milk coming in and other first days questions

[wilddreamergrl]

Hi,

I had my first baby on Wednesday at 1:35 am. So today is Day 4 but it's been more than 96 hrs. My milk has not come in yet and I'm starting to wonder if I should be concerned. Baby boy nurses throughout the day, but he is very sleepy. Yesterday he mostly napped from about 3 pm-9 pm with only little snacks in that time period. But at night, he will spend 1-2 hours nursing constantly, back and forth between sides. He has plenty of wet and poopy diapers (esp. lots of poopy ones!) He is a little jaundiced but it doesn't look severe at all. He was a home birth but we saw his ped on Friday who thought he looked good, and he isn't any more yellow since then. 

But being a first time mom this is all new and confusing to me. I've tried waking him up to nurse if he sleeps more than 2 hours during the day, but he doesn't really wake up...I might get him to have a snack but not a serious nursing. But then, like I said, he makes up for it during the night. 

Is everything ok or should I be concerned? 

thanks in advance!

[APToddlerMama]

Have you talked to a lactation consultant?  I don't really have an answer for you but if he is having enough wet/poopy diapers I don't think I'd be too worried.  The only thing I was thinking and an LC could probably tell you was if his suck is actually effective or not.  With my DS, I had to pump for a while because although I thought he was sucking/swallowing okay, he was not sucking effectively (preterm 35 weeks) and so I wasn't initially getting the stimulation I needed to increase production.  My guess though is that if he has wet diapers that probably isn't the issue.  Good luck!

[motherhendoula]

The wet and poopy diapers are a great sign.  Are the wet diapers - wet enough?  You can take one diaper and pour three teaspoons of water into it - that is your 'standard'  ..that is how much a wet diaper should weigh.  (Ive only ever done this with a disposable diaper, but i imagine CD would be the same!)   Is your pediatrician OK with babies weight? 

For most women - their milk will come in between day 3 - 5.  Are you noticing changes in your breasts?  do they feel heavy, hot, or are you more 'aware' of them?    You may also notice more veins at this time.  

I am also horrible at waking baby up - but it would probably help him sleep more during the night and nurse more during the day.   My last LO was also a heavy sleeper and my milk didnt show up until day 6 ...not really copious until day 8.  When baby is awake and alert during the day, strip him down to his diaper, hold him skin to skin with you and you can try talking to him, playing with his feet, wet washcloth on his back,  - (anything your comfortable with)   to keep him awake while he eats.  

I think waking every two hours during the day MIGHT help him sleep better at night - but thats your call! 
Another trick that i used was to try hand expression.    take a look at this link     

http://newborns.stanford.edu/Breastfeeding/HandExpression.html

what helped me was to attempt to hand express for 5 minutes directly after I nursed the baby.   I think it was the stimulous my breasts needed to completely get the message - milk showed up about 24 hours after starting to attempt to hand express. 

keep us posted - im sure milk will show up tomorrow AM!

[artekah]

It sounds to me like everything is okay. With my first, my milk didn't come in until the end of day 4, and for some it can take up to a week. The important thing is to nurse him on demand, because the baby's suckling is what tells your body to make the hormone prolactin, which tells your breasts to make milk. As long as he is peeing and pooping and seems healthy, he is definitely getting colostrum. I would just keep nursing a lot and not worry at all at this point!

ETA: IMO waking him up to nurse isn't necessary, as long as he nurses plenty when he's not sleeping. Speaking as someone whose baby didn't sleep for more than an hour at a time for the first 2 months, I would definitely count those longer sleep stretches as a major blessing! And again, just nurse as much as you can when he's up, and keep an eye on the pee/poop situation.

[PatioGardener]

I would wake baby up to nurse every 2 hours.

My little guy (also born at home ) lost over a pound by day 3 of life. He had lots of poopy diapers, and enough pees, but was a sleepy little guy. When the midwife weighed him, I explained that he was not really interested in eating every 2 hours - more like every 3-4 hours. She gently reminded me that it was my job to get him to eat. She encouraged me to wake him every 2 hours to nurse. I had to use wet washcloths on his back to rouse him enough to feed.

But my milk came in at the end of the next day, and with frequent feeds he gained more than half of the weight back by day 6, and was back to birth weight by day 14.

I worry that if I hadn't been encouraged to feed more often that he would have gotten more and more sleepy and it would have been a downward spiral.

Congratulations on your little one!

[wilddreamergrl]

Thanks all for your thoughts...very encouraging and I feel less worried. My pediatrician just called to check in and he was not concerned about the long sleeps as long as baby is nursing well when he does nurse - which he is - and especially since his diapers are good and there's been a change in his poops (from meconium to green/yellow.) He was more concerned about baby's schedule being flipped and for me having such long awake times at night, but I don't really mind, at least not yet - I'm so much more rested than I was with the last 6 weeks or so of pregnancy insomnia! Ha. 

Just hope my milk comes in tomorrow. 

[APToddlerMama]

I hope it comes in tomorrow for you too.  As a side note, I remember feeling like I had the flu right before my milk came in and have heard that is pretty common, so that might be a tip off for you that its on its way. 

[PatioGardener]

OP, how are things today?

[wilddreamergrl]

I'm not actually sure how things are today...

I didn't think my milk came in overnight, but I hand expressed a little that does NOT look like colostrum to me - it's opaque white/watery, not thick or yellow. I wasn't able to express much but I'm not sure I even am doing it right. Wish I had a pump. Is it possible for your milk to come in without many/any symptoms? My breasts did feel firmer this morning but nothing like the rock-hard I've heard about, and no tingly let down feeling.

I called to make an appt with a LC but they didn't have anything til Thursday. Grrrr.

My DS seems fine - maybe a little happier even. Yesterday there were quite a few times that he was very mad and fighting with the breast before finally latching. That seems better today,

He hasn't lost any more weight since his ped visit on Fri, though he hasn't gained any back either.

He's still pooping and peeing though his pee has uric crystals in it, which I thought I read was common BEFORE milk comes in.

So I guess the answer is, I'm still not really sure....

Sigh. I just want to know my little guy is ok. It breaks my heart when I put him to the breast and rather than solving the problem, he seems mad at it...

[PatioGardener]

My breasts never got hard, but baby's poops changed a lot (went to that breastfed yellow and lots!) and he started peeing up a storm when my milk came in.

Have you tried to call La Leche League? They were awesome when I called them - really sweet and full of good advice. I wish I hadn't waited so long!

[Llyra]

With my first two births, my breasts never felt hard or engorged, and I never felt letdown until about the third or fourth week. For me, "milk coming in" was more a gradual thing that happened slowly over the course of a few days. It was only the third time, with my twins, that I had the sudden rock-hard boobs phenomenon.

My milk has also always been slow to come in-- even when I had the twins, who between them were logging about 23 hours of suckling time a day, I had only colostrum until late on the fifth day.

If baby has stopped losing, and the poops are changing, then you are definitely making the transition to mature milk, IMO.

It's pretty common for baby to be fussy at the breast, in the last day or so before the milk comes in-- mine always were. This is the stage where a lot of mamas give up, and give a bottle. But that fussiness is not a sign that you're doing anything wrong-- it is a sign that baby is awake and alert and eager to nurse, and that's a very positive thing. Unfortunately, babies fuss a LOT in the early weeks, and often fuss at the breast-- it takes them time to learn how to latch well every time they try to, and lots of things get in the way-- they need to poop, they need to pass gas, they are tired or overtired, they are overstimulated and disorganized, they are too hungry to concentrate on the job, etc. It just takes time and patience, and they figure it out.

Congratulations! It sounds like you are doing very well, actually. What you're describing is almost exactly how it was for mine in the first week, and we did fine. I'm sure you will too!

[PatioGardener]

Originally Posted by Llyra 

It's pretty common for baby to be fussy at the breast, in the last day or so before the milk comes in-- mine always were.

Also, mine started to get MORE fussy when my milk came in!

I agree with Llyra - babies are really fussy those first few weeks. Hang in there!

[motherhendoula]

The hand expression isnt really about collecting milk...its really just about adding stimulation so your breasts get the hint and start producing...if you are seeing a few drops - you are ON THE WAY!  i would say by Wednesday AM you will see more, and really your breasts arent supposed to get hard as a rock....its a good thing that they DONT....it just does feel different than prior to nursing....you may feel this sensation  after baby has been asleep for a few hours.    And you may notice when you nurse on one side - the other side will leak like crazy. 

Its fine not to wake baby during the day to nurse - but basically baby's day should be in 2  twelve hour sections  - during one section, baby will nurse at least every 2 hours and during the next section - baby will nurse every 3 -4 hours.   So if he sleeps during the day, its fine - as long as he up every two hours all night long!   His good mood is also a indicator that everything is perfectly fine.  Does he have periods of 'wakefull contentedness' ?  like is awake, looking around and not eating from time to time?  

Fussiness at the breast is quite common - my LO at about 2 - 3 weeks would seem like he forgot how to latch on...id put him to the breast and he would CRY - i mean the nipple was right in his mouth - all he had to do was shut it....no, he would scream.  This only lasted a week or two and happened only once or twice a day....but frustrating nonetheless.....

A call to LLL leader is always a good idea too - she may have more tips on keeping baby awake for a feed.