No breast milk....psychological?

[tappingmama]

With my first baby I attempted to breastfeed and the midwives were satisfied that dd was latching on and off home we went. It was 3 days later (hard to believe now) 3 days with a crying and jittery baby until a routine visit from a hv uncovered the awful truth. I thought I was not producing much milk and dd was not interested in feeding but the hv put her finger to the roof of dd's mouth and said she was dehydrated. The hv sat with me and tried to help me express but there was no milk, not a drop. The hv was shocked and sent out for emergency formula feed and bottles. DD was bottlefed and happy as anything once the problem had been identified. Since then nobody could explain why this happened and other hv's said they had never heard of it. Great! So I want to know - am I really as freaky as they think or has anyone else had this one? Got to say - as a result I get pretty miffed with the judgemental branch of the breast is best brigade! :)

I don't want to say anything that might cause further upset, I'm certainly not going to 'judge' you, and breast isn't best, it's normal. It's certainly incredibly rare for a mother to have no milk, but it can and does happen. I don't know enough about specific conditions that lead to this though. It's not surprising that HV's hadn't heard of it either as they aren't really highly trained (the majority of them) in breastfeeding issues.

Have you ever talked through your experience with a breastfeeding counsellor? They're not only there to help with problems as they happen - the counselling part of the role can extend to any feelings of frustration/guilt/grief/confusion associated with BF, even years later. They may be able to give you more information about what might have happened.

It's also important to know that not expressing a drop doesn't mean your baby wasn't getting anything (though, of course, dehydration would suggest it). Some people can't express at all but have thriving healthy babies - there's nothing more effective at removing milk than a baby!

You don't mention how long you were in the hospital for, but if it was only a day or so, three days later, your milk may not even have 'come in' yet. Newborns are often jittery, and yes, they cry a lot - their whole world has been turned upside down and it can be a scary place.

I definitely think calling one of the breastfeeding support lines (LLL, NCT, National etc) and speaking to a specialist might help you, particularly if you're worried about feeding subsequent babies. If not, enjoy your DD, who is a happy and healthy girl. You fed her, perhaps not the way you thought you might, but you did, she survived, all is well. No one has the right to judge you for feeding your baby, but there are steps you can take to feel less judgement, where perhaps there isn't any.

Thanks for your response. Really kind. I was in hospital for the minimum number of hours - so not long enough to really know what was happening or not happening. A friend of mine was training to be a midwife and she used my case as an example at a breastfeeding conference - the expert thought it was most likely psychological. Unfortunatley with child number 2 I was redy for the same thing to happen and so bottlefed from the start. 5 days later I had boobs like hot rocks!! Typical x

At 3 days your milk might not have come in yet - did the midwives/HV tell you it would just be a small amount of colostrum at first?

There are a few things that could have been going on here, and it's impossible really to know which.

First, yes, maybe you could have not been producing milk, but that is very very unusual. We know that there are some medical issues that can cause this (tubular breasts, PCOS maybe - but even then, these tend to produce less milk, not no milk). This is very rare, but slightly more common in people who have needed help to get pregnant, from what I know.

Second, as others have said, three days in, we wouldn't expect tons of milk. For some mothers, milk has come in at this point, for some it hasn't (depends on how the birth was, and how well, and often, your baby has been feeding.) For some mothers it often takes longer than three days to come in.

Third, pumping just isn't as effective as breastfeeding, as mombojombo has said. Plenty of mums breastfeed well for months, but never manage to get anything with a pump.

Fourth, there is a psychological element to let-down. If a mother is too tense (and who wouldn't be, after being told your child is dehydrated, and being poked and prodded), then sometimes let-down doesn't happen.

Did your breasts ever end up feeling full and sore?

A baby who is in serious danger at three days, from being underfed, is generally sleeping a lot - if a baby is not getting food at all, then they often sleep a lot to conserve energy. A jittery crying baby is generally not a starving baby, from what I know.

Ah, sorry, just reread your second post, it sounds as if you are clearly capable of making milk - but the full boobs thing didn't happen, at all, the first time around?

It sounds very very strange that a HV should say this with a baby who is just 3 days old!

Nowadays, the guidance says that no-one should suggest extra formula feeds unless there is a clinical indication - ie a baby who has lost >10% of birthweight, or sometimes an ill or prem baby. In these cases you would expect a paediatrician to be involved, not just a HV. I have never heard of such a diagnosis just on the basis of feeling the roof of the baby's mouth and finding it hard to express (which is very common and doesn't mean much by itself).

I also think that it might be helpful for you to speak to a breastfeeding counsellor about this - you could call the NCT or LLL helplines. They would certainly not judge you for not breastfeeding, and neither do we!

But many people might raise a at what this HV said. For a mum to produce no milk at all is exceedingly unlikely, but unfortunately there are lots of HVs who know next to nothing about breastfeeding.

I would add that i have never heard of dehydration being definatively diagnosed in that way.

On the basis of the info in your post i think the hv (why hv? At 3 days pp?) has over reacted and knew very little about normal bf and how to resolve early problems :(

I tried to express at about 3 days to put in dd's gunky eye and couldn't get so much as a drop, I've never got more than half an ounce out in ten months. My milk didn't come in til day 5 either, and I've never once been engorged or leaky. My 2 stone 10 month old is proof there's milk there!
I'm not at all trying to suggest that was the case for you btw - I know nothing and clearly there are women who don't make any milk. But there are definately people (me!) that are just rubbish at expressing.

Most people can not express at three days. For me, my milk only came in on the night of the third day, so on day 3 I was also not producing milk. 24 hours later there was plenty though. I was in hospital for 48 hours after the birth, I tried hand expressing colostrum during that time in a syringe as DS was not yet latching well. I managed about 0.2mls! A tiny amount! It did not mean that I was not capable of producing milk.

I'm not judging you in any way, as you say, your child is healthy and happy and well fed so I dont think there is any need for guilt and blame and all that. It does make me sad though that women who want to breastfeed receive such dreadful advice from health professionals who do not really understand how normal breastfeeding works.

Thanks for all your feedback. I do find it worrying that you get different opinions and advice from every new mw/hv you encounter! Yep for me personally I had no leaks and no engorgement (first time round) after switching to the bottle. A real mystery for me. But there you go. No complaints...one midwife did say to me if you line up 10 children it would be impossible to tell which were breastfed and which bottlefed and I think that is a good way of looking at it.

tappingmama the same thing has happened to me!

I have a 5 week old and he latched on within an hour of the birth, and nursed constantly it felt like for the first 3 days. about 5 different midwives confirmed the latch was perfect. Milk never came in.

I was in hospital for 3 days and on day 2 they said "it'll come in tomorrow" and on day 3 they said the same. My baby was nursing all the time with a great latch but clearly very hungry. I went home and on day 4 there was still nothing. No rock hard boobs, no milk in the babies mouth after he came off the breast, no leaking or tingling. nothing.

I expressed with an electric pump and got 1ml from each side. We started giving some formula, just 1oz at a time to take the edge of his severe hunger. The midwifes visited everyday and said "i'm sure the milk will come in tomorrow" but after a week they had to conclude it wasn't coming! They did blood tests but no answer was found.

Baby is now 5 weeks and I still breastfeed him everyday...he seems to get about 1oz of breast milk in 24 hours (judging by what I can pump, about 5ml at a time) so he is 99% bottle fed, I only breastfeed because I want to.

The health visitor said she had seen one case before like this, but only one. They have no idea why it happened.

A mystery and I'm interested to read it happened to someone else too!

Thanks for sharing HeidiHole!

It is actually vaguely reassuring to know I am not alone! (Hope that does not sound rude - I know how concerning it can be!)

There was one theory that was thrown around - that perhaps as a vegetarian I was low in iron and that might affect milk supply.....nobody knows why it happened and that is the reality.

I guess we are just special!

tapping, from the information here, I think it's highly doubtful that you had no breastmilk.....it is far, far more likely you had really poor postnatal support and a poorly trained HCP involved, both phenomena a zillion times more common than zero milk production :(

Heidi, I'd say the same about your experience, though I'd need to know more. The lack of fullness you describe is normal when a baby has been feeding very frequently - plenty of mothers with keenly nursing babies just don't experience a huge and obvious 'event' of the milk coming in.

tapping, anyone who links vegetarianism with no milk/lack of milk is just announcing their lack of knowledge about bf, too :)

Cows are vegetarians and they produce milk.

Hi, I didn't get any milk in til around 6/7 weeks with all 3 of my dds and they found with my 3rd dd that this was due to high blood pressure. It wasn't excessively high just slightly raised but this can stop milk apparantly!!

O3angels - no milk at all until 6-7 weeks? Linked with slightly high BP?

Did they share with you some evidence that this was the case?

Some conditions can lead to delay (of a few days) of milk coming in; some conditions can mean getting a full milk supply is really hard; but I have never heard of slightly raised BP meaning milk does not appear at all until 6-7 weeks postnatal.

My milk didn't come in for about 5 days - wasn't that dramatic when it did, never had any leaking etc. Tried to express a couple of time (on advice of HV who thought I should give bottle of expressed milk at bedtime ) but never got more than 1oz. However, DD was exclusively breastfed for 6 months , and is still breast feeding now at 2 - so there is obviously plenty of milk there!

The only reason I can think that I never panicked for the first 5 days, when there was presumably just a bit of colostrum, was that I had a very supportive midwife (not HV) who told me to trust my ability to feed DD. I was lucky.

tapping, being a vegetarian definitely has nothing to do with it as my MIL is vegan and BF both her boys.

I had a similar thing when I had my DS. I was producing, but there was absolutely nothing in it. May as well have been water :(

My poor DS started having seizures at 3 days old because he was literally starving.

Not one MW or nurse suggested that it could be my milk quality causing it. No-one figured it out until they did blood tests and found him to be quite poorly

Once we got him onto formula, he was fine. He carried on having seizures for a couple of months, but then they just stopped

Like you, no-one had e ver heard of it happening. A couple of MW's said they'd seen instances where no milk was produced, but not where the milk came but wasn't substantial. They never followed it up though, I now wish they had

When I had DD, I managed to feed her for 3 weeks before my milk dried up, and she thrived!

Imnotaslimjim that must have been very distressing :(

Babies can experience dehydration in the early days and low blood sugar - there are many earlier signs of this than seizures, though, so one might wonder at the care you were getting :(

I am assuming from what you say that your baby had low blood sugar. You would not expect seizures to continue once this had been addressed though (by formula in your case) so it would be likely there was something else causing these.

Women don't produce large volumes of breastmilk in the first 0-3 days postnatally - it is normal for small vols only of colostrum to be available. All women produce colostrum, but not all babies can access it, and any baby not transferring milk effectively soon after the birth may need expressed colostrum. It will be there - hand expression gets it out, drop by drop.

Not enough info in your post to know what happened, but it doesn't sound like you had a good explanation from the midwives.

Hi tappingmama. I know what you mean about feeling like you weren't in hospital long enough to really know what was going on. DD latched straight away and seemed to be feeding okay (I saw my colostrum so it was definitely there) and I was discharged quite quickly. But my milk didn't come in until day 5 and until then there was no leaking or engorgement. I don't know why this was, but it was a bit scary - DD was sleeping lots, passing urate crystals and not pooing. I was VERY lucky to have a supportive health nurse who only advised a formula top-up to get baby rehydrated as an emergency measure. I definitely knew all about it when my milk came in, though: I had taken my baby to bed for some skin to skin, and woke up with giant boobs and a drenched baby!

Off-topic somewhat: I'm not sure that many health visitors are honest/knowledgeable enough about just how frequently a baby needs to be at the breast in those early days. I certainly didn't quite understand this myself at the start - in hospital I was told feed baby every 3/4 hours. Thankfully my health nurse explained the concept of timing feeds from the start of a feed rather than the end. DD is 23 weeks now and still breastfed, and given the rocky start, I think I was one of the lucky ones.

Hi tappingmama. I know what you mean about feeling like you weren't in hospital long enough to really know what was going on. DD latched straight away and seemed to be feeding okay (I saw my colostrum so it was definitely there) and I was discharged quite quickly. But my milk didn't come in until day 5 and until then there was no leaking or engorgement. I don't know why this was, but it was a bit scary - DD was sleeping lots, passing urate crystals and not pooing. I was VERY lucky to have a supportive health nurse who only advised a formula top-up to get baby rehydrated as an emergency measure. I definitely knew all about it when my milk came in, though: I had taken my baby to bed for some skin to skin, and woke up with giant boobs and a drenched baby!

Off-topic somewhat: I'm not sure that many health visitors are honest/knowledgeable enough about just how frequently a baby needs to be at the breast in those early days. I certainly didn't quite understand this myself at the start - in hospital I was told feed baby every 3/4 hours. Thankfully my health nurse explained the concept of timing feeds from the start of a feed rather than the end. DD is 23 weeks now and still breastfed, and given the rocky start, I think I was one of the lucky ones.

Hi tappingmama. I know what you mean about feeling like you weren't in hospital long enough to really know what was going on. DD latched straight away and seemed to be feeding okay (I saw my colostrum so it was definitely there) and I was discharged quite quickly. But my milk didn't come in until day 5 and until then there was no leaking or engorgement. I don't know why this was, but it was a bit scary - DD was sleeping lots, passing urate crystals and not pooing. I was VERY lucky to have a supportive health nurse who only advised a formula top-up to get baby rehydrated as an emergency measure. I definitely knew all about it when my milk came in, though: I had taken my baby to bed for some skin to skin, and woke up with giant boobs and a drenched baby!

Off-topic somewhat: I'm not sure that many health visitors are honest/knowledgeable enough about just how frequently a baby needs to be at the breast in those early days. I certainly didn't quite understand this myself at the start - in hospital I was told feed baby every 3/4 hours. Thankfully my health nurse explained the concept of timing feeds from the start of a feed rather than the end. DD is 23 weeks now and still breastfed, and given the rocky start, I think I was one of the lucky ones.

sorry - no idea why that posted thrice...