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Thread: Keeping milk flowing *after* it has come in

  1. #1

    Default Keeping milk flowing *after* it has come in

    Hi LLL,

    My mom has been a very big fan of your movement, and I'm looking for help. We have a 1 week-old who is trying to feed every 1 hour at night but can sleep 3-4 hours during the day. We want to go breast-feeding only. However, we have some issues to solve.

    Our baby does appear to be gaining weight, though we went to the pediatrician today and weighed her both before and after breast-feeding, which produced a 4 ounce difference before and after. The previous weight had been between these two numbers 3 days ago, so I guess our daughter is at least not losing weight. We think she was weighed just after feeding 3 days ago, so this would place her at +2.5 ounces since then comparing to the after-feeding weight.

    One problem is that our daughter was breech, and we waited until after full term for her to turn and tried a manual turn but it never happened, so we were forced into a c-section. My wife is a very scheduled sleeper and always slept nights, but now the baby wants to be up mostly at night. My wife is now trying to recover from the surgery, but is unable to sleep in the day very much and our daughter won't let her sleep at night - well, we can just let her cry for an hour or two which we have been doing so my wife can get a little sleep (I hold her, and so does my wife's mother, but the baby doesn't care, she wants to eat).

    One thing that seemed really hopeful is that our daughter started strongly rooting and feeding right away only an hour after the surgery and never stopped that behavior. Then my wife's milk seemed to come in on time, about 4 days after the birth.

    The problem now is that it seems one of her breasts has gone dry and she cannot get it to express. I'm worried that because of the surgery and the lack of sleep that the milk is beginning to stop. Neither of us want to turn to formula. Please help if you have any suggestions on how to keep the milk from drying up.

  2. #2

    Default Re: Keeping milk flowing *after* it has come in

    Hi there, I'm a newbie posting here but saw this and thought you might find the following links useful: http://www.llli.org/nb/nbearlyweeks.html

    You're doing so great at supporting the momma during her recovery. She is recovering from surgery and really the best bet is to have her rest/sleep when baby is sleeping (even just lying down while baby rests!!!). Babies are often born with schedules that are opposite of ours so your wakeful daughter is simply continuing the schedule she was maintaining in utero.

    Making sure that mom is doing hand expression the right way is important- http://www.lactationinstitute.org/MANUALEX.html and http://www.llli.org/nb/nbjulaug07p168.html
    but don't worry if baby is nursing fine on that side (you can hear swallows, etc).

    I encourage you to seek in-help assistance from a LLL leader if one is close to you and available. What a great job you're doing to seek out help for your wife/daughter!
    Punk-rock luvin mate to DH and mama to DD1 (born '03) , DD2 (born '08) and nursling DS (born '11) who survived infant botulism.

  3. #3
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    Jun 2009
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    Default Re: Keeping milk flowing *after* it has come in

    Congratulations on the arrival of your baby! Thank you for supporting your wife & baby.

    At one week it is entirely normal for a baby to want to nurse that often, and very important that baby nurse as often as baby wants-as long as it is a minimum of 12 times a 24 hour day. Minimum. And night and day is irrelevant to this young a baby. This will get better, but that is how it is in the early weeks. I also had two c-sections and the recovery from surgery is very difficult, but all new mommies need to learn to sleep in snatches when they can, expecting a regular nighttime stretch is unrealistic on every level for quite some time. Even bottle, formula fed newborns need feedings throughout the night. Personally I found when I was able to get off the narcotic-based painkillers (they prescribed way more than I needed) life became much more manageable. Support your wife in finding ways to nap during the day. This is vital.

    I am confused about what you are asking about weight. Are you saying your baby took in 4 ounces in one nursing session according to a before and after nursing weight check? That would be rather remarkable intake for this age! A very well nursing baby of one week would typically take 1-2 ounces per feeding, going up to approximately 2 ounces per feeding at age two weeks, and eventually typically getting to be about 3-4 ounces per feeding after week 4 or 5 or so. This is why babies need to be fed very, very frequently. Also babies nurse for comfort as well as food, and this is entirely normal and very important for breastfeediing going forward.

    Generally, weight gain goes like this: Most babies lose several ounces post birth, and then from day 5 or so, begin to gain, getting up to a gain of about an ounce a day at about a week or two, with a regain back up TO birth weight expected by 10-14 days old. Of course it is fine if your baby is gaining faster than this. Baby must be weighed on the same scale in a dry diaper or naked every time, or the weight check could well be off.
    Output (poops) is the other way to tell baby is getting enough milk from nursing.

    I agree with pp, if your wife has concerns or questions about breastfeeding, she could really benefit from chatting with an LLL Leader and/or attending a meeting. (She or you can call ANY LLL Leader anywhere if there is no one local to you, some Leaders prefer to only speak with the mom.) You or she can ask if you could come as well to the meeting if she cannot drive yet, also she could bring a friend. I also strongly suggest the book The Womanly Art of Breastfeeding (8th edition, 2010) and the following articles:

    What is normal in the early weeks: http://kellymom.com/bf/normal/newborn-nursing/

    Frequent nursing: http://kellymom.com/bf/normal/frequent-nursing/

    and nursing after a c-section: http://kellymom.com/ages/newborn/new...rns/c-section/

    Diaper log (for tracking poops) http://www.llli.org/docs/00000000000...diaper_log.pdf

    Laid back nursing-restful, comfortable nursing position for mom (baby can be adjusted to any position to avoid coming into contact with incision site: http://www.llli.org/docs/00000000000...astfeeding.pdf and www.biologicalnurturing.com for more info.

    Nursing cues: http://www.llli.org/docs/00000000000...eding_cues.pdf

    For dads: http://www.llli.org/docs/00000000000...t_partners.pdf
    Last edited by @llli*lllmeg; July 24th, 2012 at 04:11 AM.

  4. #4
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    Default Re: Keeping milk flowing *after* it has come in

    Nursing on demand is e best way to keep milk flowing. And this means mom is going to miss sleep. Can she nurse laying down? That is a very helpful position for any mom.

    Mom wanting to sleep all night is unrealistic, unfortunately, and totally unfair to baby.

    Babies often have night and day reversed, and it takes some weeks to reverse this trend. But that is why she eats at night

    Just because mom can't express any milk does not mean milk isn't there.

    Check out the links given Lots of good information there.
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

  5. #5
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    Default Re: Keeping milk flowing *after* it has come in

    i loved sidelying nursing, and i made it my priority to learn our first week home. i found this helpful:
    http://mother-2-mother.com/tut-layingdown.htm

    but i have also heard from a number of c-section friends that twisting and lying on their sides was just not possible until about a month or 6 weeks. maybe others have suggestions of laying down positions that are c-section friendly?
    DS1 6/7/11
    DS2 10/29/13

    Nursing, pumping, cloth-diapering, babywearing, working professor mama with the awesomest SAHD ever.

  6. #6
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    Default Re: Keeping milk flowing *after* it has come in

    Laid back positioning as I posted above can be very c-section friendly as long as baby is not placed in such a way where baby kicks mom's incision. Ouch. For a sitting up position, I found that the clutch or football works well post c-section, but really best to lie down as much as possible. As I recall I was able to side-ly as well but its been a few years I could be forgetting.

  7. #7
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    Default Re: Keeping milk flowing *after* it has come in

    I had a vertical incision and I also agree that side lying was very painful something that helped me TREMENDOUSLY was to wrap my abdomen tightly, even wearing 'girdle panties' my OB suggested them from day one but I was all whatever I don't need that and I regret every minute I was not utilizing them in the post opp days, even before the staples came out. and Keep us posted.

    oh and call your local leader ASAP for in person support!!! it was the best decision I ever made!!!
    Autumn
    Moma to *Silas* 10-30-07

  8. #8

    Default Re: Keeping milk flowing *after* it has come in

    Thanks to everyone for the helpful suggestions and links. We have noticed that our daughter does swallow on the breast that my wife was having trouble expressing, and she was just now able to express some on that side.

    Also, I didn't mean to give the impression that my wife wants to sleep through the night and leave the baby out to dry. Our problem is that my wife has a very tough time sleeping during the day, particularly because of the surgery pain, but is then up every hour or 2 (2 when we give her an hour respite by trying to calm the baby) at night. Note that at night the baby is often feeding 30 min at a time (15 min each side is typical), and then gets sleepy for 30 min before waking for more. My wife is willing and able to feed at night, she just isn't getting sleep and I worry about that in terms of healing and keeping milk production up. My question was really about the milk production on lack of sleep and was not meant to be about how to allow my wife to sleep nights against the baby's schedule.

    I've been reading the links, all very helpful.

    Also, in terms of feeding positions, my wife has a horizontal incision and has been able to feed on her back and on her side (the side is more painful, but now that she is a week out it is getting less so). She is taking ibuprofen for the pain (our midwife has suggested it only minimally effects the breast-milk) and though she's been prescribed a narcotic she has forgone taking it. She mainly feeds on her back or sitting up with pillow underneath, since the incision is quite far down her abdomen the back position isn't too bad and our daughter doesn't kick.

  9. #9
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    Default Re: Keeping milk flowing *after* it has come in

    It sounds like things are going quite well. Great your wife has found some positions that work for her. As long as baby can nurse and poops and weight gain is on track, there is absolutely no reason to even worry about expressing milk via hand expression or pumping unless it is needed due to mom getting engorged. Otherwise expressing milk is extra unneeded work. Yes of course whatever your wife needs to take to manage the pain, even including any prescribed narcotics, is fine, proper pain management is vital. I just personally found my doctor expected me to take the narcotics long after I needed them & could switch to the power Motrins only, and the narcotics made it much harder for me to feel rested or in a positive mood.

    Lots of folks are concerned about the need for lots of sleep in order to recover. Of course it makes sense, but somehow, throughout millennia moms have managed to recover from difficult pregnancies and every imaginable type of very tough labors and yes even surgery while nursing around the clock. Babies need what they need no matter how tough the birth and recovery are. Milk supply is simply not that fragile, if it were, we never would have survived as a species. For the vast majority of women, as long as they keep telling their bodies there is a live, healthy baby that needs their milk by nursing frequently, milk production is fine.

    I suggest you keep helping your wife by doing EVERYTHING else for her so she can concentrate all her energies on herself and feeding baby. Feed mom, take care of the necessities around the house, keep visitors to a minimum and try to see that they are helpful and positive, take baby when needed so mom can take care of her personal needs, and keep telling her she is beautiful and doing so great. I will never forget how well my husband took care of me in the early days with our kids, still brings tears to my eyes. Ypur support is absolutely vital to breastfeeding 'sucess,' however you and your wife define that.
    "Sleep when the baby sleeps" sounds quaint but it is really a survival technique. If daylight or noise is keeping mom up, try dark curtains and white noise machines or fans, etc. Unplug the phone and put a do not disturb sign on the door. Seriously, being able to nap even for very short cat naps makes a world of difference. Your wife could also consider encouraging baby to nurse more often during the day and see if that helps get a slightly longer stretch at night, but particularly this young who knows if that will help at all. Newborns and nursing change very quickly in the early weeks and months, it will not always be this intense!

  10. #10
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    Default Re: Keeping milk flowing *after* it has come in

    If daylight or noise is keeping mom up, try dark curtains and white noise machines or fans, etc.
    THIS. I have trouble sleeping during the day as well, and black-out curtains and a ceiling fan help tremendously.

    As lying on her side gets more comfortable, she'll probably find that side-lie nursing helps her get more sleep. I think that that was the only reason I got any sleep at all for the first few months of DS's life!

    It will get better. One week is still so very new!
    Breastfeeding, babywearing, sci-fi loving, total geek of a mom!

    Be who you are and say what you feel, because those who mind don't matter, and those who matter don't mind. — Dr. Seuss

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