How to encourage or stop milk coming in?

In a previous article, we talked to you about lactation. Today, we are going to give you some advice on how to help or stop your milk coming in.

How can I help my milk come in?

The first milk secreted by the breasts is called colostrum. It is produced in the middle of pregnancy (around 12-18 weeks) and in the first few days after birth. Even if your baby only feeds on this first milk - that is, when you decide to exclusively offer the "welcome feed" - the value of this precious liquid is undeniable. This thick, yellowish substance has many benefits, including nutrients that boost your baby's immune system and help fight infection. About 2 to 4 days after birth, you will notice that your breasts are larger. This secretory activation is often referred to as a "milk rush. Your milk adapts to your baby's needs. The composition of your milk changes and colostrum becomes transitional milk before mature milk. Each time your baby feeds, your body knows to produce more milk for the next feeding. A host of studies have shown that the earlier the feeding is offered at birth, the more milk will be produced. This factor - if combined with skin-to-skin contact from the delivery room onwards - is considered one of the best ways to allow lactation to take hold. If for some reason your baby doesn't latch on to the breast, it's fine to collect your colostrum in a teaspoon and give it to her. It is also known that the more the baby sucks during the first days, the more milk secretion is stimulated, which helps to avoid severe engorgement because the blood flow combined with interstitial edema at the time when the milk is produced in greater quantity can result in pain and a particularly unpleasant sensation of breast tension. As you can see, this complication can be prevented by feeding as often as possible or, failing that, by expressing the colostrum manually. Ask the maternity ward staff to make sure you are comfortable. A comfortable position will allow you to place your newborn at the breast yourself and be able to see him or her without making any effort. This will release precious oxytocin, which will help your milk flow more easily. If you have any doubts about your baby's ability to suckle properly, or if you are having difficulties, don't hesitate to talk to your midwife or a lactation consultant if there is one at the maternity hospital. Some people around you may ask you how often your baby feeds, how long the feeds last. Keep in mind that one of the most pragmatic ways to identify if your baby is getting enough milk is to pay attention to his diapers. Babies should have their first meconium bowel movement within the first 24 hours of life. Some babies pass meconium in the delivery room. You can expect your baby to have passed meconium by D3. Finally, it is a good idea to stay well hydrated with water throughout the day, drinking as much as you feel like drinking, especially after giving birth and before your milk comes in, but also throughout breastfeeding because milk is mainly made up of water.

How can I stop my milk coming in?

If you don't want to breastfeed or no longer want to breastfeed your baby, we will take care to bring your lactation to dry up gradually by avoiding engorgement. You may need to pass warm water over your breasts during a shower to encourage the flow of milk that is produced despite everything. Some mothers massage their breasts or pump just enough milk to keep their breasts supple in the days after birth. Some mothers will need to take an analgesic or even an anti-inflammatory medication to relieve discomfort and pain. There is weak evidence that some pharmacological treatments are superior to no treatment in stopping lactation symptoms in the first week after delivery. It is also worth noting that the side effects of these types of medications call for caution. If the situation requires it, a drug treatment, a lactation inhibitor with the best benefit-risk ratio will be prescribed. Finally, we would like to remind you that this article was written to give you some advice on how to encourage or stop your milk coming in, but nothing can replace the advice of a health specialist. However, nothing can replace the advice of a health specialist. We therefore advise you to discuss your situation with your lactation consultant or midwife first.

- Article reviewed by our IBCLC lactation consultant, Carole Hervé

What is lactation surge? Read our article here