Your breasts during nursing

Breast and nipple shape

Breast and nipple shape, size and colour vary from one woman to another, and sometimes even from one breast to the other. Most newborns adapt easily to their mothers’ breasts. For unknown reasons, however, there are some babies who have more difficulty latching onto flat or inverted nipples.

Breast care

The breasts are often bigger and heavier during the first six weeks of breastfeeding. Whether or not you choose to wear a bra depends on your comfort. Nursing bras are usually more practical than regular bras, but you don’t have to wear one. Regardless of what you choose, your bra should be comfortable and large enough to avoid squeezing your breasts. Don’t hesitate to sleep barebreasted if you feel comfortable doing so.

If you use nursing pads, choose cotton or disposable ones without a plastic lining and be sure to change them often.

A daily shower or bath is all you need to keep your breasts clean. Creams, ointments and other products are not necessary. Washing your hands with soap and water before nursing is the best way to prevent infections.

When your milk comes in

Having your milk “come in” is a normal phase of milk production. Between the second and the fifth day after delivery, your breasts become warmer, the appearance of the milk changes and production increases rapidly. Most women also find that their breasts become larger.

Some women experience no discomfort when their milk comes in. But for most women it can be uncomfortable, especially if their breasts become engorged and firm to the touch. To ease the discomfort, which generally lasts from 24 to 48 hours, thorough and frequent feedings (8 times or more during a 24-hour period) are recommended at regular intervals, both day and night.

Your baby will generally want to nurse more often during this phase, which will ease the discomfort in your breasts and help him gain weight.

What if he has difficulty latching on because the breast is too firm, or your breasts become painful? You’ll find advice in the table entitled Painful breast.

Milk leakage

Milk may leak from your breasts between feedings or during the night. This is normal. It’s a natural mechanism that helps relieve pressure in your breasts.

If it bothers you, you can protect your bed with a towel at night. During your daily activities, you can wear absorbent cotton pads in your bra or a camisole with a built-in bra.

Producing a good supply of milk

Milk production is a matter of supply and demand: the more milk is removed from your breasts, the more milk they will produce.

To get milk production off to a good start during the first few days

  • Encourage skin-to-skin contact at birth when possible by offering your baby the breast. Continue skin-to-skin contact regularly afterwards.
  • Within an hour of your baby’s birth, stimulate your breasts by nursing your baby or expressing milk if your condition allows. Breastfeeding or expressing milk within three hours of birth helps initiate breastfeeding. Afterwards, stimulate your breasts at least 8 times every 24 hours, day and night.
  • Express your milk if your baby isn’t sucking effectively or latching on properly. During the first few days, expressing manually is often more effective than using a breast pump

Milk production fluctuates during the first 4 to 6 weeks, depending on demand. That’s why it’s important to stimulate the breasts during the day and at night during this phase.

Some women produce substantial milk. For others, however, milk production can be less reliable, decreasing as soon as stimulation lets up or becomes more infrequent. A person trained in breastfeeding can often help new mothers increase milk production, especially during the first weeks (see Insufficient milk production).

Let-down reflex

Stimulating the breasts also results in the release of oxytocin into the bloodstream. Oxytocin is a hormone that causes the breasts to contract and expel milk. This is known as the “let-down reflex.”

This reflex might be triggered when you put your baby to your breast, or if you stimulate the nipple and areola when expressing milk. Just hearing your baby cry or thinking about him can trigger the let-down reflex, too. It ensures that milk will be available when your baby begins nursing.

It’s not unusual to experience the let-down reflex several times while nursing. The results typically last from 30 seconds to 2 minutes. Some women feel a tightening or tingling in the breast; others feel no sensation. During the first few days after delivery, you may experience intense thirst and uterine contractions in conjunction with the let-down reflex.

During the let-down reflex, milk flows more rapidly and babies will swallow more quickly for several minutes. Sometimes the let-down reflex is so strong that your baby will need to let go of the breast to take a breath of air. Women expressing milk can see the pace quicken and even notice spurts during the let-down reflex.

Areola: Darker area of the breast around the nipple.

Express: Pump or squeeze milk from the mother’s breast.

Oxytocin: A hormone produced by a gland within the brain. Oxytocin circulates in our blood, causing uterine contractions during childbirth and the expulsion of breast milk.