Milk not in Day 6

[AfterGlow87]

Hi everyone,

I had an emergency section on Thursday - my baby was born pre term at 32+6. Currently in the NICU but doing well thank god. I started hand expressing immediately and pumping at 72 hours, however I’m still only getting 25mls from both. I know my milk hasn’t come in yet and I’m day 6 post delivery today. I’m pumping 2 hourly during the day and 3 hourly at night plus using compress, massage etc. Doing skin to skin and putting baby to the breast even though he can’t really suck much.

I’m desperate for it to come in as I’m going home today and there is restricted visiting due to Covid so won’t be able to do as much skin to skin as I can only visit from 1-7. They want him on exclusive breast milk and he is on a strict regime so I’m feeling the pressure to get volume.

Is this delay normal after a preterm section? 😭😭
I’m starting to think it won’t and im getting myself really upset

Thanks so much x

Contact your local La lache league. Does your hospital have a qualified lactation consultant?

Definitely try to see a lactation consultant. I don’t think this is unusual but I’m not an expert. I had a c section at full term and my milk never “came in”. I had to supplement with formula from birth. Nobody should be pressuring you to produce milk. If you don’t have it, you don’t have it.

Don't panic OP! Milk changes gradually from colostrum to mature milk. The in-between stage is transition milk and the volume isn't nearly so high as it will be after baby is about 2 weeks old. A full term baby's stomach at about 7 days old can only hold about 45-60 ml per feed. Your baby's stomach will be smaller than this and is still only 6 days old! Additionally, c sections can cause a slight delay in milk 'coming in'. You sound like you're doing pretty well actually. The best thing to do is to keep up the pumping. You'll notice the volume levels creeping up day by day. The more you pump, the more demand you put in for the next day. What colour is the milk you're pumping currently?

P. S. Just to add, talking about milk coming in on day 3/4 can be quite misleading actually. In reality, this is just the beginning of the transition, which takes a couple of weeks. It begins to change colour and the quantity increases little by little, day by day. Even a full term baby's stomach at 6 days old, could not take the volumes of milk that you'll produce as your milk becomes mature in another week or so.

So just keep doing what you're doing. It must be so hard being separated from your baby, but you're doing a wonderful thing for them x

@Thatwentbadly

Contact your local La lache league. Does your hospital have a qualified lactation consultant?

This! Lll has an excellent website with lots of information. Local groups are running zoom calls as a group and one to one. The west London LLL is on Thursday at 1pm. You need to register (they've said before if it's urgent like yours it's ok to say you're the right area at present as they want to help support).

Tommy's - info on breastfeeding premature babies.

You could also as the hospital about donor milk if your baby needs more than you can produce right now. Hearts milk bank supplies milk where possible to hospitals and community-based clinicians for babies across London, East Anglia, the southeast of England

Breastfeeding helplines are good for getting info and support if there isn't enough in the hospital. Consider renting a double electric pump from the manufacturers if the hospital can't loan one. There's every chance it will come right, but make sure you have some skilled support.

Thanks so much everyone for responding!

@Somethingsnappy your lovely comment making me nearly cry 😭 the milk is still pale yellow but lighter than the colostrum colour I had and it’s much more watery. I’m now producing 30mls from a pumping session the last 3 times so maybe it is coming in slowly? I was only getting maybe 10-15mls a couple of days ago

I’ve seen the lactation specialist who put me on the 2/3 hourly regime. I’ve also rented a hospital grade pump which has arrived at home and have videos and a baby vest with his smell on it to help me

To be fair to the nicu they did offer donor milk but I’m just so keen to feed him my own. He’s doing really well other than prematurity so I know I should be grateful! Maybe once I head home to my own environment I’ll relax too as I’ve been in the hospital nearly 3 weeks

Congratulations on your baby!

I’m really shocked that they have those restricted visiting hours for mothers of babies in NICU, especially if they think he should be EBF. Pumping is a great thing to do for him but not as effective as getting milk out (and therefore getting your supply up) as the baby. Could you visit for longer if they let you? If so I would be pushing hard for them to do so. Even without the challenges of being premature I think it would be extremely challenging to EBF any new baby you only had six hours a day with.

Ask them to stop going on about 'exclusive breast milk' you don't need the stress. Offering you donated milk must also be stressful to you .

Well done and congratulations!!

I wasn’t in the situation you are but I couldn’t pump anything unless I was watching a really cute video of my baby, I had newborn videos that made me gush on repeat. Milk release is hormonal so trick it ❤️.

Good luck, sounds like you’re doing fab.

@mummylovesthesunshine

Ask them to stop going on about 'exclusive breast milk' you don't need the stress. Offering you donated milk must also be stressful to you .

Why is donated milk more stressful because it’s human?

Either cow or human is fine, neither is more stressful.

@AfterGlow87. The colour of your milk sounds right on track for this transition stage. Also, increasing amounts of 5/10 ml a day sounds perfect too. From what you've described, I'd say you've just experienced a very slight delay (understandable after a c section and on being separated from your baby), but you are only a day or two 'behind'. And because your baby is premature, with a tiny stomach, this tiny delay shouldn't matter at all. Obviously, the staff in the hospital are best placed to know if the amounts of milk you are expressing are currently enough, but my opinion is that those kind of volumes, produced every 2 or 3 hours, will be more than sufficient for a premature baby.

Once your baby is a little older and stronger, their sucking at the breast will help to build up your supply even more, but meanwhile your pumping schedule sounds perfect and the amounts of milk are increasing at an expected rate, if a day or two behind.

As for expressing, make sure you are warm, comfortable and relaxed and thinking about, or looking at, a picture of your baby. Also try putting a sock over the bottle into which you are pumping.... It really helps to decrease anxiety when you can't constantly see the amounts you are producing!

But mostly, I'll just repeat my point that at this stage, even with a 'normal' delivery and full term baby, the amounts of milk per feed would only still be relatively small... 40-60 ml, as described previously. Well done! You are doing fabulously and you will see rewards for your efforts every day, as the volume of milk creeps up. It is the best thing you can do for a premature baby, so... A big well done! So glad to hear your baby is doing well x

Thanks everyone! Unfortunately I’m in Ireland and my Hospital are extremely strict about the visiting policy. My husband can only visit one hour per day and it can’t be at the same time as me so we haven’t really even seen our baby together as he was intubated at birth as whisked away to the unit.

I’ll keep going for now and hope I continue to get the small increases each day. I’m happy they can offer donor milk but it’s just my own personal preference to give my own (if I can!) at this stage. The sock trick a good idea as I find I can be obsessive about the amounts 🙈

It's natural to feel obsessive about the amounts at first, but as they continue to increase, you'll begin to have faith that your body is doing what it's supposed to do and you'll feel more confident and relaxed, I promise! And all this regular pumping will really build up your supply and establish it for the future. Normally, without having to pump, you'd have no reason to have any idea about the amount in mls your baby would consume at each feed. It's only because you're pumping that you have to see the volume! But just remember that your body is producing the amounts that are perfect for your baby's tiny stomach. As he grows, your milk will increase in volume to match what he can take x

Accept the donor milk, please, it'll take the pressure off and I'm sure you will start producing enough in no time

The hospital will be able to tell you how much your baby is having on a feed, which I'm sure will reassure you - you're probably pumping about a feeds worth at the moment which is great.

It'll come, get lots of water and oaty things to eat, and make sure you get some rest! We've just done a stint in NICU and it is hard going. Fingers crossed you'll only have a few weeks and you'll all be home together.

So I’m home now and getting 40mls per pumping session overnight and just got 60mls there so gives me faith that my milk is coming in! I had expected to get engorged etc but maybe because I’m pumping so regularly I won’t get that? I definitely feel more relaxed about it and so happy the amounts are increasing 🥰 I also met with a friend in the hospital who is a lactation specialist and she gave me a plan that involves a bit more sleep so I feel much better overall. Thanks to very one who commented x

That's Brilliant, well done! There's a lot of support out there, glad you're feeling better about it all, and also know it's not just you worrying about getting it all right- I worry constantly!

Fantastic OP, well done! Your commitment is paying off.

Yes, you are pumping so regularly and effectively, that your breasts won't ne engorged in between. Not everyone will get engorged anyway. It often happens in the early days for all sorts of reasons, including an oversupply before the supply regulates, or a baby not having learned a really effective latch yet. Soft breasts do not usually indicate a lack of milk. At the moment your demand (your pumping schedule) is equal to your supply, so there is no 'need' for engorgement.

Just a little update - I’m now getting 55-70mls per pump and I’m day 10 post delivery. Baby is taking 38mls per feed and I’m managing to meet that demand so I’m so delighted. I even managed to freeze 2 bottles last night! It was tough at the start but glad I persevered. Thanks to everyone who responded, it meant a lot when I was very stressed! X

Well done. You are doing so brilliantly. Congratulations on your little boy. How is he doing?

He’s doing great! Nearly back up to his birthweight, moved to a cot today and just needs to get the hang of using the teat and gain a bit more weight before we can go home. He still can’t really latch on yet but I’m going to try BF when we get home 😊

So much positive news. You must be so pleased. He'll find it easier to suck as he gets bigger. Just keep putting him to the breast and practise as much skin to skin as you can. I hope he's home soon.