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Thread: no breast milk despite all efforts

  1. #1

    Default no breast milk despite all efforts

    I had a c-section 3 months ago, found I had no breast milk in the days that followed. About 5 days after the c-section, I started pumping 8-12 times in a 24 hour period and also consumed fenugreek and other lactation support galactogogues. I finally started making about 2 oz of milk a day which over time increased to about 5 oz a day. During this time (approx 2 months after my c-section), my son was mostly formula fed. I would nurse him first everytime he was hungry and then later gave him formula - a practice that I continue till today. After nursing him, I would pump. I am no longer able to pump as frequently since a couple weeks ago.

    My question is - it seems that I have followed every bit of advise, ie frequency of pumping, nursing, eating lactation support items, why is my milk supply not increasing? I just got my period and the small amount of milk that I did produce has also diminished. How do I find out what the problem is? Are my prolactin levels low? How do I find out if they are low?

    I want to identify what the problem is so that there may be a possibility of doing something about it when I have my next child. BTW, I am 38 yrs old and this is my first child. I have been assured age has nothing to do with my troubles and neither is the fact that I had a c-section. I also consulted 3 lactation consultants and they are as confounded about the problem as I am.

    Please help!

  2. #2
    Join Date
    Mar 2013
    Location
    Illinois
    Posts
    102

    Default Re: no breast milk despite all efforts

    What kind of pump are you using?
    Happy Mama of 4 beautiful boys ages 14, 10, 7 and the newest member of the family:
    Damian Gabriel 2/13/13 , , twice a day at work, and finally successfully. We never gave up and we are as happy as can be !!

  3. #3

    Default Re: no breast milk despite all efforts

    i am using hospital grade medela symphony breast pump.

  4. #4
    Join Date
    Jul 2010
    Location
    New York
    Posts
    860

    Default Re: no breast milk despite all efforts

    greetings Dotsnotfeathers!
    Your breastfeeding glitches could have multiple causes.
    However, it would be helpful if the lactation consultants who are confounded offered some explanation.
    although the issue of relactation and infant suck retraining is not what you asked information about , that avenue is open,
    i have been told that certain health factors impact a mothers ability initially make milk.
    1. Loss of a significant amount of blood during/after delivery
    2. retained placenta fragments
    3. Never experiencing breastmilk coming in during first week. if mother never has that early hormonal first milk production that could indicate other factors are impacting ability to make milk
    a. insufficient glandular tissue
    b. breast injury
    c. breast surgery
    4. Milk production depends on stimulating the breasts to produce milk every 2 hours around the clock. Hospital grade rental pump and hand expression to finish off the pumping session.
    DD#1 July 1986 VB
    DD#2 April 1988 c/sec
    DS#3 April 1990 VBAC
    DS#4 June 1993 VB
    and suprise!
    DD#5 April 2001 c/sec
    BTDT scars and stretchmarks,: wrinkles and grey hair

  5. #5

    Default Re: no breast milk despite all efforts

    thanks for that response. I lost about 800cc of blood during surgery; as far as i know the surgery did not leave me with any placental fragments (the doctors explained the surgery to me as it was being performed); i do not have any breast injury or surgery and I did pump and nurse (so i could get the necessary breast stimulation from my son) every 2 hours for the first three months after the surgery. My son is now a little over 3 months old. What I did not experience is any breastmilk coming in during the first week - this is where I feel the problem lies. i pumped at the hospital on my last day there (which is day four after giving birth) and didnt get much but a few drops of milk from one breast only. I cant seem to find any information on what are the possible factors that could impair my ability to make milk. If you could shed a little light on that, i would be grateful.

    Also, I would appreciate it if you could expound the idea of relactation a little more. Is this something I can consider at this stage as a way of producing more milk? My son seems to latch on just fine but he sucks on the nipple as he does on his bottle ie he wraps the nipple in his tongue and then sucks for milk. Since i have no experience in what the sucking mechanism should be like (except the videos i have watched), i dont know if he is trying to extract milk from the breast in the appropriate way.

  6. #6
    Join Date
    May 2006
    Posts
    21,246

    Default Re: no breast milk despite all efforts

    The most common reason for low supply is a problem with breastfeeding management. A bad latch. Not nursing often enough. Scheduled feedings. Time limits at the breast. Use of a nipple shield (only rarely problematic). Unnecessary formula supplementation. Pumping instead of nursing. Using an underpowered pump or poorly fitting pump shields. Use of certain forms of hormonal contraception.

    If none of these factors apply, then you're left with the rarer causes. Breast surgery or injury. Retained placenta fragments. Thyroid issues (either hyperthyroidism of hypothyroidism). PCOS. Insufficient glandular tissue (IGT). A baby who is unable to suckle due to something like a tongue tie or a suck-swallow coordination issue (which seems possible, given your description of your baby's nursing style). Another pregnancy.

    If you rule out everything on the above list, then... Well, then you're left with a real mystery.

    Relactation works on a supply = demand principle. Demand more from your body, by nursing more or pumping more, and it will supply more milk, as long as there is no physiological reason preventing your body from making enough milk. This is possible because milk production is not controlled by your reproductive hormones, but by hormones produced in your pituitary gland. Stimulation to the breast by suckling or pumping causes the pituitary to pump out Prolactin (the milk-making hormone), and Prolactin directs the breast to make milk. Practically, you'd want to get a double electric hospital-grade pump with properly fitted shields and use it for 10-20 minute sessions at least 8-12 times a day, with more sessions being better than fewer. The issue with this is that you've already tried it. It does no harm to try again, but it's not gauranteed to work.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  7. #7
    Join Date
    Jul 2010
    Location
    New York
    Posts
    860

    Default Re: no breast milk despite all efforts

    You are feeling bewildered, yes? I wonder if a face to face session with a highly recommended board certified private practice IBCLC who takes insurance might be the way to go.
    DD#1 July 1986 VB
    DD#2 April 1988 c/sec
    DS#3 April 1990 VBAC
    DS#4 June 1993 VB
    and suprise!
    DD#5 April 2001 c/sec
    BTDT scars and stretchmarks,: wrinkles and grey hair

  8. #8
    Join Date
    Jun 2009
    Posts
    5,735

    Default Re: no breast milk despite all efforts

    I also consulted 3 lactation consultants and they are as confounded about the problem as I am.
    can you tell us more about this?

  9. #9
    Join Date
    Apr 2013
    Location
    Salt Lake City
    Posts
    86

    Default Re: no breast milk despite all efforts

    It sounds like your son is sucking the right way. A baby wraps his tongue around the nipple to take it far back into his mouth. I think it's so fantastic that he's learned to do it and is willing to do it every time even with the obstacles.

    I wanted to weigh in on the pumping issues, because I have experienced problems with my pumps, too. My single electric pump actually works best for me. I just got a single manual pump and it works better than my double electric. I really think that every woman responds differently to each kind. Something as simple as a bad association with the pump you have could be causing it to work less efficiently, in my opinion.

    First, are you able to hand express any milk after pumping goes dry? Feel your breasts and see if there are any lumps or firm spots. You can press on them gently and see if milk comes out. You can also massage around the areola and nipple to try to express milk.

    I also suggest trying another pump. A single manual pump is a good option because you can find one for around $20. Try it after pumping with your double electric to see if there actually is still milk left behind.

    And if you haven't already, then make sure you are using the right size flanges/shields. If your nipples are touching the sides while you pump it can be restricting the milk flow and you'd want to try larger ones.

  10. #10
    Join Date
    May 2013
    Location
    Oregon
    Posts
    115

    Wink Re: no breast milk despite all efforts

    Hi! Your story sounds similar to mine. I tend to agree with the last poster in that you might try a different pump. I don't think my milk really came in until strangely, about 5 weeks post birth (also cesearean) at which time I got really sick with norovirus and after my recovery I was spraying milk. My body is such that at the slightest hint of any illness, or recovery from that surgical birth, and it conserves all its resources for me, leaving very little for my baby.
    Recently I had to use the manual attachment for my double electric pump while I was out with friends for about 4 hours, away from baby. It was a single manual pump and I got more by hand, in a non-relaxing setting than I do at work in one pumping with relaxing sounds on my headphones and staring at photos and videos of my little guy. This was sitting in a car in a parking garage, never having used this pump before and boy, did it take a lot of arm strength! 7-8 minutes on each side with the manual produced a bottles worth versus 15-20 minutes with the electric. So maybe just experiment.
    Also the psychology of this: I notice you are saying you are "making no milk" but you ARE making milk, you can't be sure of how much, from what I hear you saying. I found that at first I would get myself all worked up "ah! he's not latching (this was at the 6 week mark when he was having trouble), I'll never be able to nurse him" or later on when I would get sick or start to show signs of restarting my menstrual cycle and my pump output would dip, I would start to have those spiraling thoughts again, that I wouldn't be able to continue nursing him. The fact is you are still doing something and you are a success! And so is your baby, obviously loving to nurse even with all the formula.
    My baby eventually tapered off formula and I figured out I was then making enough milk. He is now 8 months and is an awesome little guy who still loves his nursing time when momma is with him and gets expressed milk while I'm away.

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