# Need help --milk not coming in ((UPDATED!))



## Marni (Sep 11, 2003)

_UPDATE: Thanks for everyone's imput!!! I forwarded your wise words to my dear friend and she did a "boob-a-thon" with her little guy and at 1.5 weeks her milk was coming in strong! Yay!!! We saved a baby from a life of formula!!!!!

THANK!!!!_

I just now posted this on the BF Challeges forum -- but I figured this forum gets more action:

My bestfriend had a healthy baby boy a week ago -- her very first. She was told his latch was great, and the colustrum was great...but then she went home and her milk never fully came in. His weight dropped a lot (from 9.1 to 7.12), he was screaming mad and hungry all the time, and her milk was at a trickle (when she pumps -- with a hospital grade-rented pump) she only gets about 1/2 and ounce -- SOMETIMES one ounce. SHe is pumping every 2-3 hours, staying hydrated, taking hot showers, dreaking Mothers Milk tea...

She has now seen 4 LC's, and the last one (who is super crunchy, my friend being in Berkley CA and all) -- said she needed to suppliment ASAP (said this 2 days ago, when baby was 5 days old). So she did, and alas, the poor guy is finally getting some sleep and gaining some weight. But my poor friend is DEVASTATED. She REALLY wants to EBF. Every 2-3 hrs she gets him on the boob (so he won't forget how) or a bit, then pumps, then makes him formula (mixing it with her little bit of pumped bm).

* Is there more she should be trying to do?
* Has anyone been through something similar?
* What is the longest time it can take for milk to come in?
* She mentioned a DRUG for helping lactation. Anyone heard of that?

Any advice will be GREATLY appreciated.


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## MCatLvrMom2A&X (Nov 18, 2004)

I would advise her to use a SNS that way even tho he is getting formula he would be getting it while sucking on the breast. This will also stimulate more milk production and stop nipple confusion. Remind her that even tho she is using a good pump some woman just cannot get much milk that way. Me being one I would soak thru shirts from collar to hem but still not be able to pump more than a oz. at a time. My body just wont respond to a pump.


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## Synchro246 (Aug 8, 2005)

I wanted to second the notion of not relying on the ammount that can be pumped as being a good indicator of milk supply. Having said that though obviously there was an issue because that seems to me to be a substantial weight loss.

NO, repeat NO, bottles. Using and SNS is great (though I acknowledge those are kinda pricy). If she can't afford one of those, and because this issue will probably not be persistant she can use a small oral syringe or a small cup to serve the supplement. If she already has used bottles no need to fret as long as he's still nursing, just don't continue to risk nipple laziness/confusion any more.
*ANY suckling needs to be done at the breast for two reasons 1) to encourage her to make as much milk as possible ASAP and 2) so that the darling baby continues to like/need/want to suckle at the breast.*

If she is one who just isn't responsive to a pump no matter how much she makes I don't know how to tell when to start getting off the supplement. I'm sure there are ways to know. When she does get off the supplement she will be able to know there is enough milk by the number of poopy diapers and by his weight gain.


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## leerypolyp (Feb 22, 2005)

Wow, that's hard. It sounds like she's doing a lot, and could use a hug and a pat on the back. I know there are lots of women on here with a wealth of knowledge on the topic, and I haven't been through this myself, but just so you get a reply quickly, I'll chime in:

1. Get a Lact-Aid or an SNS so she can supplement at the breast. That way the baby is getting formula and breastmilk, and providing sucking stimulation as well. A baby's mouth is usually way better than a pump at extracting milk.

2. There are two drugs that can help with supply -- Reglan and domperidone. The second is harder to get thanks to the FDA, but often more effective with fewer side effects.

The thing is, unless she and her HCPs can figure out what's going on, it's hard to know which suggestions will help the most. Did she have IV fluid during labor? Any drugs? Does she have PCOS?


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## Marni (Sep 11, 2003)

Thank you SO MUCH ladies!!!

one ignorant question though ....

What is an SNS???


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## FreeThinkinMama (Aug 3, 2004)

My milk didnt come in until day 5, by that time my ds had dropped from 8.12 to 7.7 and was ketonic (starting to get dehydrated and on the brink of being hospitalized). Your friend did the right thing supplementing with formula since she can't provide enough pumping. Please reassure her of that, there is so much negativity about formula but sometimes it can literally save a babies life. What we did was nurse every 2-3 hours (on demand and if he went over 3 hours long I woke him up). Then we "topped him up" with formula and some expressed milk (I couldn't pump much either). We had to correct our latch, he wasn't taking enough of the areola in (my areola is huge, like the bottom of a bottle) and this was causing him to not get enough milk and not stimulate production I think. Within 2 days he was refusing the supplements after nursing since he was so full and was gaining steadily. I also second the advice to not use any bottles just now. We topped up ds with a syringe to avoid nipple confusion. He's now 2 months old and nurses like a champ. He was a little tongue tied but not enough to warrant getting it clipped. Has your friends baby been checked for that?


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## MCatLvrMom2A&X (Nov 18, 2004)

A SNS is a supplimental nursing system. It is tubing attatched to a container than holds the formula/expressed bm and the tubing is taped to the breast so that the tip lines up with the tip of the nipple when the baby sucks on the breast he will on the tubing as well and the milk will flow.


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## Dov'sMom (Jan 24, 2007)

nak

supplemental nursing system

bottle hangs vetween breasts, tube from which formuka comes out is along nipple so babyy suckles for formula too


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## the_lissa (Oct 30, 2004)

I second the idea of an sns. She can also pump to try and help bring her milk in and to be able to supplement with her milk, instead of formula.


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## _betsy_ (Jun 29, 2004)

My milk didn't come in until day 6 - up to ten days can still be considered normal, I think I read somewhere. Tell her to nurse, nurse and nurse more. Every hour or all day long if baby will do that.


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## FillingMyQuiver (Jul 20, 2004)

Milk coming in can be so dependent on the birth experience. After I homebirthed DD, I had to be admitted to the hospital the next day and have a DandC for retained placenta. I was under general anesthesia and couldn't nurse DD for 24 hrs. so we had to give her formula. My milk didn't come in for 7 days!!! It worried everyone, including my MW. but she spoke to a LLL leader who said having a DandC can throw the hormones out of whack and prolong milk production. I think she even said that while 3-5 days is considered typical, it could take up to 10.
So, I agree, your friends should get an SNS or LactAid to help stimulate milk production. Also, get her some fenugreek, have her take it to the point she smells like maple syrup.
Tell her to stay in bed and nurse all day and to try and keep her stress at bay b/c that will also affect her milk supply.
She should be nursing/ pumping more frequently. There are NBs that nurse every 2-3hrs, but in my experience, it's usually every 1-2hrs, so she needs to stimulate the [email protected]@ outta her breasts.

I hope she finds relief soon. I have a little brother who will be 2 in April and I watched my mom struggle w/ bfing and providing enough milk for him. Regardless of ALL the things she did right, her body just couldn't do it (she was 48 when she had him) and at 4mo, her milk literally dried up and wouldn't produce a drop one morning. She had already been supplementing b/c of reduced supply. I know how frustrating bfing can be and have seen how much emotional pain can be experienced when you feel like your body is failing you. Please, have your friend take care of herself and to be gentle w/ herself.


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## kathryn77 (Mar 11, 2007)

Quote:


Originally Posted by *Marni* 

Every 2-3 hrs she gets him on the boob (so he won't forget how) or a bit, then pumps, then makes him formula (mixing it with her little bit of pumped bm).


I had a problem with my supply until I finally stopped doing this (well, not the supplementing, but the scheduling). Kyle's weight dropped really fast, and the dr was really wanting me to supplement. But instead, we nursed literally around the clock for 24 hours. And then I nursed WHENEVER he wanted. Regardless of it it has been only 15 minutes from when he had stopped the last time. His weight immediately started going up. For the first several weeks he nursed a LOT. By about 6 weeks we were back to every 2 hours and he was happy in between and his weight gain was good.


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## polyhymnia (Jan 6, 2007)

A friend of mine was concerned about this and she was able to rent/borrow (forget which) a hospital scale - although I am sure a regular sensitive scale would work too - and she would weigh her baby, nurse her, and then weigh her again. This way she could track how much milk the baby was getting and decide when to supplement or not. She was able to use donor milk from another friend of ours rather than formula but it amounted to the same thing. She used an SNS also. Good luck


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## Synchro246 (Aug 8, 2005)

Quote:


Originally Posted by *FillingMyQuiver* 
Milk coming in can be so dependent on the birth experience. After I homebirthed DD, I had to be admitted to the hospital the next day and have a DandC for retained placenta. I was under general anesthesia and couldn't nurse DD for 24 hrs. so we had to give her formula. My milk didn't come in for 7 days!!! It worried everyone, including my MW. but she spoke to a LLL leader who said having a DandC can throw the hormones out of whack and prolong milk production.

I don't know about the D&C, but I do know that a retained placenta in and of itself will cause a delay in milk coming in. The birth of the placenta and the subsequent change in hormones (the placenta is a BIG hormone producer) is what signals the body to start producing milk.

I can't wait for an update from the OP.







hint hint.


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## the_lissa (Oct 30, 2004)

I had a D&C for pph and no problems with my milk coming in.


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## sedalbj (Mar 17, 2004)

Quote:


Originally Posted by *crayolaab* 
A friend of mine was concerned about this and she was able to rent/borrow (forget which) a hospital scale - although I am sure a regular sensitive scale would work too - and she would weigh her baby, nurse her, and then weigh her again. This way she could track how much milk the baby was getting and decide when to supplement or not. She was able to use donor milk from another friend of ours rather than formula but it amounted to the same thing. She used an SNS also. Good luck

This is what I was going to say, put a dry diaper on the baby, weigh them, feed on both sides, weigh again and you can calculate the oz the baby has gotten. It would help her decide how much to give (formula or donated) and would also show her progress and give encouragement as her milk supply builds (using an SNS)... Our local bfing center will do weight checks like that for a few dollars, as often as you want.


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## spughy (Jun 28, 2005)

This happened to me. I had extensive bleeding after my DD was born and a suspected but never confirmed very tiny bit of retained placenta. (I bled for 12 weeks pp). My milk never really came in, I had to supplement. I experimented with an SNS but found that it was counterproductive in that my milk flow was slow, and the baby would get filled up before my boobs were completely emptied when using the SNS. What I did - and it was a HUGE pain in the ass and completely took over my life - was top up after each feed with a syringe (we switched to a bottle at about 6 weeks). DH did this while I pumped to get every last drop out on every feeding. It was hell. But it worked. Also, I went on DOMPERIDONE which is the drug that helps lactation and it boosted my supply quite a lot. And I just kept working at it. As she grew out of the sleepy newborn stage I started feeding her as often as I could, typically every hour or hour and a half. Gradually the amount I had to supplement decreased and eventually - at 4 months - we didn't need any supplementation anymore.








to your friend. This will probably be the hardest thing she ever has to do. She needs support and a shoulder to cry on. I still get upset thinking about the hell I went through and the horror I felt at giving my baby formula. But I'm SO glad and so proud of myself for sticking with BF'ing and not giving up.


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## Amila (Apr 4, 2006)

Tell her to try eating lots of oatmeal! It really works.


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## sue2u (Feb 14, 2007)

I'm not in this DDC but I used a Medela SNS you can get it on the Medela web site, or you can get a Starter SNS from any lactation consulltant who carries any supplies with them. The starter ones are only a temporary one, but I kept cleaning mine and used it for almost a week until it broke. I got mine from a LC at the WIC office. That saved me!!! I did have to buy the actual SNS though. It only took about 2 weeks of nursing with the SNS and I was EBFdng. It cost around 56.00 but it was well worth it!!! Once she gets the SNS I would stop pumping b/c even with the best pump, you still won't get as much as a baby can get. kwim?


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## attachedmamaof3 (Dec 2, 2006)

Tell her to check out kellymom.com. Stop supplementing, have baby nurse nurse nurse. My milk didn't come in for 8 days with my first. This can be normal and the more she supplements, the less milk she's stimulating to be produced.


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## The4OfUs (May 23, 2005)

Quote:


Originally Posted by *kathryn77* 
I had a problem with my supply until I finally stopped doing this (well, not the supplementing, but the scheduling). Kyle's weight dropped really fast, and the dr was really wanting me to supplement. But instead, we nursed literally around the clock for 24 hours. And then I nursed WHENEVER he wanted. Regardless of it it has been only 15 minutes from when he had stopped the last time. His weight immediately started going up. For the first several weeks he nursed a LOT. By about 6 weeks we were back to every 2 hours and he was happy in between and his weight gain was good.









: Ditch the clock, and the supplement, and get that baby on the boob a lot more than every 2-3 hours! Up until about 12 weeks, I swear my DD nursed every 1-1/2 hours...and that timing is from the BEGINNING of one feeding to the BEGINNING of the next - NOT from the end of the feeding until the beginnig of the next. So, it may even look like this:
Nurse: 10am-10:15am
Nurse again: 11:30am-11:45am.
seems like it's only been 45 min, but it's really been an hour and a half if you go from 10am to 11:30am. And yes, for the first few months, it may be just about all you do, is nurse your babe...but if that's what they need, that's what they need.

Do you have an update, I hope??


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## spughy (Jun 28, 2005)

Quote:


Originally Posted by *The4OfUs* 







: Ditch the clock, and the supplement, and get that baby on the boob a lot more than every 2-3 hours! Up until about 12 weeks, I swear my DD nursed every 1-1/2 hours...and that timing is from the BEGINNING of one feeding to the BEGINNING of the next - NOT from the end of the feeding until the beginnig of the next. So, it may even look like this:
Nurse: 10am-10:15am
Nurse again: 11:30am-11:45am.
seems like it's only been 45 min, but it's really been an hour and a half if you go from 10am to 11:30am. And yes, for the first few months, it may be just about all you do, is nurse your babe...but if that's what they need, that's what they need.

Do you have an update, I hope??









That sounds like great advice and when my DD was a newborn I TRIED SO HARD to do that, but she just wouldn't. wake. up. Sleepy babies are a real problem if you have low milk supply and if you have a sleepy babe, there is no way you can nurse every half hour. Really. If you were able to nurse your babe every half hour or even hour when they were less than 6 weeks old, COUNT YOUR BLESSINGS.

Sorry. I need to extricate myself from this thread. It is bringing up too many painful memories. But please - before you advocate ditching the formula/supplement and "just nurse!"ing, understand that that does not always work, and can be dangerous advice. It sounds like the OP's baby lost quite a lot of weight and probably DOES need supplementation. The discussion should be around the best way to do that with an eye to eventually weaning off.


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## The4OfUs (May 23, 2005)

I'm sorry that you had problems and my post hurt you - I went through sleepy baby with my firstborn, and latch problems, thrush, and overactive letdown with my second, so my nursing relationships haven't been all sunshine and roses. I just wanted to make sure that the OP's friend was not waiting to put babe on the breast and doing it whenever possible; NOT watching the clock to see if it was "time" to nurse. And, if she is able to nurse the babe more often (I didn't see any reference in the OP about a sleepy baby preventing nursing) then she should ditch the supplement in order to increase her own supply.

I didn't mean to offend or make anyone feel badly, just wanted to be sure that the OP's friend was getting every opportunity to continue EBF as she wanted to.


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## chandasz (Apr 13, 2005)

Does she have thyroid problems? My cousin has graves and her milk never came in-- even with the medications. Sucks and rare but it does happen. Get a thyroid check!


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## Marni (Sep 11, 2003)

Bumped to update -- see OP at top of thread.

THANK YOU!!!!!


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