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Thread: Milk supply not coming in?

  1. #1

    Default Milk supply not coming in?

    I had my baby about 3 weeks premature. I had an emergency c-section since she was in the 1st percentile of weight for gestational age on my 36.5 week ultrasound.
    From the beginning, she was put on a bottle due to hypoglycemia when she was first born. She spent 4 hours in the special care nursery and then was brought to me. I was allowed to breastfeed the first day, and she latched ok but was extremely sleepy at the breast. I had to use SNS with formula because, at 4#11oz, my baby couldn't afford to lose the usual 5-10% of her weight during her first couple of days. Then, she needed to go under the lights for jaundice. I had to bottle feed for that 24hrs since she wasn't allowed to be taken out from under the lights for breastfeeding. Once that was resolved, my baby no longer latched. I could get her on with a nipple shield only, and she remained very sleepy at the breast. We were prescribed a feeding schedule of 1.5oz formula or breastmilk 10 times per day, with breastfeeding allowed only 2-3 times per day (pediatrician didn't want her to expend energy at the breast). I rented a hospital grade pump, but was only able to get 10-15 mL per 15 minute pump (every 2-3hrs).
    I have had supply problems ever since. My baby is 4 weeks old now, and up to 6#. I am allowed to breastfeed on demand now. My baby is starting to latch directly onto my nipple (however this is inconsistent). She eats ok sometimes, and not so well at others (weigh/feed/weigh results vary from 8 mL to 1.5oz). She is still very sleepy at the breast. When I pump, I get about 20 mL now. I need to supplement her with formula or pumped milk after almost every breastfeeding session (when she cries and roots after breastfeeding for 40+ minutes; she is usually satiated after taking 1-1.5oz from a bottle).
    What's wrong with my supply? Shouldn't my milk be adequate by now? I am taking fenugreek, mother's milk tea, and reglan. I spend 10 hrs per day feeding and pumping, so it's not a supply/demand problem. My pediatrician told me some women just can't do it (have inadequate milk ducts or something). Has anyone heard of this? Any ideas on what else I can do?

  2. #2
    Join Date
    May 2006
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    21,341

    Default Re: Milk supply not coming in?

    Hi Mama! I'm sorry you and your baby got off to such a rough start.

    It sounds like you should really go and see a lactation consultant, preferably an IBCLC. Nothing beats hands-on help when you are struggling!

    Do you still have the SNS? If so, supplement that way instead of by bottle so that your baby doesn't get hooked on the faster flow and start to reject the breast. And keep at it with the pumping, herbs, and Reglan! I know (from experience!) that it is incredibly draining, but it is the best way to increase your supply if your baby isn't doing the job on her own.

    My pediatrician told me some women just can't do it (have inadequate milk ducts or something). Has anyone heard of this?
    Yes, some women can't breastfeed due to insufficient glandular tissue. But the number of women who are truly physically incapable of producing milk is very small, probably <1%.

    Other problems which can cause low milk supply include breast reduction/augmentation, polycystic ovarian syndrome (PCOS), hypothyroid (very common postpartum!), hyperthyroid, and retained placenta or placenta fragments. So go to your OB or primary care doc and get yourself thoroughly checked for any physical problems which could be inhibiting your supply!
    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!"

  3. #3

    Default Re: Milk supply not coming in?

    Other problems which can cause low milk supply include breast reduction/augmentation, polycystic ovarian syndrome (PCOS), hypothyroid (very common postpartum!), hyperthyroid, and retained placenta or placenta fragments. So go to your OB or primary care doc and get yourself thoroughly checked for any physical problems which could be inhibiting your supply! [/QUOTE]

    pcos can cause a low milk supply ? ive read everything i can get my hands on about breast feeding because i have no help at home my mother wasnt able to breast feed and i have come across nothing about pcos relateing to breast feeding please give me a link or something to further my readings....
    Tristen's Mommy
    June 13, 2009 Beautiful Baby Boy
    and loving it !
    Made it 15 weeks !

  4. #4
    Join Date
    Jul 2009
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    Default Re: Milk supply not coming in?

    What a rough start! You're doing an awesome job, mama.

    My thought is that she's growing so much right now that she is trying to increase your supply by nursing a lot. My advice is to let her eat/sleep at the breast as long as she wants. If she fusses when you take her off, put her back on. Lots of skin to skin contact increases milk production, too.

    When my lo wouldn't stay awake to eat, my LC told me to rub his jaw kind of under his ear (the "hinge")- I still do that if I want him to eat more rather than nap. You can also try holding her arm over her head. For whatever reason, that was another suggestion that worked for us too.

    I know it's frustrating and you'll think she's "eating all the time", but she's just trying to increase your supply to meet her needs. You're constantly making more milk to replinish what she's drinking so don't worry about being "empty".

    GL!!
    Sara, Clint & Carter born 01/03/2009


    Full-time working, part-time pumping, absolutely in love with life, booby mama to Carter.

  5. #5
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    May 2006
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    Default Re: Milk supply not coming in?

    Quote Originally Posted by @llli*tristensmommy View Post
    please give me a link or something to further my readings....
    Here you go: http://www.kellymom.com/bf/concerns/mom/pcos.html
    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!"

  6. #6

    Default Re: Milk supply not coming in?

    Quote Originally Posted by @llli*sixyearplan View Post
    What is your dose of reglan?
    I am taking 15mg three times per day.
    Sorry it took me so long to respond- I'm sure you all understand life with a newborn!
    So, I rented a scale and my lo is consistently taking in about an ounce per feeding (about every three hours). Based on her needs, it is about half so we are supplementing with an ounce of formula after each feeding. I am also pumping after each feeding and getting 5-10 mL only.
    My baby is getting better at the breast, not so sleepy. More efficient, too. She gets the ounce in about 20 min. After I reweigh her, I have been putting her back at the breast for an additional 15-20min, but she only takes 2-4 mL in that second 15-20 min, so I'm not sure it's doing anything.

    Question: is it possible to have retained placenta after a c-section? I have a follow up with my OB on Tuesday and I can ask her about that, too. I had my thyroid checked and it's normal. No PCOS, breast augmentation or reduction, or anything else like that.

    Thanks so much for the input!

  7. #7

    Default Re: Milk supply not coming in?

    I was trying to nurse every 2 hours during the day, but it was making me crazy since each nursing/bottle feeding/pumping session takes about an hour, I had no time to do anything else at all, let alone sleep. So my LC said it would be ok to do every 3 hours day and night.
    I am pumping for about 10 min after each feeding. I will look into that hands-free thing- that would make my life a little easier!
    I tried to re-introduce SNS last week, and it didn't go well. It is even more time consuming to prepare and clean/steralize that, than just to breastfeed for a while and then pump. Plus, I am doing weigh/feed/weighs at all feedings for as long as I have the scale rented (another week), and that would mess up the results... My LC gave me a feeding tube system, similar to SNS but it doesn't drip on it's own, to try. My lo wasn't able to get any milk/formula through that at all.
    Well, I'm not giving up yet. I am researching goats rue and blessed thistle now. Maybe those will help! Also checking into getting domperidone instead of reglan.

  8. #8

    Default Re: Milk supply not coming in?

    Hi

    I am having similar problems, my baby (nearly 4 weeks old) was not gaining weight, so the health visitor advised to top-up with formula milk after every feed. As a result we had a weight gain of 500grams over the last two weeks, but now the baby stays on the breast for only 5 mins. I am expressing only 5-10ml after feeds, and regardless the amount of water I drink, the milk supply is not improving.

    Any suggestons to increase the milk supply?

    BR

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