What to do if milk comes through late?

growyourown77 · 2013-01-22T15:03:41+00:00

Stupid question perhaps, but if your milk comes through late (day 4/5), say due to delayed BFing due to CS, medical reasons or lack of initial support what do you do? Give the baby formula then try when it's through? I keep hearing about delayed ilk coming through on various threads but don't really understand what happens for mother and baby in the meantime. Can anyone shed any light please? Thanks.

Whiteshoes · 22/01/2013 15:32

Hi. This happened to me, well at least b/f was an initial disaster and the midwives forgot me, so no one came to check she was feeding successfully, and we failed to establish b/f at hospital. I'm sure part of this was the delay in my milk coming in, and I don't think she got any colostrum either.

What happened was a mishmash of conflicting and confusing advice at hospital. It was a nightmare. I kept on trying to b/f. She wasn't very interested, I imagine because she wasn't getting much. She was obviously hungry and only doing poo nappies for days and days. We gave her formula in a special cup in hospital when we had a midwife who would allow it! They wouldn't let us take a feeding cup home, which was insane, leaving us only with bottles or starving her available to us. Bastards. So we sterilised odd shaped things and formula fed her because she was so hungry. When my milk came in, we did finally crack it, although we were almost readmitted because she was still below the appropriate weight.

I then went on to b/f her for over a year and I loved it!

Whiteshoes · 22/01/2013 15:32

Hi. This happened to me, well at least b/f was an initial disaster and the midwives forgot me, so no one came to check she was feeding successfully, and we failed to establish b/f at hospital. I'm sure part of this was the delay in my milk coming in, and I don't think she got any colostrum either.

What happened was a mishmash of conflicting and confusing advice at hospital. It was a nightmare. I kept on trying to b/f. She wasn't very interested, I imagine because she wasn't getting much. She was obviously hungry and only doing poo nappies for days and days. We gave her formula in a special cup in hospital when we had a midwife who would allow it! They wouldn't let us take a feeding cup home, which was insane, leaving us only with bottles or starving her available to us. Bastards. So we sterilised odd shaped things and formula fed her because she was so hungry. When my milk came in, we did finally crack it, although we were almost readmitted because she was still below the appropriate weight.

I then went on to b/f her for over a year and I loved it!

Whiteshoes · 22/01/2013 15:32

Oops, sorry for double post.

CheungFun · 22/01/2013 15:36

I'm quite interested in this too as my milk didn't come in for 5 days and DS was hungry so he ended up having formula. Only part of my many problems with breastfeeding and not getting the hang of it! I'm trying to learn more though as I would try to bf when I have more children one day!

emsyj · 22/01/2013 15:42

I was given donor breast milk from the milk bank when DD was born, as she was too sleepy to feed from me. A lovely infant feeding specialist midwife expressed my colostrum for me (as I sat dazed from morphine after a crash section) and fed it to her with a syringe, then she was cup fed with donor milk until my milk came in - encouraged by a hospital grade double breast pump which the hospital provided for me. DD eventually fed from me at 6.5 days old.

megandraper · 22/01/2013 15:46

Happened for me with DC3. On day 4 she had lost more than 10% of bodyweight so was sent to hospital, where they found she had extremely high jaundice and was a little bit dehydrated.

One night of feeding formula in hospital (and pumping but not getting much out). By the next day my milk came through and we just carried on bf, and I didn't give any more formula.

I was very upset about it (having to give formula) at the time, but it all worked out fine, and we are still bf 18 months later.

Original poster

growyourown77 · 22/01/2013 16:04

Good to know there are ways around it for some people and that mixed feeding isn't hte end of the world. It sounds like it would be sensible to take the electric breast pump into hospital with me and some sort of cup. What cup did you use? A baby one with a spout? Open topped?

OP posts:

Whiteshoes · 22/01/2013 16:11

Amongst the conflicting advice I was given was that pumping wasn't appropriate until your milk comes in. Very happy to be corrected though.

I would hope your midwives would give you a feeding cup. I couldn't find one to buy anywhere, but it was a little prepackaged and pre-sterilized cup with a small flat spout. They also showed me how to feed her that way. It's amazing. Babies lap milk like cats do! So clever!

Original poster

growyourown77 · 22/01/2013 18:47

Cool! Now cats....that's something I know lots about!

OP posts:

NanoNinja · 22/01/2013 19:50

Happened to me. Baby had hypoglycaemia and low body temp, I was spaced after CS. Baby had formula, milk not coming through. Horrible. I pumped loads, drank fennel tea like water and by week three managed to get back to ebf. Was bloody hard though.

thehumanegg · 22/01/2013 20:06

Growyourown Glad you asked this, it's an interesting one. BTW re pumps I seem to remember in the hospitalnot being allowed to plug in electrical devices (health and safety) so a manual might do, if hand expression isn't successful. That's what I'll do if there's a next time.

Bottleoffish · 22/01/2013 21:33

I have had five 'normal' vaginal births, although one was a premature twin birth and my milk has never come in until day 4/5. Each time I just fed my baby (or hand expressed in the case of my prem twins) and have never needed to use formula or supplement with donor milk, none of my babies lost more than 10% of their birth weight, although my youngest was close, but she quickly gained once my milk was properly in.

For most babies colostrum is just fine until the Mum's milk comes in.

Bottleoffish · 22/01/2013 21:34

Oh, and I found any sort of pump was a waste of time until my milk was in, any colostrum that came out got wasted int he pump parts. Hand expression made 'catching' the tiny amounts I did get easier. I used to hand express into a syringe or medicine cup.

LBsBongers · 22/01/2013 21:44

With DS milk didn't come through for 4 days he was hungry and we were both distressed. With dd1 I planned ahead and she had 2oz of formula on day 2 and 3 ( in between near constant BFing), she was more settled and EBF from that point till 12 months. With dd2 did the same she literally sank 2oz of formula on day 2 and 3 and has been EBF since.

My point is that with experience I learned that it wasn't the end of world to offer a small bit of formula before milk comes in. As I learned with DS both parties can end up a bit frazzled and hungry if it takes 3 days for milk to come in.

Andcake · 23/01/2013 14:18

I wish I had given formula but kept on getting advice not too. Baby lost 14% of body weight and we ended up having 4 days back in hospital and tube fed. It seems v common with cs. Ds was breech I think I would have made more effort to turn him if I knew cs risks to bf but hospital had told me there were none. Bf eventually failed.

tiktok · 23/01/2013 15:25

If feeding has not got underway within a few hours of the birth, then a mother should be enabled to hand express colostrum - pumps are a poor idea before the milk comes in, really, as the tiny amounts of colostrum get stuck to the bits of the pump, and hands are more effective anyway.

Doing nothing for days except continuing to try the baby at the breast is poor maternity care - babies get dehydrated, jaundiced, panic buttons are pressed re weight, and in many cases, it could have been averted if someone sensible and knowledgable had spotted the baby was not transferring colostrum :(

Abra1d · 23/01/2013 15:33

'Happened for me with DC3. On day 4 she had lost more than 10% of bodyweight so was sent to hospital, where they found she had extremely high jaundice and was a little bit dehydrated. '

My son had a similar experience. We were in a midwives' unit post CS for a breech, and there wasn't much weekend cover. I couldn't find anyone to 'allow' me even to give him some water. He was getting hoarse and I was worried. He lost over 10% of his birth weight and was jaundiced but they didn't readmit us to hospital (for which I was grateful as I knew I would be better off at home, relaxing with the baby if I wanted to feed). Fortunately the milk did come in on day 4 and he made up for lost time and some winter sunlight cleared up the jaundice. But I don't think we were properly warned this might happen and it wasn't a great start for him.

The HV was good though, and my mother, who'd just retired from being a HV, was helpful too in making sure that when I had the milk he was latched on well and really getting as much as he could. I went on to BF for nine months.

My SIL, 43 when her son was born in the autumn by CS, had even worse problems and gave up after eight weeks BF because he wasn't gaining enough.

Abra1d · 23/01/2013 15:35

As far as colostrum goes, I have no reason to think that wasn't transferred, though. And I know that was doing him good.

emsyj · 23/01/2013 19:41

The cup used was as another poster describes, an infant feeding cup with a little lip that came pre-sterilised and packaged.

To clarify also, my colostrum was hand expressed (initially by the infant feeding midwife and later, when my morphine drip had gone and I was a bit more with-it, I did it myself). I didn't start using the electric pump for a couple of days, it's hard to remember exactly when... I was getting actual milk (in bucketloads) from it though, not colostrum by then.

DD began gaining weight very well as soon as she was able to feed from me.

Zara1984 · 23/01/2013 20:37

As always, wise words from Tiktok. I actually muttered "absofuckinglutely right" when I read it. This was what happened to me. "Just keep trying dear" when baby isn't latching, first feed was a measly 5 minutes about 5 hours after the birth = dehydration by day 3. They only need little bits of liquid when that small, but they do need something.

inthewildernessbuild · 24/01/2013 12:19

this happened to me too with twins after c-section. Milk didn't come in till day 6. It was a disaster! I felt really angry nurses hadn't recommended giving a bit of formula as babies were dehydrated, jaundiced by day 4 and we had the saga of being told to express, treated like criminals because they had lost a Ib each (5 and 6 Ibs to start with so pretty bad weight loss). And I had repeatedly told them that babies were not feeding properly, too sleepy, were not latching and they wrote in my notes Day 3 that babies feeding well! I/they should have given them formula in those crucial days when I was recovering from C-section and the panic that ensued and considerable cost to hospital of keeping me in for a week would not have happened. Such a bad start. But we got over it, and they breastfed for two years. Mixed feeds to start with, slowly phased out by six months.