Breastmilk not coming in Day 5 :(

[JenChem]

So I'm fairly new to the boards and mostly lurked during my pregnancy. Unfortunately I just feel like everything has gone wrong since labor and now my milk hasn't come in on Day 5 and I'm really down.

The labor: I went in on Tues May 12 with ridiculously high blood pressure (something like 190 over 120). My doc put me on bp and fetal monitoring and told me he'd like to induce. We held off until Wed evening and when it wouldn't drop we induced with cervadil at 8pm. My water broke at 4am. Around noon the next day we started pitocin but my cervix wouldn't dilate. I labored until 7pm when I asked for an epidural. The epidural took my bp down to normal and put the baby into distress. We got the baby back out of distress but after an hour of waiting and no further dilation they took me in for a CS.

The good news: DS is perfect and healthy. He has a strong latch. We had a great in hospital experience with nurses who had just come back from a conference on nursing and skin to skin experiences and I was finally feeling good about pregnancy tho still disappointed about the CS.

Now it's Day 5 and my milk hasn't come in and DS has dropped from 6lb 8oz to 5lb 12oz. My ped wants me to supplement and pump every other BF session. I tried the pump and only got half an ounce of breastmilk out of one breast and no milk out of the breast I gave DS that session. I'm just really down and wonder if anyone has any BTDT and BF went on to be successful?

[jgenie]

:hug5: I haven't had the same experience, but wanted to offer hugs. If you try posting at LLL (http://www.llli.org/resources.html?m=0), I'm sure someone has BTDT and will offer advice. Hang in there. :hug5:

[ahrimie]

YES! I was totally there a year ago. I had really high blood pressure going into labor/delivery too (and I've never had high bp). Though my DD came out nice and easy, my bp remained really high so I was put on meds. They told me that it may affect my milk supply (after they had given it to me and I was wondering why my milk wasn't in!) but it was necessary for me to take it for obvious reasons. My DD's weight dropped too so I did supplement (well mostly just formula because I would pump so little. I would get 1-2 cc's at first.) I was in the hospital for 6 days to monitor my bp and even as I went home, I had very very little milk. I met with 2 LC's at the hospital and one told me that I had to work on my supply and to just give formula and bottles for the time being. I pumped religiously for 2 weeks and my supply started to finally come in but then I had nipple confusion issues to deal with.... ugh.

But, you CAN make breastfeeding work!! I did it for nearly 8 months. The first 2 months were sooo hard and god awful (to be honest) but I kept trying, looked online at kellymom.com, read "the nursing companion", and came here for advice. If you really want it to work, you totally can do it. I think it's just harder for some women than others and if you can't/don't end up doing it, it's okay too. I beat myself up a lot in the beginning because I couldn't "feed" my baby but that kind of guilt doesn't help your milk come in either, so I hope you're not feeling the same thing I did.

Hang in there!!

[LMPC]

Sending hugs definitely and encouragement to keep putting that baby to the breast! Have you met with a LC? I saw one at about day 3 and she weighed DD, then had me nurse, and then weighed her again. That way we could see what she was taking in. It turns out what I was able to pump was less than what DD was really getting. We supplemented too until she was up to a constant weight. And for the first month or so I was pumping every 3 hours. Now she's 7.5 mo and almost EBF (except for a little solids here and there). Don't give up!

[egoldber]

I would see an LC again. But honestly it does not sound like things are going badly. :) If you are getting half an ounce at a pumping session on day 5, your milk is in. Really. That is a normal amount to pump. How about diapers? Is he having wet and dirty diapers? You want to see at least 5-6 wet and 2-3 bowel movements a day.

I want to second kellymom.com and if nothing else read this:

http://www.kellymom.com/bf/normal/newborn-nursing.html

I did not realize with my older DD (failed induction, followed by a c-section) that the fluids they pump you with during the induction and for the c-section can artificially inflate the baby's birth weight. Also, it is NORMAL to take until 2 weeks post birth for the baby to re-gain birth weight.

So what I am trying to say is that it actually sounds like things are going OK if you able to pump any quantity of milk at this point. I would see an LC to check baby's latch and do a before and after weighing.

But at first blush, I think that your ped is being overly cautious and is perhaps not very knowledgeable about the normal course of breastfeeding. A shocking number of peds are not. For example, with my older DD, it took FOUR WEEKS for her to regain her birth weight, and my peds did not suggest supplementing to me. They suggested seeing an LC, watching to make sure she started to gain, and keeping an eye on things.

So personally, I would not start supplementing yet. I would give it at least another week or two, and check in with an LC to make sure nothing else obvious is going on.

I know that in those first postpartum days you are overwhelmed with hormones, the aftermath of a birth that was not at all what you planned and fears about being able to feed your baby as you planned. I would try to focus on the fact that things really, really do sound normal.

Hugs!!!!

[JenChem]

Thanks for all the encouragement! It's just very overwhelming dealing with the CS and now BF.

Im definitely not engorged although I did notice a change from colostrum to more like milk. Diapers have been scarce and mostly thick/dark until I tried the supplement this afternoon. Since the supp feed and one reg feed we've had 2 soiled diapers much lighter. I was doing some reading on the kellymom site and it's really heartening to hear that some moms stop BF altogether and manage to restart it. I just have to keep pumping and feeding and eventually I hope it works.

[KBecks]

You can do it! BF can really suck, but keep trying, you and your baby both need the practice and experience getting familiar with nursing. Nurse as much as you can. Drink LOTS of water.

I agree, in the beginning you don't get much out with pumping and that's normal. Frequent feeding is important. It can be exhausting. Keep going and hang in there, it gets much better over a few months. You can make it!

[Melaine]

MY lc prescribed reglan and it worked quickly to boost my supply. I know some people have side effects, but I had none and would do it again in a heartbeat. Hang in there!

[tiapam]

Thanks for all the encouragement! It's just very overwhelming dealing with the CS and now BF.

Im definitely not engorged although I did notice a change from colostrum to more like milk. Diapers have been scarce and mostly thick/dark until I tried the supplement this afternoon. Since the supp feed and one reg feed we've had 2 soiled diapers much lighter. I was doing some reading on the kellymom site and it's really heartening to hear that some moms stop BF altogether and manage to restart it. I just have to keep pumping and feeding and eventually I hope it works.

IME, engorgement happened very few times and mostly when we were overdue to nurse. Your breasts don't necessarily have to look or feel full to have milk.

[hellokitty1]

I have in fact BTDT and my post is somewhere on these boards from February. I was 1.5 weeks early and had a c/s and my milk took FOREVER to come in. I did supplement for about a day and a half but it was via a very thin tube that was inserted while DS was nursing as opposed to a separate bottle. I think it would have been fine not to supplement but i was overly paranoid. From my experience, I would suggest continuing to pump after each session and do NOT pay attention to the amount of milk that comes out. If your milk truly hasn't come in, the pumping will kick start it. My ped was also concerned about weight gain issues and I was going in every couple days. I made sure over the weekend that I nursed a lot and pumped. Please give it more time. If you got free formula from the manufacturers, you might have gotten a shortened version of The Nursing Mother's Companion by Kathleen Huggins, titled "Nursing - The First Two Months. If you read it, it will make you feel so much better and confident.

But I must end this note by saying whatever choice you make, as long as you are happy, baby will be happy. no pressures. GL.

[larig]

I've not exactly BTDT, but close. My production was never sufficient, so supplementing was necessary, but we still breast fed what I could do. I tried Reglan, but it made me soooo tired. Fenugreek was a bit helpful, so you could try that. My sister in law swore by a tea too, but I can't remember what it was called.

[zag95]

I had a similar experience. Please work with a LC to see what they can do-they are a terrific resource!

Some things that impacted me- recovery from my CS- I was on pain meds- I was tired, probably didn't drink enough water

I had to pump all the time because my daughter was born with a bilateral cleft lip and palate, and couldn't nurse. I was a mess!

I tried it all- multiple visits with the LC, Fenugreek, teas, Domperidone (prescription meds to help with milk production) and all I haver got was less than an ounce. After 2 months of trying to eek it out- I stopped- and went to formula. My body struggled with recovery from my CS- I had trouble healing, allergic reactions to different things, and was pretty wiped out- I was going to Dr. appointments almost daily for myself, or my daughter.

What you can do is what you can do. You are doing all your can for your baby. Please don't beat yourself up if you are having trouble- You are a great MOMMY, regardless of whether you produce breastmilk or not!!

Good luck!

[kijip]

I did not realize with my older DD (failed induction, followed by a c-section) that the fluids they pump you with during the induction and for the c-section can artificially inflate the baby's birth weight. Also, it is NORMAL to take until 2 weeks post birth for the baby to re-gain birth weight.

So what I am trying to say is that it actually sounds like things are going OK if you able to pump any quantity of milk at this point. I would see an LC to check baby's latch and do a before and after weighing.

:yeahthat:

F was supposedly 6 pounds 13 ounces at birth but he dropped 11 ounces in less than 2 days- he was full of fluids that they put me on when I came in the day before he was born with PIH. It took him almost 4 weeks to get back up to 6 pounds 13. My doctor, like Beth's, was very proactive and understanding without pressing for supplements or discouraging nursing. It helped that he has daughters who gained slowly so he was more laid back overall. It sounds like you are doing better than you think. So long as baby is wetting diapers etc, they are fine even if weight gain is marginal at first. Certainly don't worry about getting back to birth weight at 5 days pp.

[ThreeofUs]

Hugs! I have BTDT. 36 hours of induced labor, running down the halls to an emergency section, feeling like I'd been hit by a truck for a looonnnnggg time afterwards.

When you labor for a long time, your body really takes a beating. Don't give up on your ability to produce milk; it'll come in very soon. Get some support from an LC and your local La Leche - they'd love to help!

[justincase]

:hug: Hugs, mama. Go easy on yourself! As everyone has said, you need to take care of yourself first. Hydrate, try to rest, don't think too hard about anything on a sleep-deprived brain with those hormones raging. I know it is easier said than done...

I haven't BTDT exactly as my issues weren't supply-related but I certainly had issues! I was pumping around the clock and stressing out just one month ago. I can't give advice on the milk coming in part, but I just wanted to reach out to say hang in there.


I did not realize with my older DD (failed induction, followed by a c-section) that the fluids they pump you with during the induction and for the c-section can artificially inflate the baby's birth weight. Also, it is NORMAL to take until 2 weeks post birth for the baby to re-gain birth weight.

:yeahthat: And also to add that my ped told me that in addition to the birth weight being inflated by the fluids they pump into you, it is also inflated in a c/s baby because their belly full of amniotic fluid never got squeezed out. She said there was no way that DD's "true tissue weight" was as high as her "birth weight" indicated (her words). DD took over THREE weeks to regain her birth weight, not the two that everyone says. Ped never seemed stressed about it and encouraged me to keep up with the BFing.

Definitely read kellymom.com, check in with an LC, and keep hanging out on these boards! The moms here are awesome -- experienced, encouraging... :)

[3blackcats]

I have btdt with the milk supply issues. My labour was perfect, but I have issues with milk supply. My milk supply came in, it just wasn't enough. I did supplement with formula to get DD weight back up. What a great feeling to see my child actually get some nutrients. The formula worked wonders on getting her weight back up, she was able to regulate her temperature and was so much more alert with food in her system.

I did an insane pumping routine after talking to an LC. I drank tons of water, tried to eat and sleep as much as I could. My dr. prescribed Reglan too, but I felt the depression side effect. The drug I am on now is Dom peridone (sp?). It is the drug they use in Canada (where I am from originally) that does the exact same things Reglan does with zero side effects. My dr here in the States prescribed it for me, but I could not find a drugstore that carried it. Everyone here knew what it did - dr's, pharmacist, LC's etc, but no one carried the drug. I was able to get it from my Dr in Canada. Maybe you can find that drug in your area. (Note to self: Write Bitching Post about American drug companies and how screwed up they are)

Anyways, my DD is thriving on my limited supply of breast milk and supplementing the remaining with formula. She breast feeds every time she is hungry. My LC told me to look at it this way: She is getting the benefits from me by breast feeding as much as she can, but she is getting the calories she needs from the formula.

It was very stressful for me not being able to produce enough milk. The world makes you feel like you are a bad mother if you even think of giving your baby formula. It took me a couple of weeks to get over that, but when you see your child actually getting nutrition, you get over that.

Good luck and know you are not alone. And that you are not a horrible person if you do have to give your baby formula.

[egoldber]

Im definitely not engorged although I did notice a change from colostrum to more like milk. Diapers have been scarce and mostly thick/dark until I tried the supplement this afternoon. Since the supp feed and one reg feed we've had 2 soiled diapers much lighter. I was doing some reading on the kellymom site and it's really heartening to hear that some moms stop BF altogether and manage to restart it. I just have to keep pumping and feeding and eventually I hope it work

Engorgement is not necessarily an indication of milk supply. I was only engorged with Amy (and I had plenty of milk, she was in the NICU and I was able to pump 8 ounces at one week) when she had gone a long time in between nursing. I also never leaked much.

The thick dark poop is meconium, and again, is normal. Moving to the regular poops is a good sign.

I would really, really go to see an LC ASAP. Almost all that you have described really is totally normal. I think a good LC (find one that is IBCLC certified) would be able to reassure you that things are going pretty well.

Also, remember that in the absence of other issues (e.g., poor latch, palatte issues, prematurity, extreme jaundice) your baby is MUCH more efficient than any pump. The best thing that you can do to increase your supple is put your baby to the breast often, letting the baby nurse as long as they, making sure to drain the first breast at each nursing session, and not letting baby go too long between nursing sessions during the day (not more than 2 hours).

[WatchingThemGrow]

I haven't gotten to read carefully since the beginning, but here are some things that helped me continue to BF (not exclusively and not easily) despite early problems with supply, a discoordinated suck pattern in DD, tongue tie with DS (ask about both of these!!! - ask several professionals), etc:

trixietracker.com - to manage the diapers, pumping,supplementing, weight gain stats in ONE place so docs, LCs, family, can keep up while DH just input the info so I could keep doing MY stuff

domperidone to increase supply - got info from Jack Newman's website and kellymom I think, maybe also BFAR.org, maybe LLL, but I'm not sure. google "compounding pharmacy" and your town. They are legally able to make it for you if your doctor prescribes it. My OB was all for having me try it and now the hospital LC dept. will prescribe it to others based on my experience and others that have followed.

renting a hospital grade pump and scale for our house - kept us pumping with a little stronger pump than the PISA and kept us in touch with what DC were getting each feeding from me. It was a little technical, but when each lost like 13% of their body weight and we were going in every other day, things were nuts. Our ped could check in by phone and on trixietracker to see the stats.

With all these things in place, I felt like I was doing the best I could to BF both of our DC. It was a personal decision to go through all that, so don't feel judged if you decide you aren't going to do ALL that. It is a slippery slope emotionally, so be on the lookout.

[egoldber]

Just wondering how things are going. :)

[JenChem]

Well I'm trying to take this new mommy-hood day by day. We supplement every other feeding with formula (we generally see 1oz go down). I went back in today and DS is back up to 6lbs. I actually managed to BF while waiting between the weigh in and the appointment and asked the dr to measure again to check consumption and he'd taken in 2oz from a short feeding. I'm feeling much better today although I wonder if my supply is truly in yet. At that point the ped said we might drop the supplements to twice daily.

Ofc as soon as I start feeling better about that, she sends me in for a bilirubin check and he's at 18.9 (on day 7 so likely this is peak) :( So we're trying to decide whether or not we want to pick up a biliblanket for the weekend or just keep up the supplements and try to get some sunlight throughout the weekend. Any advice on that front? FWIW the hospital doc seemed very concerned and wanted the blanket but our ped is more laid back and pushed the supplements and sun. Don't you hate when you get mixed signals like that???

[egoldber]

The high bilirubin explains a lot actually. Babies who are slightly jaundiced are often sleepy and inefficient nursers. Which would explain why your milk may have been slower to come in. But if your baby took in 2 ounces at that feeding, why do you think your milk is not in?

2 ounces for a feeding is a normal amount for a newborn. He gained 4 ounces in 2 days, yes? This is what is expected and is normal. Actually an ounce a day is considered normal weight gain at that age. At that rate he will regain (his probably inflated anyway) birth weight before 2 weeks. Which is normal.

Milk supply is a fluid thing. Your baby nursing at the breast is what signals the body to make more milk. Your supply will grow and increase as your baby nurses more to increase it.

As for the lights, I would use the blanket rather than supplement personally. If you want to exclusively nurse, than you need to work on weaning from the supplements. If it were me, I wouldn't even supplement knowing that he takes in 2 ounces at a feeding. Some peds automatically recommend supplementing for every jaundiced baby, even though there is seldom a medical reason to do so.

http://www.kellymom.com/newman/07jaundice.html