The stimulus to produce milk already occurs during birth, immediately after the exit of the placenta, when the level of estrogens and progesterone, female hormones produced in large quantities during pregnancy, fall suddenly, while the secretion of prolactin, a hormone produced by the hypothesis (a gland situated at the base of the brain) increases suddenly. This stimulates the production of milk.
In the first days after birth, the breasts produce a dense yellowish liquid, called colostrum, which, apart from possessing a very high nutritional value, contains antibodies and other substances to defend the baby from infections for several months after birth. The sucking on the nipple stimulates the production of another hormone by the mother’s hypothesis, oxytocin, which helps the beginning of the milk volume increase. This is a very important phenomenon, which often creates discomfort. With it appears a pronounced swelling of the breast, together with congestion, a rise in the local temperature and a feeling of tension, which at times can be very intense. Once this phase has passed, in general it lasts 24-48 hours, if the newborn baby has started to suck milk regularly, the disturbing symptoms of the increase in milk volume disappear and the secretion of milk continues without any other particular unpleasant effects.
 To help the flow of milk, it can be useful to apply hot compresses or have a warm shower before breast-feeding. Cold compresses after the feeding can, on the other hand, reduce the tension and the swelling of the breast. A good nursing bra can also help to give support to the heavy breast and provide relief. A model without wire, with cups that can be opened completely and which does not constrict the breast is advisable. The shape and size of the breast do not influence the capacity to produce milk.
Once the increase in milk volume has occurred, lactation is then maintained thanks to the stimulation of the nipple by the baby and by the empting of the mammary glands during breast-feeding. The production of milk is regulated by the effective needs of the newborn child: the more the baby sucks, the greater the production of milk. It s very important, therefore, not to interfere from the beginning with the sucking rhythms of the newly born child. The mother and the baby must not be separated if at all possible (rooming-in). The newly born baby must be latched on to the breast as soon as it is born and, afterwards, whenever it wants, without restrictions in regards to the time or length of the feeding, both day and night.
Factors which Decrease the Production of Milk
- stress
- Worry
- Tiredness
- Pain
Factors which Increase the Production of Milk
- Rest
- Latching the baby to the breast
- Drinking
Most newly born babies that are breast-fed, initially require 8-12 feedings every 24 hours. The timing of the feedings during the course of the day varies from baby to baby and there are no fixed rules. It is better to feed the baby on request, every time that it shows signs of being hungry, for example, when it moves its head from side to side, when it sucks its fist or its hand, when it opens its mouth and sticks out its tongue. It is not true that every hungry baby cries, because crying is a late sign of hunger. Rather than the clock, the mother must let herself be guided by her own instinct and experience, which allow her to understand when the baby is hungry.
Later, when the production of milk has stabilised, even when maintaining breast-feeding as and when requested, it is better to keep intervals of at least two/three hours between one feeding and the next. This helps to avoid rhythms that may be too arduous for the mother and do not give her time to have the rest she needs or allows her to have a social life.
Breast-feeding at fixed times, which ensures the nourishment needs, is however advisable for “lazy” babies, who suck with little energy (for example, those with neonatal icterus). These babies should be woken up at regular intervals and given small and frequent feedings.
 Breast-feeding on request establishes a mother-baby relationship based on the trust of the newly born baby who knows that it can rely on its mother in order to satisfy its needs. In the first months of life, sucking does not only mean feeding, but also emotional growth. The baby’s sense of security of being loved, its peace of mind and balance, are certainly influenced by the way in which the baby is fed.
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