Breastfeeding mothers may notice that their newborns can actually produce breast milk from their nipples after a few days or weeks of life. This may be seen spontaneously, or sometimes when the nipple is squeezed, either intentionally or when manipulating the baby. This has been noted for centuries, and is historically referred to as “witch’s milk,” as it was thought the milk was nourishment for witch’s spirits. Obviously, newborn milk production is not a supernatural occurrence, but a normal scientific phenomenon, and a very old one, too.
A Long History
The technical term for milk production in people besides breastfeeding moms is galactorrhea. Interestingly, there is a long history of recorded cases of galactorrhea, in both newborns and adults. There is a reference in the Book of Esther in the Bible in which Mordecai may have breast fed his niece Esther. The Talmud includes a case of a man who breastfed his infant after his wife died during childbirth. And Aristotle described men who lactated. The first recorded case of “witch’s milk” in an infant occurred in 1684.1
One study examined the levels of various hormones in newborn breastfed babies.2 The babies had elevated levels of prolactin, growth hormone, estradiol and progesterone at birth, but then demonstrated dramatic decreases in estradiol and progesterone within 72 hours after birth. Those two steroids inhibit breast milk production, so their fall allows the prolactin in the babies to stimulate milk production. These hormones are not being made by the baby, but are passed from the mother through the placenta into the fetus in the womb. Breastfed babies continue to get prolactin from their mothers’ milk, so this process continues for a while.
The frequency of this phenomenon has been quoted as low as 4.6% of newborns at 2 weeks old3 and as high as 100% of newborns less than 3 weeks old.4 In my personal experience, the incidence is closer to 100% of the breastfed babies, and is usually apparent by 5-7 days old. In fact, the lack of breast milk production in breast-fed babies is sometimes used as a marker that they are not getting enough breast milk, or at least not getting as much as the mother thinks.
Most babies will stop producing breast milk by 2 months of age, but investigators in one study were able to express milk at late as 19 weeks old.4
In addition, because of the milk production, the breast buds become engorged, which often worries parents that their newborns are undergoing pubertal changes. But this, too, is a normal phenomenon, and the buds will shrink when milk production stops.
Remember that milk production and breast bud engorgement occurs with equal frequency in both girls and boys. Both genders are born with some breast tissue. It’s only because of prolactin that adult women are able to produce breast milk and breastfeed their offspring, and it’s the prolactin that causes babies to produce breast milk, too. In fact, if we gave prolactin to dads, they’d be able to share in the breastfeeding duties. No doubt some woman will win a Nobel Prize for figuring out a safe and inexpensive way to do that.
When Should I Worry?
As you can see, breast milk from newborns is normal, in both boys and girls. But sometimes, babies have bloody discharge from one or both nipples. This is worrisome to parents, but can actually be normal, though it is uncommon. Parents are often concerned that this may be a sign of breast cancer, but that is an exceedingly rare occurrence in children, and not seen in children younger than 20 months old.5 Bloody discharge is usually caused by hormones from the mother, passed either through the placenta or in the breast milk.
Some bloody discharge is not a concern if it is coming from both nipples. However, bloody discharge coming from only one nipple is worrisome, and should be brought to the attention of your doctor. Other signs to watch for: bloody discharge that lasts for months, bloody discharge that is getting worse (the volume is increasing), a continually expanding breast bud, or a breast bud that shows signs of inflammation (red, warm, tender, swollen).5 If these appear, be sure to consult with your doctor.
- Rohn RD. Galactorrhea in the adolescent. J Adolesc Health Care. 1984 Jan;5 (1):37-49.
- Hiba J, Pozo ED, Genazzani A, et al. Hormonal mechanism of milk secretion in the newborn. J Clin Endocrinol Metab. 1977 May;44 (5):973-6.
- Madlon-Kay DJ. ‘Witch’s milk’. Galactorrhea in the newborn. Am J Dis Child. 1986 Mar;140 (3):252-3.
- Buehring GC. Short communication. Witch’s milk: potential for neonatal diagnosis. Pediatr Res. 1982 Jun;16 (6):460-2.
- Weimann E. Clinical management of nipple discharge in neonates and children. J Paediatr Child Health. 2003 Mar;39 (2):155-6.