Once the hormonal process is well underway, we must turn our attention to the act of breastfeeding. Milk transfer is necessary to feed the baby and to ensure mom continues to make milk. If baby is unable to empty the breast, mom should be encouraged to hand express to finish the process. If the breast is not emptied, it is in jeopardy of slowing production. A full breast not only will not make more milk, it can even inhibit milk production (this is a good time to refresh your memory on the FIL or feedback inhibitors of lactation).
Often babies will self-latch and feed within a few hours after delivery. Medications and interventions can alter the schedule, but ideally a mom and infant left together to bond will have a successful time breastfeeding (remember the laid-back technique for easy and biological breastfeeding).
Measuring milk transfer can be as easy as noting the babies behavior. Is baby having 1 wet diaper on day 1 (24-hour period), 2 on day 2, 3 on day 3...6-8 on day 6 and beyond? That is one indicator of milk transfer.
The scale is also a good tool to use (especially for the premature infant). Pre and post test weights can assure milk transfer has occurred.
The infant test-weighing procedure should be performed using an electronic digital infant scale with accuracy to at least 2 grams. The infant is weighed clothed pre- and postfeeding without changing the diaper between weight measurements. The prefeed weight is subtracted from the postfeed weight, and the difference represents the volume of milk consumed, where 1 gram of weight is equivalent to 1 mL of milk intake. Milk is slightly denser than water, so in theory this calculation overestimates the test weight results, which is countered by insensible water loss during feeding.Milk transfer is an area of concern and we must make sure early on that the infant is being fed. Know signs and symptoms of dehydration and make sure early follow-up appointments are kept. Unfortunately, I have to say, many lactation consultants, including myself, have witnessed mismanagement of feeding to a point of readmission to the hospital. Let's educate parents and keep our eyes open to possible warning signs.
For more detailed description of oxytocin and prolactin visit http://www.breastfeedingbasics.org/cgi-bin/deliver.cgi/content/Anatomy/physiology.html
For visible cues of milk transfer, visit http://www.letsbreastfeed.com/research/visible-cues-of-poor-milk-transfer/