Breastmilk Production in the First 4 Weeks after Birth of Term Infants

Abstract

Breastmilk provides the ideal nutrition for the infant, and exclusive breastfeeding is recommended for the first 6 months. Adequate milk production by the mother is therefore critical, and early milk production has been shown to significantly affect milk production during established lactation. Previous studies indicate that milk production should reach the lower limit of normal for established lactation (440 mL per day) by day 11 after birth. We have used test-weighing of term infants before and after each breastfeed over 24 h to measure milk production in the first 4 weeks of lactation in mothers with and without perceived breastfeeding problems to provide information on how often milk production is inadequate. Between days 11 and 13, two-thirds of the mothers had a milk production of less than 440 mL per day, and between days 14 and 28, nearly one-third of the mothers had a milk production of less than 440 mL per day. The high frequency of inadequate milk production in early lactation and the consequence of suboptimal milk production in later lactation if left untreated suggest that objective measurement of milk production can identify mothers and infants at risk and support early intervention by a lactation specialist.

Keywords: breastfeeding; insufficient milk; milk production.

Figure 1

Total milk production of mothers with (circles) and without (crosses) perceived breastfeeding problems. The dotted lines indicate the mean ± SD of milk production derived from the literature [7,9,10,11,12,13,14,25]. The horizontal grey line indicates the lower limit of normal for established lactation [8].