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One week after birth and still no milk. I should panic, right? Cause I am!

post #1 of 44
Thread Starter 
Hi ladies,

This is my first baby. She was born a week ago tomorrow. It was a very tramatic vaginal birth, and I lost a lot of blood. We were kept in the hospital for observation an extra day because of my blood lose. The baby wasn't affected by the birth experience in any negative way.

My panic: MY MILK HASN'T COME IN YET. My colostrum is the only food my baby, and although she is wetting diapers (5+ a day) I know this isn't enough nutrition, is it? The Dr and my midwives told me that my milk would take a day or two longer because of the circumstances of her birth, but it has been days later now, and still no milk to speak of. I'm paniced. My midwive suggested pumping, so I am, but to no avail. I'm drinking Mother Milk tea.

Baby has lost a pound (I know some weight lose after birth is normal). She's nursing every 2 hours. Her diapers are wet. She's even gassy at times. But again, I have no milk.

Is this me?? Should I be tested? Could it be my thryoid? Baby's thyroid test came back unstable so she is being tested again, but she shows no sign of a slow thyroid. She's alert, strong, seems very content after nursing. It takes us an hour plus to get her fill, but she doesn't seem hungry until her next feeding.

Help, please. It is beyond hard to know what to do with this being my first baby. Do we suppliment with formula?

Thank you.

lellian
post #2 of 44
She has to be getting something based on the fact that she is satisfied, is having the appropriate amount of diapers, and she isn't screaming while nursing.
What makes you think your milk isn't in? Have they become engorged at any point? Are you not feeling a let down?
See if you can take her to an LC to be weighed before and after a feeding. I would try pumping. I wouldn't think that if she is not showing any signs of malnutrition that you need to supplement at this point.
post #3 of 44
I would say it sounds like she is getting what she needs. I can understand being worried. But when I pumped I don't think I ever got much milk, and none in the beginning. 4 days is pretty normal for milk to come in, and a couple more days would still only be 6. If she seems happy, there's no need to panic. Keep drinking your tea. Make sure you're getting enough water and sleep. Don't forget, skin to skin contact helps too. Good Luck!
post #4 of 44
How many dirty diapers is she producing? What colour is her poop?
Good advice above, lots of skin-to-skin, feed "on demand;" great sign that she is alert and wetting five diapers a day, but if she isn't producing dirty nappies and has lost more than 10% of her birth weight, then yes I would be considering supplementing (along with expressing to keep the message to your body that the demand is there and it needs to keep producing!).

Blood loss can indeed delay milk "coming in," but it sounds as if you're on the way. If baby is wetting five diapers a day, then there's definitely milk even if it's not quite enough just yet for full nutrition. Hang in there!
post #5 of 44
What pump are you using? It might be worthwhile to rent a hospital grade one for a week; my preemie son was in the NICU for a week and I did this, it was a lot nicer than the one I own. Also, there is a breastfeeding support group at my hospital, headed up by the hospital LC, which is free and you can go use the scale for free. Is anything like this available to you? Ditto what the pp said about weighing before & after a feed, and some women just don't get much if any milk when they pump! Definitely keep weighing baby though, the weight should start to go up soon even if just an ounce. and ((hugs)) try to relax and cuddle your babe a lot. I drank some Guinness in the first week too, not sure if it helps your milk come in sooner but it definitely helped me relax!
post #6 of 44
Quote:
Originally Posted by ratrodgrl View Post
I drank some Guinness in the first week too, not sure if it helps your milk come in sooner but it definitely helped me relax!
And Henry Weinhard's root beer, if you prefer.
post #7 of 44
Just popping in to say keep at it- if baby is alert and not screaming during a feed, it is unlikely that you have no milk at all. I have oversupply and rarely pump more than 2 oz. at a session of up to 30 minutes or more. Yep. So there is a good chance your milk is coming in already, but only she can taste it.
post #8 of 44
Thread Starter 
jeliphish: no engorement to speak of, and no let down. She is an awesome nurser, and nurses every couple of hours with no screaming, or fussing. I pump in between feedings, but haven't gotten even one drop of milk from pumping. Not one drop.

mntnmom: do you mean I should undress her every time she nurses? Not opposed, just wanted to see if that is what you meant? I don't know if it is possible to drink more water, but I'll try.

She's waking up so time to nurse. I LOVE this time.
post #9 of 44
Quote:
Originally Posted by lellian View Post
jeliphish: no engorement to speak of, and no let down. She is an awesome nurser, and nurses every couple of hours with no screaming, or fussing. I pump in between feedings, but haven't gotten even one drop of milk from pumping. Not one drop.

mntnmom: do you mean I should undress her every time she nurses? Not opposed, just wanted to see if that is what you meant? I don't know if it is possible to drink more water, but I'll try.

She's waking up so time to nurse. I LOVE this time.
Just because you can't pump milk doesn't mean that your body is not making milk. Definitely watch the diaper output, and check in with your midwife if you're concerned, but keeping yourself calm is important. Here are some things that helped my body make more milk:

1. Eat lots of Oatmeal
2. Undress her and your top so that her skin is right next to your skin.
3. Eat lots of fatty foods (not junk food, but good fats...full fat milk/yogurt/etc, avocados, coconut milk, etc).
4. Make sure you are getting as much sleep as humanly possible with a newborn. If your family can cook/clean/pamper you for a couple of weeks, that would be idea. You need to rest and breastfeed, that's it.
5. Mothers Milk tea did nothing for me, but I'm convinced that THIS tea saved my nursing relationship: http://www.westernbotanicals.com/cfp...glish=1&type=4

Good luck! I had a long traumatic birth too, and my milk took a while to come in. Dd also lost a pound after birth (but she was 10lbs 7oz, so it was still less than 10% of her birth weight, AND we were on IV and pitocin so that can inflate birth weight too). She was fussy during nursing sometimes though, which made it really hard for me to relax, and I couldn't let down if I couldn't relax. It was really hard. But yeah, I kept a chart of dirty diapers for a while to set my mind at ease, and then I found that tea and everything got better!
post #10 of 44
As far as let down goes, I've been nursing for almost 16 months and have never felt a let down. I also never got the standard engorgement either.
post #11 of 44
Quote:
Originally Posted by lellian View Post
jeliphish: no engorement to speak of, and no let down. She is an awesome nurser, and nurses every couple of hours with no screaming, or fussing. I pump in between feedings, but haven't gotten even one drop of milk from pumping. Not one drop.

mntnmom: do you mean I should undress her every time she nurses? Not opposed, just wanted to see if that is what you meant? I don't know if it is possible to drink more water, but I'll try.

She's waking up so time to nurse. I LOVE this time.
It sounds to me like you are doing just fine! I never got engorged with either baby, and never felt letdown with DS - but had oversupply with both! You don't need to pump, especially when it is stressing you out so much. Many women, even those with oversupply, just can't express when pumping. It's NOT indicative of what a baby can get out at all - plastic horns will never compare to a baby's mouth!

If she is peeing and pooping, then she's getting milk - if it doesn't go in, it can't come out.

Your body doesn't stop producing colostrum all of a sudden and then start making "regular" milk - there is transition milk around the 1-2 week mark, and it's not going to be obvious by sight when this happens. I pumped for both babies at first when they were in the NICU, and the milk I pumped was still yellow at about a week and a half, then gradually got less yellow over a few days.

Keep feeding on demand, eat to hunger and drink to thirst, and trust in your body! Also keep in mind that different scales can differ by up to a pound, so if your baby was weighed on 2 different scales in the first week, the difference may not be 100% accurate.
post #12 of 44
At one week baby should have 6 heavy wet diapers in 24 hours, and should now be up to 3-4 poopy diapers in 24 hours (each poop bigger than a quarter counts). Poops should also be yellow now, not brown or dark anymore.

I second the LC consultation. Baby should now be gaining weight back, so watching weight gain is important. At 1 lb weight loss after birth it will take 16 days or so to get back to birthweight (typical gain is about an oz a day once they start to gain.) As long as you have someone watching milk transfer, weight gain and you are getting the correct number of pees and ppops a day, then you know baby is getting enough milk.

If baby isn't gaining as expected, as well as thyroid I would ask to have your prolactin levels and your hemoglobin checked (they probably did that after birth). Both can be low after a traumatic birth, and both have been linked to supply issues.

A previous poster mentioned that if baby is contented then it is unlikely that she is not getting enough. This is not always true in my experience. I have seen several 'happy to starve' newborns who were sleeping a lot and not fussing at all, and not gtaining any weight from not getting enough milk, so a content baby doesn't necessarily mean that all is fine. But a content baby with good pees and poops and weight gain does!
post #13 of 44
Quote:
Originally Posted by PatioGardener View Post
A previous poster mentioned that if baby is contented then it is unlikely that she is not getting enough. This is not always true in my experience. I have seen several 'happy to starve' newborns who were sleeping a lot and not fussing at all, and not gtaining any weight from not getting enough milk, so a content baby doesn't necessarily mean that all is fine. But a content baby with good pees and poops and weight gain does!
post #14 of 44
Thread Starter 
Thank you for your responses.

A couple of things:

DD hasn't had a poopy diaper since she passed the meconium in the hospital. Her last dirty poopy diaper was 4 days ago. She is wetting diapers, but I wouldn't call the heavy. She wets between 5-8 diapers a day. She nurses ever 2 -3 hours, and has a great latch and sucking.

I didn't know that Pit could affect birth weight? I do know that when we looked back on her birth video yesterday DH and I were SHOCKED at how thin her face has gotten.

She was 7pd14oz at birth, 7pd1oz at discharge 3 days after birth, and 6.98 on a totally different scale at the dr.'s office. I also didn't think about the scales being off, even by a little, and how that would affect her weight.

Talked to our midwife tonight. She suggested contacting the LC at the hospital tomorrow, I will. She also suggested funregeek.

My blood levels were all kind of messed up after birth, they were just leveling out when we were discharged. I lost so much blood they were considering an transfusion and only backed off of that after they use cytotec is stop the bleeding. I'm going to suggest my blood get tested again. IN the meantime, another day with no milk and I feel like the world's biggest failure. Not looking for sympathy, but my GOd, my heart is breaking. Between the birth, DD thryoid issue (we see a specialist on Wednesday and she's on meds already in her week long life), and not producing milk. . .I think I'm failing at this mother stuff. . . at the very least I'm not passing with flying colors.
post #15 of 44
I couldn't read and not reply.

Hopefully after you see the LC you'll get a better idea of what's going on. Even if there is some issue, IME early problems are NO indicator of how your experience will turn out. With my ds1, I thought everything was normal, but he was tongue tied and didn't get above birth weight until he was three weeks old. We ended up nursing for 18 months. So hang in there. You are a wonderful mom! You and baby have been through a lot. So give yourself a break! It's way too early for you to give yourself a failing grade.
post #16 of 44
Mama, you are NOT failing at this! You are watching baby carefully and getting help - that is AWESOME parenting!

If I were you I'd get to a good IBCLC tomorrow (don't wait) - get baby weighed, have baby examined (rule out tongue-tie, poor latch, poor milk transfer etc) get some blood tests for you (make sure they do prolactin levels!), and if necessary learn how to supplement baby at the breast until your milk supply sorts itself out. The most important thing is to feed the baby. The lack of poops is disconcerting. To see if the diapers are wet enough, you can create a heavy wet diaper by pouring 3 tablespoons of water into a dry diaper. Remember that if you are concerned about the number of pees or poops you can call your public health nurse, health line or whatever resource you have in your area.

You can do this - you ARE doing this! You are getting the help you need. That is not failure, Mama, that is success

Depending on how much blood you lost, you may be at risk for something called Sheehan's syndrome. The pituitary gland can take a hit after a bad postpartum hemmorhage. That's the gland that produces prolactin - the breastfeeding hormone. This is very rare, but something your docs should be able to rule out/be aware of if your baby isn't gaining as expected.

This is NOT YOUR FAULT. You are doing all you can right now - nursing as much as possible, watching baby's diapers, and making sure that your baby is monitored by a breastfeeding expert.
post #17 of 44
You're doing fine. Pit and a traumatic birth can both effect the length of time it takes for milk to come in.

With my first, I never felt let down, not once. She nurse for 20 months.

DD1 was born on a Weds. morning, my milk didn't come in until Tuesday. When it did come in, I KNEW it! Engorged, milk spraying all over, leaking, hard and painful knots in my armpit, etc. Baby was just fine on colostrum, no supplementation needed.

What really helped my was to go to my ped. and have baby weighed before and again after a feeding. She got 2 ounces of colostrum, which my ped said was a huge amount at 5 days PP for a one-sided, uninterested-baby feeding.

I do think if it had taken much longer to come in, I'd have been calling LLL, a CLC, anybody I could think of for help!

Oh, and taking baby's clothes off for a feeding helps your body release the feel-good, nurturing hormones associated with nursing, as well as makes her more interested in nursing.
post #18 of 44
Hugs to you Mama! I'm sorry that you are going through this! You are doing the right thing, seeing the LC tomorrow. Hopefully she can give you the help and reassurance you need. IMO you ARE "passing with flying colors"! All of your worry and concern and the things you are doing to get help make you a GREAT MAMA! So many would have just given up and switched to formula (I'm not saying that's a bad thing, but your dedication to bf'ing is something to feel good about!) Please keep the updates coming when you can!
post #19 of 44
I rarely felt a letdown and was never engorged with any of my 3. All were EBF.

The wet diapers are definitely a good sign, though it would be better if we were seeing poop at this stage.

Can you squeeze any drops out by hand? What does it look like?
post #20 of 44
I never really got engorged, not painfully so, anyway. I never leaked, either. I didn't feel let down for several weeks. I think you have an efficient nurser! If baby is content and producing wet diapers then it sounds like you are doing just fine.
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