Been reading bf myths and this has been really bugging me...

[Heated]

..what do you do about feeding nb baby while waiting for your milk to come in? Or did you have milk almost immediately?

8 hours after delivery and not managing to bf ds, was told I had to give a bottle. And 2nd day, told he was low in blood sugar, not getting anything via bf so had to bottle feed.

I don't know if I'm usual or unusual in this but I had no milk until day 5 (after traumatic delivery & constantly hooked up to a breast pump but producing nothing).

Don't you have any collostrum? Yellowish fluid. NB baby only needs collostrum until the milk comes through, and I understood it took up to 5 days for the milk to come in.

Don't give a bottle if you don't want to.

no milk milk or nothing at all? I spend ages milking myselg onto a spoon (the joys!) when DS was born, sometimes it took ages to come through. I very much doubt I would have been able to use a breastpump straight away. Last time I had 'milk' (more like water) leaking from about 16 weeks, this time it's started at 24... that's what I sort of worked with (if that makes sense).

You should be producing colostrum. In most cases this is enough for the baby if he/she is feeding frequently (every 2 hours or so). If there is a genuine blood sugar problem in spite of frequent feeds then some supplementation can be given by cup feeding.

Not being able to pump anything doesn't mean you aren't producing anything; for colostrum in particular hand expressing tends to be more effective than pumping.

No colostrum until day 5 - thick, creamy looking stuff, yes? I had to keep a diary of how much I expressed and how much baby fed which is why I remember so well. Used a electric pump & hand pump but could never hand express successfully even when milk did come in.

Had a traumatic delivery with ds 1 so one suggestion made was that this delayed things? But had a good delivery with my 2nd child, milk came in a day earlier on the fourth day.

I feel I could have tried harder to bf with my 2nd since she would at least attempt to latch but tbh I was scared of going back to those horrendous days/months after birth of ds with which my failed bf was very much a part of.

My milk didn't come in until Day 5 although i did have colostrum before that. I don't think it is that unusual tbh but then again I had an elective c-section at 38 weeks so didn't go into labour iyswim. I reckon that that had something to do with the milk being slow to come in although other mn-ers have suggested otherwise to me.

I don't really get this and suspect that buggering about with bottles makes things worse.I have leaked the grand total of 1 drop of milk in 3 1/2 years of breastfeeding.

I never knew when/if/how my milk came in and noone ever questioned it. I merely put baby to breast asap, felt her sucking and relied on body to do the rest.

I never leaked milk before the births, when my milk came in on day 3, i knew it! My breasts were like rocks, but now I don;t have that full up feeling (unless Callum misses a feed) and I don;t feel letdown.

I had colostrum from day one i think!
After emer cesarean I had milk after day 5/6
I supplemented with a syringe of soya formula in hospital (nurses took DD away and gave it to her) I was out of it on morphine and DD wailed and wailed.

After that I used to leak only from my left boob, and used to catch an oz every feed in an advent shell.

sorry you were told you didn't have milk. I was told milk comes in after 5 days after a section, but that colostrum is all babs needs for first few days to clear out meuconiumin gut and establish colonies of 'good' gut bacteria / flora. They do need to be almost permanently on the boob though to get your body to produce milk. And that's why the 15 mins on each side 'advice' is so wrong.

my DS1 was small (5lb 13oz) even though full term. He didn't have the sucking reflex fully established and therefore could not get my colostrom out. His blood sugar was low, he was lethargic and was not waking up to feed (I was very worried...). I was determined to breastfeed so did the following (by the way I made up this method myseld because midwives in hospital gave me so much conflicting advice I just made up my own solution).

1. Really tried to get him on the breast every 3 hours - however not sucking and slept through the whole thing
2. Was desperate to get my milk going so expressed straightaway with big hospital machine every 3 hours - even during the night - baby was not even waking up to feed so woke myself and him up with an alarm clock (hell!). Got precious drops of colostrum out this way and therefore got the milk going after about 3-4 days.
3. Fed the colostrum to baby via a syringe. If he spat it out I scooped it back in - he was having this golddust!
4. After all this I then topped him up with a bottle of formula (about 1 oz is all he would take). This had the effect of getting him stronger which then meant his sucking reflex started and hey presto he started to breastfeed (I had NO problems at all with teat/nipple confusion)
5. Will NEVER forget that first moment when he finally latched on.
6. Breastfed exclusively for 6 months.....

It was hard work, scary, but worth it. By the way, please don't let people scare you with nipple confusion, if they need a kick start with formula and a teat then I would say bloody well do it. My friend had the same issue as me (v small baby) was petrified to give a kick start with a bottle and her baby ended up in neo-natal unit. She did the same as me above and breastfed exclusively after the first day or two.

That's a very heartening tale Soph.

I attached ds for a bit but not for long, sustained periods of time because he got so distressed and he didn't latch at all well despite lots of attempts, mw said my nipples were rather flat .

Is that where I went wrong? Was the breast pump a bad idea?

DD2 was much better at latching and like I said I feel guilty because I do think I could have bf her - maybe stimulated milk to come in earlier? - but having been told ds was getting dehydrated and ill, I was scared the same would happen with her.

Thank you Sophiebb, it really helps.

Heated,you did yuor best with what you were told when in a very vulnerable position.What more could you do?

Thanks moondog.

I want to be better informed next time round and do a better job. Really don't get why there was no colostrum or milk, zip, nada, for so long, makes me feel a bit freaky tbh. Know now that lots of skin to skin important and will do what Sophie advised if need be. Thanks.

Heated - By the way, getting the colostrum out for the first 2-3 days via a pump was pretty hellish and it came in drops and very very slowly. Really do not get upset about it though - I was that close to giving up because all you want is for your baby to feed and the whole possibility of dehydration and illness is very scary. The midwives simply did not understand this and didn't help me through it at all....

I really don't understand all this hassle some midwives give new mothers about their milk 'not coming in'. OK, in some cases I'm sure there are problems but generally isn't it the case that the human body produces colostrum because that's exactly what newborn babies need?

Feel very lucky that ds and I were in and out very quickly but I saw how my poor sister was tormented on a bloody post-natal ward by evil midwives who did everything in their power to actually prevent her b/f while parroting all the 'breast is best' stuff. Wouldn't leave her alone with her baby to snuggle up, oh no, rigid regime of expressing with horrible hospital pump. There was no reason for it - baby had no problems at all! Result of all the hassle and being made to feel bad was she gave up b/f before she left hospital. She felt forced to allow them to give her dd bottles in order to get out of there.

Hello edam

I think it depends how big your baby is - if 'normal' size then I think you are absolutely right - the baby does NOT need anything more than colostrum for the first few days and nature does its job.

However, if you have a very small baby like I did then it can be extremely scary (and sometimes dangerous - my friends baby got rushed into neonatal) to leave them for 3-4 days especially because mine simply was not strong enough to suck the colostrum out. The problem can then be that mums get so worried with their small lethargic babies that they can simply forget breastfeeding and go for the "safe" option of bottlefeeding.

Of course, if there is an actual reason for intervention that is exactly what should happen. But my sister's dd was 8lb4oz - absolutely no reason for all the drama and bullying! And I've seen it mentioned so many times on MN threads by women who didn't have any actual problems bar interfering, ill-informed health professionals.

8lb 4oz - bloody hell. She should certainly have been alright to let nature run its course then. I got so upset in hospital by the raft of conflicting advice I got re. breastfeeding from the so called 'experts' that I was in tears. However, I am sure this has all been said before on MN.

It has, but that's no reason not to say it again until those bloody HPs start to sort themselves out!

Sophie, sorry you had such a hellish start with your ds - I hope those days are long behind you now?

I was very near giving up on day 5 when my milk hadn't come in and was so confused by the poor advice I'd had at the hospital. Like you I was told it would be difficult for me cause my nipples were flat and then told it might be difficult cause I was so large (40L). Big sympathy for you, I hate looking back to those days. My milk didn't come in till day 6 and it was such a difficult time. I didn't use a breast pump but tried to hand express - didn't get much out, mainly blood! (which should have clued someone that I wasn't doing well, but didn't!) We topped up with formula for a few days but we did it by cup feeding and syringe. It's hard to keep going when nothing seems to be working, and Like edam's sister I felt that once we had started to top up with formula the hospital felt absolved of responsibility and could process us to get out. I don't think it was necessarily the worst thing in the world for us at that time (though would prefer to avoid it next time around) but what was worse than formula was the message they seemed to be giving that I was somehow mishapen and wouldn't be able to breastfeed.

In the end it was my sister and mumsnet who helped me sort everything out - using everything that has been said here: lots of skin to skin, putting DS to the breast every 2-3 hours and experimenting with lots of positions. I was obsessive about recording wet and dirty nappies so I could reassure myself that he was getting enough. The main thing I needed was reasurance to hold my nerve whilst waiting for my milk to come through. We managed to stop top ups within a couple of days and though his weight was a bit slow at first it soon picked up. We called the breastfeeding helplines and we also attended the local breastfeeding support clinic at the hospital. It took much longer to rebuild my confidence in the process of breastfeeding than it took to get the breastfeeding established. DS is now 9 months old and still breastfeeding well.

I agree that you shouldn't feel guilty - you did the best you could with the advice you were given by people who should be better informed. It's great that you want to think about things so you can be armed with more knowledge next time.

Heated, Mears posted this document 3 yrs ago. I think it may be comforting to read. The thing is, you should have colostrum as early as 16 wks. I don't know if you are pg now but if you are, you may want to reassure yourself about your body. I wish i knew this when dd was born as the midwives knew sweet fuck all and it would have saved me and dd a lot of grief.

Expressing Colostrum during Pregnancy

Hypoglycaemia Policy
Most babies have no difficulty in adapting to life outside the womb. However, some babies have an increased chance of developing low blood sugar, sometimes called ?hypoglycaemia?. Babies at increased chance of low blood sugar are:
Babies born early or premature ? before 37 completed weeks of pregnancy
Babies, who are lighter in weight than expected for the number of weeks of pregnancy, sometimes called ?small for dates?.
Babies who need extra help to breathe at birth
A baby who is ill
Babies whose mothers had diabetes during pregnancy
Babies whose mothers have had to take medicine for blood pressure (betablockers).

If any of the above applies to you or your baby, then we will encourage you to feed your baby as soon as possible after birth and then to feed often, at least every 3 hours as this will help to prevent low blood sugar in your baby. Your expressed colostrum can also be given to your baby after breastfeeds. Your baby will be carefully monitored and we will check his/her blood sugar regularly.

Is there anything I can do during my pregnancy to prepare for this?
Sometimes as early as 28 weeks of pregnancy, women find that they leak colostrums. The midwives will offer to teach you a very simple technique for expressing colostrum and provide you with sterile equipment for collecting and safely storing it with labels for dating it.

I really don't know why they give a woman a breast pump on day 1, all it will do is wreck their confidence.

How much colostrum will I be able to express?
Colostrum is present in the breasts from about sixteen weeks of pregnancy onwards. Some women leak colostrum and some don?t, both are normal. Don?t worry if you don?t leak colostrum, it is not an indication that you won?t have enough milk or a reflection on your ability to breastfeed. The amount of colostrum will vary from woman to woman. It can range from a few drops to as much as a teaspoonful or more.

When do I start?
A good time to start would be when you reach 36 weeks of pregnancy.

How often can I express?
A good time to have a first practice is when you are in the bath but you can express as often as you like.

How is it Done? In 4 Easy Steps!

1. Prepare ? gently stroke or use circular movements with your fingertips to massage your breasts, moving towards the nipple area. (It is not essential but sometimes a back massage can help. Ask someone to stand behind you with a fist either side of your spine, level with your breast and rub their fists up and down, gently and firmly).
2. Finding the place you need to press ? You need to find where your milk collecting ducts (sinuses) are in your breasts. The best way to do this is by feeling for them. They may feel like peas or peas in a pod or just a change in the texture inside your breasts. They are often found a few centimetres from the end of the nipple or where the darker tissue around the nipple area (areola) meets the skin of the breast.
3. Removing colostrum ? Place the flat your thumb above and the flat of your first finger below, in a ?C? shape, over the sinuses and gently press and release, building up to a rhythm. A few drops of colostrum may appear at the end of your nipple. When the drips stop move your thumb and finger around your breast to the next set of milk collecting sinuses, repeating this process of rhythmic press and release. You may need to swap hands to express colostrum from the other side of the same breast.
4. Collecting and storing colostrum ? You will be given a package containing equipment for collecting and storing your colostrum. There will be small sterile syringes with red caps, which you can use to collect the colostrum directly from your nipple. If you chose this way to collect colostrum, carefully replace the red cap and place the syringe at the back of the fridge. Alternatively, you may wish to use the small sterile gallipot for collecting colostrum, if so when finished re-cover the gallipot and place it in the back of the fridge. If you are expressing more than once in a day then use a new sterile syringe or gallipot at each expressing. At the end of the day, you can put all of the collected colostrum into one container (universal container) and store this in the freezer at minus 18 degrees C. When you are coming into hospital to have your baby put all of the collected colostrum into the plastic bags provided, pack the bag(s) with ice. Once at the hospital give the bag(s) to your midwife who will have it stored in the hospital freezer.

hand expressing technique in pictures in here

and here also has great info on how to do latch a baby with tongue tie. this is the most recent booklet available from the Surgery when booking in as a pg woman.

Well this document certainly would have been useful because nowhere was I able to find anything useful to read if your baby was small and had low blood sugar and therefore couldn't wait 4-5 days for the milk to come in properly. I would however have needed more guidance on this part:

"If any of the above applies to you or your baby, then we will encourage you to feed your baby as soon as possible after birth and then to feed often, at least every 3 hours as this will help to prevent low blood sugar in your baby. Your expressed colostrum can also be given to your baby after breastfeeds."

I was giving my colostrum to him via expressing and a syringe but he was not latching on and getting anymore than this and in my opinion needed something else hence giving a boost of formula. It would have been helpful to have had some advice reassuring me that was OK.

The problem is I was really scared to give formula and even more scared to give it via a teat because it had been drummed into me not to do that if you wish to breastfeed because of nipple confusion. This may be an own goal message to be giving by breastfeeding advocates because it was by using formula delivered via a teat that made my baby strong enough and alert enough to get have enough energy to latch on and start sucking away contentedly.

Anyway, all was OK - my DS1 is now 17 months and normal weight. DD2 is due next week and if she is also a smally! I have much more confidence as to what to do to get going!!!

I do hope my posts help someone - if it just manages to get one more person breastfeeding then I feel I have achieved something today!

sophie, were you advised to also have as much direct skin to skin contact (even when not actively trying to breastfeed) and possibly co-bathing? At least every three hrs can mean every one or 2 hrs too.

have you heard of breastcrawl? it has been used by a few mners already who have found that it helps with babies to latch on even weeks after giving birth.

Yes - but I don't think the midwife directly advised me to do it - it was simply the first thing I did every 3 hours - before I started expressing I tried for ages to get a latch on and hold baby close to my breast. There were lots of cold flannels and blowing on his face to get him to wake up!!! This only lasted 2-3 days though and then he was up and running!