Is it possible that my milk never came in?

[springbelle]

I have tried to find an answer to this but have not been able to. I don't want to be 'told off' (seems there is a lot of that on this board recently)!

I had a elective c-section at 38 weeks due to the fact that I have Hughes syndrome in pregnancy (medical name antiphospholipid syndrome) which in simple terms means my blood clots too easily and causes placental problems. I lost my first baby at 25 weeks due to this disorder (I didn't know I was a sufferer at this point) so part of my reasoning for having the c-section was because I couldn't face the trauma of labour again (and medically the doctors said it would be that or an early induction).

I always wanted to breastfeed. No question about it. I fully appreciate the benefits to both mother and baby. I wanted to give my baby girl the absolute best start in life.

During pregnancy I never had the 'leaky boobs' that many of my friends talked about. My boobs increased in size considerably and anatomically looked perfect for breast feeding. I'm not boasting by the way

I didn't really have any BF support in hospital after the c-section and she didn't get latched on to me until the evening (she was born at 10am). Should a midwife have put her to the breast as soon as I was in recovery?

Anyhow, the latch wasn't the problem. She seemed to know exactly what she was doing. I persevered with trying to feed her the colostrum but she was screaming with hunger and by the time we got her home 48 hours later she was becoming jaundiced. I gave in and gave her some formula as I was really worried about her. The midwife visited me on the fourth day after birth and said that my milk would come in soon. I tried to express but there was literally nothing there. My milk never did come in. The MW and HV told me that I might become feverish and that it would be painful when it did come in....but nothing happened, no pain, no nothing.

Did I do something wrong or is this possible? I have read many times that it's extremely rare for the milk not to come in.

Could anybody shed some light on this. It's really bothering me. If I have another baby is there any way of making it happen?

Yes it is possible.

I have three DC. My first was born by emergency c-section under general anaesthetic. Like you I had experienced leaking during pregnancy, and fully intended to BF. I had colostrum and fed fine for the first few days, but by the end of the first week he had started to lose weight quite dramatically. By the end of week 2 it was clear that something wasn't right, he was losing weight very rapidly despite the latch etc all being fine. On the advice of the HV I switched to formula, and he was a different baby.

I hadn't really realised that my milk hadn't come in first time round until I had my 2nd. He was born naturally, and on about day 4 my milk definitely came in. It was painful, and I definitely hadn't had anything like that with DS1. It was the same when DD was born (by elective c-section), my milk came in and there was gallons of it.

I wish that my midwife or HV had realised with DS1 that my milk hadn't come in. I felt like a complete failure as I couldn't feed, it was only 2 years later that I realised that it wasn't my fault at all. I didn't have any milk to feed with!

It probably is pretty rare, but that doesn't mean that it doesn't happen. Several midwives/BF counsellors that I have spoken to since say that it does happen, and that c-sections, especially under GA, can be a cause.

Forgot to mention that I fed DS2 until he was 9 months, and DD till she was 6 months, so all is not lost if this happens with one baby.

Yes, it is possible for milk not to come in but v rare.

How much or how little you leak or get when expressing says nothing about what is there btw. I do not leak and never have done (currently BFing DS4) and when I express I get 1-2 oz max - this is when BFing if fully established.

Ideally when you have a CS, particularly elCS, you should be encouraged to have skin-to-skin contact with your baby as soon as possible after delivery.
Also, most babies will want to suckle an awful lot in the first few days. By that I mean, hours and hours on the breast. They may well be unhappy when not latched on. BFing in the early days/weeks IME can be very very time consuming and draining, particularly if you have a baby who cries a lot.
Some jaundice on days 3 and 4 is virtually normal for all babies. Some jaundiced babies will be quite sleepy and not want to feed a lot which can affect supply.

I am very sorry to hear about your previous loss, how very sad.
May I ask, after you had lost your baby, did you get any engorgement of your breasts or where you given medication to stop this from happening (as it is of course very distressing )?
If you had some engorgement then it is very likely that your body can make milk, but that the combination of CS/medication/poor advice after delivery interfered with your supply this time round.

FWIW, it took me to DS4 to get the hang of this BFing lark and I had virtually no nipple pain and no uncomfortable engorgement at all this time round. This is after poor supply/repeated blocked ducts/non-thriving baby/exclusively expressing for premature baby - gah!
IMO the trick is to just feed constantly in the first few days: go to bed with your newborn, top half of your clothes off and just allow the baby to latch on and off as it wishes.

I do not think that anything you wrote in your OP suggests that you could not BF whenever you might have another one.

Have an under-active thyroid and both times have had problems producing milk, despite being what felt like being permanently attached to a pump. No medical person made the link between under-active thyroid and non-production despite having a pg consultant managed because of thyroid complications.

First time, didn't have any colostrum or milk at all for about 10 days, then had some milk but not much, certainly not enough to feed dc. 2nd time did more skin-to-skin and colostrum appeared at day 6 and produced more milk but by that time bottle feeding established so expressed. This time I am going to ask for drugs from my GP (forgotten name but starts domp...) to stimulate milk production, having taken advice from the LaLecheLeague. Am going to give it a good go but not beat myself up (unlike the first time) if it doesn't happen.

Domperidone, Dinah.

My milk didn't come in either. I thought that maybe it was because I was mixed feeding after a few days (a long story). I'm hoping it will be a different story this time.

i've also heard that if there is any retained placental tissue it can stop your milk come in as your body thinks you are still pregnant. don't know how common this is though...

oops sorry, coming in

My milk never came in either. I had an elective caesarean and lost a litre of blood so I think my body was struggling to cope generally. I thought that I was breastfeeding her successfully until 3 days after her birth when it transpired that she was severely dehydrated and had lost over 10% of her body weight. So... every feed I had to breastfeed and then feed her formula and then express the other breast to try and get the milk in. I lasted 4 weeks before switching completely to formula. My daughter was fine but my spirit was broken...

It was very disappointing and upsetting and it didn't help that everyone seems to demand an explanation as to why you aren't breastfeeding. I don't see any reason why you won't be able to breastfeed any future babies - worth a try, for sure. I'm pregnant again but don't think I will breastfeed as I found the whole episode quite traumatic.

Hope this helps. I think it's more common after c-section to have problems but could be wrong...

springbelle, I have never had children and so have never breastfed; I work with children and read a lot of posts on here about breastfeeding. I wanted to reply to your post so I hope that's ok given my position.

From what I know yes sometimes the milk doesn't come in (really rare, can be from stress or CS or just randomly) and sometimes it can come in without you knowing about it and other times it comes in but really late.

I think the important thing to remember is to try not to get too stressed/worried about the whole thing. What matters most if that you love your new little baby and you treasure these first few weeks together. That will give your baby, "the best start in life".

Breast/formula milk is food, it's not love so please do not feel like you have 'failed' if you do not manage to breast feed. Maybe that is easier for me to say but it's the truth.

Obviously you need to ensure your baby is well fed so maybe carry on with the formula feeds. Spend lots of time with skin to skin (bugger anything else!), in the bath, in the bed, wherever. And maybe make a point of offering the breast before each feed and see how it goes. It may also be worth getting the latch checked.

I have also heard that Fenugreek & Blessed Thistle /guiness (or other dark ale) helps milk come in and is good for maintaining a good supply. I am not a Dr though so please check before doing either.

An electric pump can also help some women but this does vary from my experience, and a baby is the best pump out there!

Hope this helps.

Thanks so much ladies for you input on this. I felt terribly guilty and a failure when I didn't get to grips with BF.

helyg - it's great to hear that you have gone on to BF your later babies. Do think the emergency c-section with your first had a psychological effect on you which could have impeded your milk production?

PacificDogwood - some great advice here! I don't think I did have enough skin to skin contact after the birth and was trying so hard to make things 'perfect' and organised (probably more so than normal after the loss of my first baby) that I didn't perhaps 'go with the flow' as it were. If I had just been told to snuggle up with my baby on me and take my cues from her then perhaps I may have had more success. I do think c-sections are known to have an effect on oxytocin which you get as part and parcel of a natural birth. To answer you question about my previous birth, no I didn't have any engorgement as was given drugs to prevent this so I can't gleam from this if I am actually able to make milk. Thanks for you positive vibes. Sounds like you tried very hard with your little ones and that it paid off in the end. I think anybody who BF's easily is very lucky!

DinahRod - various health issues do seem to have an effect don't they? I was prescribed heparin (blood thining drug) thoughout my pregnancy and for six weeks afterwards (this is normal in Hughes pregnancies) but was told this was ok to take whilst BF. Is Domperidone commonly used to help milk production do you know?
No, we shouldn't beat ourselves up about BF! We do our best!

thedollshouse - best of luck with the BF this time around. It seems knowledge is power!

babyphat - I don't think I would have had any retained placenta as I had a c-section but I can see how this would perhaps prevent your body from producing milk.

Geraldine7 - I know exactly what you mean about having your spirit broken when you have tried so hard and then it doesn't work out...but your baby did get your milk for four weeks so well done for that! I was very down (baby blues) around the same time as I was trying to get the feeding under way and when questioned about my feeding methods by various individuals did feel as if I was being attacked at times....not what you need when you are already questioning yourself.

navyeyelasH - what a lovely positive post! Brought a tear to my eye
You may never have had children but you would make a great mum with advice like that. Some of the vitriolic individuals on other threads would do well to take note of what you say - 'breast/formula milk is food, it's not love so please do not feel like you have 'failed' if you do not manage to breast feed'.

My gorgeous little girl is actually six months old now so I have missed the boat with the BF this time but I feel more positive that if I were to ever have another child I would be better equipped. x

springbell
That sounds all so traumatic
phew

I wonder if giving baby formula rather than having him/her suck constantly to encourage milk supply stopped it coming in?

Otherwise, it's possible your milk just didn't come in!
If so then thank god you had formula

Also, just my experience with breastfeeding;
my bboobs didn't seen to change during pregnancy at all, no leakage or anything.
When he was born it was like he was sucking on nothing.
I had head of milk 'coming in' but I don't recall it happening, maybe because DS was sucking every tiny bit out as soon as it came in. There must have been milk as DS was breastfed only for 7 months or so.
Then when I stopped breastfeeding I didn't leak or become engorged either, the supply just disapeared..
So it seems not everyone has great big leaky boobs at these key points.. :/

I think that the c-section with my first had both a physical and psychological effect on me, which may have contributed to my milk not coming in.

I went into the hospital clutching my TENS machine and homeopathic remedies, determined to have as little medical intervention as possible. I had originally planned a home birth, but had a bleed at about 30 weeks which made me too "high risk" to have one. I had a long labour, which suddenly turned into an emergency situation where DS' heartrate dropped and I was losing conciousness. I had to be rushed to theatre and given a GA (ironically if I had had an epidural during labour they could have just topped that up, but as it was there was no time to give me one). When I came round I didn't even realise that I'd had a baby, he had been taken off to SCBU and I didn't see him for hours. So I think that its fair to say that I didn't have the ideal starting point for BF!

With my DD I also had a c-section, but with a spinal anaesthetic so I saw her being born. She also had to be taken to SCBU so I couldn't feed her straight away. But she wasn't there for long, and having BF my second successfully I was a bit more sure of what I should be doing, and insisted that she was with me all the time from then on. My milk didn't come in until Day 7 with her, possibly due to the c-section, but I refused to give in and mixed feed, just kept feeding and feeding her. We did have problems due to her having tongue tie, but I expressed a lot as well as putting her to the breast, so we managed. I think by my third I was also a little bit bolshier with the midwives/HV etc

Also, take comfort from this: My children are now 7, 5 and 4. DS1 was BF for 2 weeks, DS2 for 9 months and DD for 6 months. Looking at them now you would have no idea, they are all equally healthy and equally intelligent. Ideally I would have BF them all for a year, but things don't always work out like that. BF is just one small part of being a mum, it may seem enormously important when they are tiny but looking back now it is just one of the many things which help them grow into little people.

I had enormous problems breastfeeding dd, my first baby. A combination of extremely poor latch (we had her snipped for tongue tie but it made no difference) and poor milk supply (this is despite definite engorgement on day 3/4) meant I ended up expressing all my milk for her for three months, which almost gave me PND, as did all the sadness and guilt about not being able to exclusively breastfeed and feeling like I was letting my daughter down.

I had to supplement with formula also as the breast milk alone was nowhere near enough for her, and I also took domperidone. Multiple visits from the NCT breastfeeding counsellor and the health visitor's own breastfeeding lady did nothing to help me get her on the boob. The pat responses you always get (including on here) is always 'Feed, feed, feed and all magically will be well' with the implication 'If only you tried hard enough it would all be okay' etc etc. All I got was mastitis, countless blocked ducts and no nice memories of my dd's first three months as I was constantly indoors expressing, and wishing she would go to sleep (rather than wanting to spend precious time with her) so I could get on my pump

All the advice never worked for me, despite 'Feed, feed, feeding' and expressing all night and all day. I used to be almost in tears with my NCT antenatal group while they all breastfed their babies while my beautiful daughter had a bottle stuffed in her mouth (which may, or may not have contained EBM!) I think poor milk supply and problems breastfeeding are A LOT more common than people think. Just take a look at this website: Mothers Overcoming Breastfeeding Issues (MOBI).

I now have a new ds, and breastfeeding is going much better this time, although despite all my efforts I am still having to give formula as well and am also once again on domperidone. For whatever reason I just don't seem to make a lot of milk. But my ds seems to know instinctively how to latch on properly and I also have more milk than I did the last time. I feel a lot more healthy mentally about the whole thing than the last time too. Being unable to exclusively breastfeed isn't the big deal that it was.

Hopefully you will have a better experience the second time too. Having said that my daughter is healthy, intelligent and beautiful and I really don't think not being exclusively breastfed for six months has had any deleterious effects on her.

Writing this all out has been quite cathartic! I should have done it a while ago.

helyg - sorry to hear that your first birth experience was so traumatic, not the ideal starting point for BF! You're right, we would all BF for as long as possible if we could but it doesn't always work out like that! There are many, many factors that contribute to a childs physical and mental wellbeing. BF is just one small part of the overall puzzle.

ChunkyChick - glad you were able to get that off your chest I would think there are quite a few mums who have come close to or suffered PND partly due to guilt issues surrounding struggling to BF. I know I felt that way. A friend of mine was determined to BF and after following all the advice (BF around the clock, not offering any formula etc) her 10 day old little boy was so dehydrated that he was hospitalised.
Your daughter sounds like she is thriving and that comes from having a loving,caring and intelligent mother. Being able to exclusively BF does not make anyone a 'perfect' mum. How could something that some of us have no control over do that?

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