Not enough milk for the first few days?

That's what people often think, not only here in Europe, but also in many other countries and cultures around the world.

Sometimes this belief goes so far that the first milk is considered impure or disease-causing. In a surprising number of countries all over the world, people are very critical of this first milk and as a consequence, some babies do not get it at all. It is usually replaced by very unsuitable food, with corresponding negative consequences. But that would be worth a separate article.

Back to the topic at hand. The medical term for this early milk in the first three to five days is colostrum. From a scientific basis, we can state at the outset that colostrum is not only very valuable, but also available in sufficient quantities.

Even the term "colostrum", which is used much more frequently than "first milk", implies that the milk is incomplete. As late as 1939, the well-known paediatrician Czerny (Charité Berlin, one of the co-founders of modern paediatrics) was of the opinion that colostrum offered no advantages to the infant.

What do we know as facts now?

In the first trimester of pregnancy, a watery fluid is formed by the breasts. It thickens in the second and third trimesters. In the last weeks of pregnancy, it can usually be collected without any problems or even flows on its own, for example when showering.

That is why there is enough colostrum even for premature babies. It is even designed to meet the special nutritional needs of these small children.

So is the milk at the birth of a mature child. It contains less fat than mature milk, because fat cannot be digested well in the first few days. Instead, it contains much more protein, as it provides the child with important antibodies. A booster against infections, so to speak. Also, the yellowing beta-carotene, a radical scavenger. Lactose, vitamins and minerals are present in adjusted doses. So, everything is nicely suited to the limited digestive skills of the newborn.

The child's stomach and the amounts of milk available are also matched to each other. On days 1-3, the stomach is about the size of a cherry, days 3-4 the size of a walnut, and from day 5, when milk production starts to be abundant, about the size of an apricot. The quantities of milk that fill it are correspondingly small.

It is important that the small stomach is filled frequently enough!

Usually, the baby comes into skin-to-skin contact with the mother after birth and remains there until the first active breastfeeding attempt. When the baby has recovered from the exertion, she will open her eyes and look for the breast. She will try to crawl to the nipple, latch on and drink.
Afterwards, breastfeeds should be given every 2-3 hours, and there should be no breastfeeding breaks longer than 4 hours, even at night. A special feature of the first 1-2 days is that the baby is tired and often doesn't always rouse herself. Wake up your baby, actively latch her on. Give her the small amounts she needs regularly. Then she will recover quickly, become more alert, and drink well.
Early and frequent breastfeeding in the first days after birth is the best insurance that milk production will get off to a good start. And this is not only true for the first few days, but it ensures that there is enough milk throughout the entire breastfeeding period.

You can find a film that shows a good start to breastfeeding in the first few days in a correct and easy-to-understand way here:
https://globalhealthmedia.org/videos/breastfeeding-in-the-first-hours-after-birth/

If you have any questions or problems, please consult an IBCLC lactation consultant.

Here you can find more parts of our series “Old wives' tales about breastfeeding”:
Part 1 - We dispel old wives' tales
Part 2 – Small breast, no milk?

Coming soon
Part 4 – Formula is just as good as breast milk these days, isn't it?

This text was written by Eva Vogelgesang

DIDYMOS babywearing instructor trainer and IBCLC and EFNB-certified paediatric nurse