Re: Milk not coming in
When you say her mikl isn't in, what do you mean exactly? Is she getting nothing when she pumps, is she getting just colostrum (yellowish, nearly transparent fluid) or is she getting mature (whitish-cream colored) milk but only in small amounts? The reason I ask is that many people think that a mom must experience significant engorgement or produce a large volume of milk in order for milk to be in, when that is not actually the case.
In general, the best thing a mom can do to make her milk come in is to nurse frequently. A baby who is nursing effectively is usually all that is required to make milk production start. However, if the baby is not nursing effectively, milk production may be reduced or delayed. In that case, a mom will need to pump in order to get her milk supply going.
It is extremely rare for a mother to be physically unable to produce milk. Most cases of low milk supply are due to failures of breastfeeding management or to mechanical issues (like a baby who is unable to suckle effectively). But there are certain conditions which can impact a mother's physical ability to produce milk, including:
- thyroid issues, which are common in the postpartum period
- PCOS (polycystic ovarian syndrome)
- retained placenta fragments
- previous breast or nipple surgery (breast augmentation or reduction)
- pregnancy (no chance in heck of this one, I'm willing to bet!)
- use of hormonal contraceptives (not true for all women, but true for some!)
- possibly use of magnesium sulfate, a drug which is often given to women who experience preeclampsia or eclampsia
- overuse of IV fluids during birth- AFAIK fluid overload and extreme swelling can result in delayed milk production
The best things you can do to get nursing on track is to nurse frequently, keep the amounts of formula in the bottles small (1 oz is a good amount), and pump after feedings using a high quality pump (I suggest using a hospital grade rental with correctly sized shields). And the best thing of all to do is to see another lactation consultant, preferably an IBCLC. Hands-on help and a second pair of eyes may pick up on some detail that will make all the difference.
Keep us posted, and let us know if any of the above looks familiar.
Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
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