Milk leakage
and Sabine Schrör, medical journalist Updated onNicole Wendler holds a PhD in biology in the field of oncology and immunology. As a medical editor, author and proofreader, she works for various publishers, for whom she presents complex and extensive medical issues in a simple, concise and logical manner.
More about the expertsSabine Schrör is a freelance writer for the medical team. She studied business administration and public relations in Cologne. As a freelance editor, she has been at home in a wide variety of industries for more than 15 years. Health is one of her favorite subjects.
More about the experts All content is checked by medical journalists.The milk entry starts a few days after the birth. The first milk is replaced by the mature breast milk. This can be uncomfortable and even painful for the mother: breasts and nipples swell significantly and there is a risk of inflammation. Read here what exactly happens when milk comes in, how you can get through this phase without major complications and whether you can encourage milk in.
What happens when milk comes in?
A few days after the birth, the colostrum is replaced by a transition milk. This point in time is noticeable when the milk comes in. Breasts and nipples swell significantly, can become tense or even cause pain. The skin is sometimes red and warm. Even a slightly elevated body temperature is not uncommon.
However, the word "milk" is a bit misleading. Contrary to what the name suggests, around two thirds of the increase in breast volume is due to lymphatic congestion in the glandular tissue - and only one third is due to the inflowing milk itself. Thus, the milk penetration is primarily a swelling of the mammary gland.
Milk injection is triggered when the hormone levels of estrogen and progesterone fall after the placenta has been rejected after birth. Therefore, the mother's mood is usually in the basement during this time. The mammary glands swell, breast volume and blood flow increase. The level of the hormone prolactin, which is responsible for milk production, also rises.
The baby also has a part in this: By suckling, it stimulates the release of prolactin, but also that of the "cuddle hormone" oxytocin. Oxytocin supports the transport of milk in the breast through gentle contractions in the breast tissue.
Milk injection: when does it start?
The milk entry begins about two to five days after the birth. During this phase, the composition of the milk changes: the first milk becomes a transition milk, which is then replaced by the mature breast milk. The milk entry after caesarean section starts around the third day after the birth.
However, milk can leak from the breast as early as the end of pregnancy. Women who are having a baby for the first time mistakenly believe that this is the milk leak. However, milk that escapes before birth is referred to as premilk. This has nothing to do with the actual milk penetration. The high estrogen level during pregnancy prevents milk from entering before birth.
Milk injection: how long does it last?
How long the milk comes in varies from woman to woman. However, the symptoms should subside after a few days. It takes about two weeks for the foremilk to become mature breast milk.
Injected milk: pain
The extent to which the milk penetration is noticeable varies. For some women, the swollen breasts are just uncomfortable, for others they are painful.
The milk leakage is a critical phase in which serious breastfeeding problems can arise. If the milk leakage is handled incorrectly, a swelling of the breast gland quickly turns into a breast inflammation (mastitis). If the pain becomes too severe and a high fever comes along, an inflammation is likely. You have to take these symptoms seriously - inform your midwife or your gynecologist "
Milk injection: relieve pain
It is important to lay the infant regularly during the milk entry. In this case, this does not increase milk production, but rather alleviates the symptoms. On the other hand, if you do not put on it infrequently, the amount of milk produced decreases and the symptoms worsen. If the milk comes in, you can therefore gently wake the child to breastfeed if necessary.
Make sure that the baby gets a good grip on the nipple when putting it on. This is not always easy, especially with full breasts. It is a good idea to take some pressure off your breast before breastfeeding, either by briefly applying the breast pump or by stroking or massaging the breast. The breast becomes soft, the symptoms subside and the breast empties more easily. You can read more about the subject of "stroking the breast" here.
Moist warmth before breastfeeding also makes the breast tissue pliable and allows the milk to flow more easily. A warm shower or a warm washcloth is sufficient.
Cooling pads after breastfeeding have a pain-relieving effect. However, you should proceed gently so as not to put additional stress on the skin and tissue. That means: no shock cooling with ice! Chest pads with quark or cabbage are a good home remedy for cooling.
In addition, a tight bra should relieve pain when milk comes in.
Promote milk penetration - is that possible?
The milk ingress is triggered by hormones. In addition, for smooth milk production, it is important to put on the baby for the first time in the first one to two hours after birth.
Over the next two to three days, you should empty the breast eight to twelve times in a 24-hour period, by laying the baby or by expressing or expressing milk. The evacuation acts on the pituitary gland in the brain and causes even more prolactin to be produced and milk production to be maintained (galactopoiesis).
A disease of the mother (e.g. diabetes mellitus, polycystic ovarian syndrome, hypothyroidism, also: breast surgery) can impair milk production. There are drugs that influence the prolactin level and thereby stimulate the production of milk and thus also the penetration of milk.
These include the prescription dopamine antagonists metoclopramide and domperidone. However, they are not approved for increasing the amount of milk, so they are used for this purpose in off-label use. Domperidone appears to get into breast milk more effectively and to a lesser extent, but it appears to be beneficial for heart problems. Careful clarification and control by the attending physician are therefore absolutely necessary!
Prevent milk from entering
In the case of stillbirth and miscarriage after the 16th week of pregnancy, doctors use drugs to block the milk entry. But women who should not breastfeed because of an illness or drug use, for example, can stop milk production after giving birth.
By taking so-called prolactin secretion inhibitors such as cabergoline (dopamine receptor agonist), milk can be prevented.
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