways to boost milk supply. [23, 24]
How can I ensure I’m eating the right foods while breastfeeding?
Focus on a balanced diet rich in protein, whole grains, fruits, and vegetables. Foods like lean meats, dairy, legumes, and nuts provide essential nutrients. Staying hydrated is also crucial.
Do I need extra calories while breastfeeding?
Yes, breastfeeding requires additional calories. Aim for an extra 330-400 calories per day to support milk production and meet your energy needs. [22]
Can I eat spicy foods while breastfeeding?
Most mothers can eat a wide variety of foods without affecting their milk. However, if you notice any adverse reactions in your baby after you’ve eaten certain foods, it may be helpful to consult a healthcare professional.
How can I manage breastfeeding if I need to return to work?
Consider pumping and storing breast milk to ensure your baby continues to receive breast milk while you’re away. Communicate with your employer about creating a breastfeeding-friendly environment and schedule.
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- Effects of Human Milk Oligosaccharides in Infant Health Based on Gut Microbiota Alteration. Hu M, Li M, Li C, Miao M, Zhang T. Journal of Agricultural and Food Chemistry. 2023;71(2):994-1001. doi:10.1021/acs.jafc.2c05734.
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