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Thread: Milk not in - help!

  1. #1

    Default Milk not in - help!

    I'm actually writing on behalf of my best friend, who just had a baby early Tues morning. So DS is 4.5 days old and her milk hasn't come in yet. Ped is very worried about weight loss and is pushing formula. She started giving him formula via a syringe RIGHT next to her breast (DH is an ER doc, don't worry!), but ped wants her to switch to bottle so he gets more. At their appt today, they tried the bottle the first time and he downed it in 3 min flat. When she nurses with the syringe, it's up to 45 min. He's already starting to be a bit resistant to the breast (won't open his mouth, turns his head, etc) and she's worried that switching to the bottle - even if only until her milk comes in - will exacerbate that issue.

    Thoughts? Should she keep him off the bottle and just give him formula via the syringe or switch to bottle?

  2. #2
    Join Date
    May 2006

    Default Re: Milk not in - help!

    Welcome to the forum!

    If your friend can get hold of an at-the-breast supplementer (e.g. Medela Supplemental Nursing System or Lact-Aid), that would be ideal, because she could supplement and nurse at the same time. If not, there's no reason to use a bottle unless the baby is unable to get sufficient supplement via syringe, cup, or finger feeding.

    4.5 days is a bit late, but not out of range for the onset of mature milk production. But now is a very good time for mom to be looking into potential causes of delayed production, and she should be working with a lactation consultant, preferably an IBCLC as she does so.

    Some things to think about:
    - Did she have a difficult birth- lots of IV fluids/a c-section/high volume blood loss/problems with the placenta?
    - Was the placenta delivered in one piece? (She should check with her ob or midwife.)
    - Does mom have any health problems that could impact breastfeeding, including PCOS or a history of thyroid disease?
    - Has mom had any breast surgery or injury, including breast augmentation or breast reduction?
    - How does nursing feel? Is it comfortable or is mom in pain when baby nurses, or after nursing?
    - Is the baby particularly sleepy, jaundiced, or non-demanding?
    - How many times does the baby nurse in a 24 hour period? It should be at least 10-12, and more would be preferable at this point.

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