My milk never came in (Really)

[melst48]

I am new to this forum and desperate for help. My son is nearly four weeks old and my milk never came in. I get little drops when I press behind my nipples, but nothing when I pump and my baby rarely swallows when he nurses on my breast alone. The only breast changes I noticed during my pregnancy were the darkening of my areola and some dried colostrum at the end of my nipples. No tenderness whatsoever. I brought him to breast about 45 minutes after he was born. The bf support at the hospital was lousy and I, unfortunately, didn't know better so we were using a nipple shield and SNS within the first 24 hours of his life. I have since weaned him off the nipple shield, but we are continuing with the SNS. I have seen five different lactation consultants. We've ruled out a thyroid problem and retained tissue of the placenta. I'm told my prolactin levels are very good for milk production. I've tried fenugreek, Maxi-Milk and Motherlove Special Milk Blend. I spend all day with my baby and pacify him at the breast in addition to our SNS feedings...all while thinking MILK! Still no firmness in my breasts or letdown feelings. All of the lactation consultants I've seen are stumped. I've found all kinds of information about low supply, but I really seem to have no supply at all. Is there anyone out there who can help me?

[ILoveMyBabyBird]

sorry you are having a hard time, there are many reasons your lo may not be getting enough breastmilk. It could be PCOS related, IGT-insufficient glandular tissue, lip or tongue tie (baby). Or many other things. Read "The Breastfeeding Mother's Guide to Making More Milk" by diana west and lisa marasco, it goes into detail on the possible reasons for low supply and how to maximize your milk supply potential. Have you had implant or breast reduction? These procedures can sever milk glands and could result in low supply as well. There are some rare instances where women truly cannot make enough milk, but that doesn't mean you have to give up breastfeeding. I had a lot of problems and continued to breastfeed my son to 28months eventhough i had to supplement him.

The best herbs i read about are goat's rue and fenugreek for increasing you supply. Eat lots of old fashioned or steel cut oats. This Breastfeeding Challenges forum is an excellent forum full of resources. IF you have any questions many here are great and knowledgeable.

[melst48]

Thanks. No breast surgery here. It's not PCOS and my baby isn't tongue-tied. I'm told my breast tissue should be sufficient. Also working on the book you mentioned. I feel like I've tried it all! Thanks for your suggestions though.

[treeoflife3]

Just wanted to give my support for you. I've got no ideas but I know how sad I would be experiencing this kind of difficulty

[sattygirl99]

Originally Posted by melst48

I'm told my breast tissue should be sufficient.

How do they know this? Have they done an ultrasound of your breasts? The ONLY way to know for sure if you have glandular tissue is to ultrasound your breasts.

I have a local friend who has diagnosed IGT and she had to pay out of pocket for an ultrasound to confirm as to why she didn't produce milk.

Just by looking at your breasts, they can't tell you if your glandular tissue is sufficient. You can have normal looking breasts and have IGT or have breasts that fit the IGT mold and have oversupply.

I'm so sorry you are having issues! I would absolutely fully rule out IGT as a possible cause.

Are you supplementing at the breast? You can still breastfeed your baby even if you are having supply issues. I highly recommend the lact-aid if you go that route... It's much nicer than the Medela SNS.

Big hugs!

[melst48]

I did not have an ultrasound, but I'll ask for that, thank you. I was told by a LC who just felt my breasts.

[Artichokie]

You might also poke around the kellymom.com forums - I am pretty sure they have seen every breastfeeding challenge under the sun there.

I don't have any other advice, but welcome!

[AtYourCervices]

I have IGT (and I'm a B/C cup, btw). I would get angry at people who would say things like "every woman can breastfeed" or "you must be doing something wrong...". They'd offer all sorts of suggestions on how to get my supply up and nothing seemed to work well. It was depressing and it really hurt my self esteem (especially since I'm already self conscious about my breasts).

When my first daughter was born, she was diagnosed as failure to thrive. We started supplementing with a bottle, and unfortunately a nursing strike at 6 1/2 months resulted in her weaning.

With my second daughter, I was prepared and weighed her often. However, she, too was diagnosed as failure to thrive. I tried every dietary change, every herb, and even Reglan to increase my supply. Reglan seemed to help, however my physician wouldn't prescribe it for more than a week because of the side effects which included depression. His reasoning was because I had post partum depression after having my first child, Reglan would guarantee I'd have it again. He didn't seem to understand that the reason I had experienced post partum depression was because I couldn't breastfeed. If only I could breastfeed exclusively, things would be wonderful...

I eventually turned to using the SNS and supplementing with bottles. Unfortunately a forced separation caused my daughter to "forget" how to nurse, and she weaned at about a year.

When I had my son, I didn't even wait to see if my milk would miraculous be sufficient. I started right up on using the SNS and cup. Of course I still tried all the herbs, teas & dietary changes. But, I accepted the fact that I just couldn't breastfeed exclusively and I decided I wasn't going to cry anymore over it. My son breastfed until he was around 20 months old.

My youngest is turning 4 in January and she still nurses occasionally. When she was born I started off supplementing with bottles. I don't even remember if I used the SNS this time. I consciously decided I wasn't going to worry about it or judge myself just because my body can not produce enough milk. We are lucky that we have bottles & formula available. In some areas there are milk banks available, and some women have "wet nurses" available to them. Don't stress if you can't breastfeed exclusively. You're not choosing to not breastfeed for the sake of convenience. Mothers breastfeed because they want what is healthiest for their babies. If you can't produce milk, what is healthiest for the baby is supplementing. You can still put the baby to the breast for comfort, though. Don't ignore that!

I credit the stress free approach to breastfeeding/supplementing with my children nursing longer with each successive child. I suggest you relax, accept it, let yourself cry about it but don't obsess over it, and don't beat yourself up! Go ahead and try different methods to attempt to get milk in, but don't get your hopes up and don't get depressed if it doesn't work. My recommendation is to try to get a prescription for Reglan or Domperidone.

[germin8]

I am SO right there with you. I have tried everything. I had absolutely no breast changes during my pregnancy... (I wish someone would have told me this was a red flag). For the first 6 weeks after my DD was born, I pumped around the clock and took dom, MMP, & Goat's Rue. My supply built up so that 4 hours after an SNS feeding, I could pump 2 oz off each breast. But then, I had to go back to work and it just dropped. I have since resigned and have been unable to build up my supply to that, b/c I do not pump around the clock. I pumped every 3-4 hours and at night it was every 5-6 hours. Now, I get about 1 oz off each breast every 4-6 hours.

I have a really slow let-down... it's like "drip... drip". I squeeze and nothing really comes out. On a few rare occasions I would see a tiny squirt and that was it. Only a few times have I ever felt "full", but the LC says that feeling goes away in time.

When DD was 3.5 months, I went to LC again and they pretty much gave up on me... I'm thinking this was b/c of the mothers that are coming in this month due to our huge February winter storm... lots of babies for this month.

Anyway, I pretty much gave up too... everything else normal.
I still pump though... I do get about 10oz a day... and supplement the rest.

BTW, I'm vegan... but I know others with low milk supply that eat regular meat meals. I'd wonder if my progesterone or other hormones weren't right since progesterone helps with making glandular tissue during pregnancy.

Sorry to hear about this. It's no fun. Check out milkshare.com if you are interested in supplementing with donor's breast milk.

Originally Posted by sattygirl99

How do they know this? Have they done an ultrasound of your breasts? The ONLY way to know for sure if you have glandular tissue is to ultrasound your breasts.

Ultrasound? Yikes.

[teton1898]

What about starting domperidone and/or Shatavari? Also, alfalfa is another herb to try. Whatever you do, DON'T STOP NURSING!!! If you do have IGT, all the nursing and pumping you do to increase your supply for this baby, even if its only a few ounces day, will greatly benefit future babies as women CAN grow breast tissue and achieve full supplies with subsequent babies. Spend the time needed now to figure out what the problem is so that you can aggressively address it in the future. I wish with all my heart I had known those 2 pieces of information with my first instead of learning about it with my 4th.

[mama_daba]

i am really sorry for all the mama's never able to make enough milk that sounds really difficult.

i just wanted to say that i have never been able to pump more than an ounce and that took over an hour to get but even though my breasts make nothing for a pump i can produce plenty of milk for my son. just wanted to put that out there. also i have never been engorged and i have never been able to squeeze much out but my son is 3 now he was exclusively breast feed the first six months after that food was mostly to play with and slowly he ate more and more and now he nurses a lot less. just saying those because don't wants someone who can produce milk to read the thread and think that if they never get engorged or never get anything pumping it means for certain they can't produce enough milk. i know there are other women like me who don't get engorged and don't make milk with a pump but are able to breast feed.

[Somemyrrh]

If the tiny droplets you see are white, your milk did come in; it's just a tiny amount.  That's okay.  You are still a nursing mama.  It means the hormones are there to help you bond with your child in this special way.  In terms of advice, I would say keep taking Fenugreek and Goat's Rue if you can, and consider adding Domperidone if possible.  I have IGT and take lots of Fenugreek, some goat's rue, and Dom in order to have a little more than an ounce/feeding (maxing out at 1.75 oz. total if I go a little longer).  My breasts never got hard after either birth, but I am nursing my DD along with formula supplementation.  I had far less milk with my son, just half an oz. at a time, not enough that we were able to sustain a nursing relationship past six weeks since I did not have proper diagnosis then.  IGT can improve with subsequent babies, but since you probably have it (sounds as though you have done everything else), you may need to just try to focus on getting what milk you can make rather than worrying over an unobtainable full supply.  Even a tiny amount of milk gives the baby antibodies that help keep the tummy feeling well.  When making milk, our breasts put the good stuff in first.  Mixing in supplements won't take away the benefits that come from milk, and certainly will not take away the benefits of closeness with your baby.

The only other advice that comes to mind is to wear your baby.  One of my LC's advised wearing my baby as high up on my chest as possible, which means a wrap carrier (Sleepywrap or Moby) for me, in order to stimulate the production of oxytocin.  This has been a great bit of advice that has made me feel very bonded with both of my children.  It has also helped my letdown and helped me max out my low supply so baby gets as much as possible from me. 

There are some mamas who can make sufficient or even too much milk, and some who do not make enough.  We low suppliers are not mythological creatures, and we can have happy fulfilling nursing lives, even though our children have to get nourishment from supplements.  If your son will latch, then you are nursing.  There is so much more to breastfeeding than just milk, which is why people get so passionate about promoting it (even sometimes ignoring the truths some of us live with low supply, but hey, they mean well).  Most of all your baby just wants YOU, whether or not you have milk to give.  Please give yourself a break and know that you are a good and okay mother.  You are giving your baby your presence, which is best of all for baby. 

[PatioGardener]

Originally Posted by Somemyrrh  If your son will latch, then you are nursing.

This is so true, Mama.  There are so many great reasons to nurse your baby - the SNS or lactaid is a super tool that can help your little one to get all feeds at the breast.  Congratulations - you are working so hard at this!  Keep going - we're all cheering for you

[BethHH]

I'm right there with you.  My daughter squeaked by at her final weigh-in at the hospital (if they lose more than 10% of their body weight, you have to stay an extra day), and daily visits from my midwife confirmed that she was consistently losing weight.  At 12 days, I decided that her health was what was important, so I began supplementing even though it broke my heart to do so.  She is 5.5 months old now and we're still doing a mix, but we've definitely increased the amount of breastmilk.  We get the gorgeous bonding (I do love breastfeeding), her immune system is better than my husband's and mine (she recovered from a cold in 24 hrs, it took both of us 4 days), and my husband gets the joy of being able to feed her without me.

Here's what helped me: I haven't used my pump in months.  Babies are much better at emptying the breast than pumps, and an empty breast is a signal to your body to make more milk.  I use fenugreek (12 capsules a day, I smell like a pancake) and when I'm home I offer the breast every hour or two.  She doesn't drink long, but it's enough.  We've been able to feed overnight without bottles for about 3 months now - a huge accomplishment for us considering where we started.

I agree with the other posters - if your baby is latching, you are breastfeeding and giving both of you a gift.  Any amount you can do is fantastic!  Don't lose heart.