Breastfeeding help needed - no milk coming in!!

[Beemommy]

Hi ladies,
I have a question for my sister in law, she delivered a baby via c section 4 days ago and till now she is not able to feed her baby!

Her breasts seem full and engorged but there is no milk coming out, she can maximum get few drops with a pump. When she is trying to breastfeed the baby is pulling off and crying as obviously he is not able to get anything as well.

What can be a problem??

Is baby definitely latching on properly? It's worth asking a midwife to watch her feed and check that he is. It can be hard to express even when you have a lot of milk in my experience!

The amount a woman can pump bears no real resemblance of how much milk she has- my friends couldn't express even 1 oz but ebf both of her babies. If her breast feel full then her milk is there. How is her babies weight? Plenty of wet and dirty nappies? I think it's common to feel that the baby isn't getting enough purely because they ask for so much in they the early days! Will she see the mw tomorrow? Next stop would be one of they he hehe help lines- LLL 0345 120 292018 and the nct 03003300771, I found them very useful.

She needs the midwife to come and help her latch.

Also get her to Google the marmet hand expression technique, there are pictures and video. It's more effective than a pump. Pumps are not a very efficient way to get milk.

But really she needs real life help ASAP.

Thanks for replies...
The baby is definitely not latching properly as she already got cracked nipples from trying hard.
He is also not getting enough as he lost 200g since birth and yesterday no dirty diaper so today she gave him a bit of formula.
I thought she should be able to make things work with a pump but she is not getting even 10ml...

Put the pump down and put the baby on the boob. It looks like nothing when you pump (especially at the beginning). This will start unecessary and incorrect panic about 'having no milk'. I wish your friend the best of luck with her breastfeeding journey and hope she cracks it if that what she wants to do.

At only 4 days I would be amazed if she (or anyone) could pump much more than that. Depending on his birth weight a 200g loss might be well within normal range. I think at this stage some women panic that bf 'isn't working' and give f which affects milk production so bf doesn't work as well (I know I did). I know it's awful and it can be as a result of bad latch but cracked nipples are common I think- I had them, so did almost every other mum I know. She needs to get her latch checked, someone to watch a while feed if possible and to avoid f if at all possible. Is his poo yellow? Does he have short periods of alertness?

Also, has she tried Lansinoh nipples cream? It's a bit expensive but worth every penny.

Has he been checked for tongue tie?

If she was on a drip of fluids at any point it's also quite possible baby's birth weight was inflated by these. If her boobs are engorged she has milk, what she needs is help getting baby properly latched so he can get the milk out. She should get a MW or lactation specialist in to help check positioning, consider tongue tie, etc. If she is still in hospital they should come to her, if she's home she could get to a BF support group, or call an IBCLC if she can afford it.

Is the milk coming out "mature milk" (thinner, white) or colostrum (thick, sticky, yellow)? It often takes a bit longer for mature milk to come in after a CSec than a vaginal birth. If she still has colostrum it's normal for a pump not to really work and colostrum is high calorie and comes only in small quantities. She can hand express the colostrum and give it to baby via spoon or syringe.

The pump is no indication of how much milk the baby can get. A new baby needs only the tiniest amount of milk. And it often takes up to 5 days for milk to come in. Weight loss in the first 10 days is normal. That her breasts seem engorged is a great sign. One day without poo is not a problem if there are plenty of wet nappies.

She needs to get the baby on the breast pretty much constantly. Crying and pulling away can be because there is TOO MUCH milk, or because it is difficult to latch. Get some lanolin on her poor cracked nipples and call her midwife or health visitor and ask for help getting a good latch. Right away, search YouTube for deep latch technique videos and follow their instructions to get the baby to latch on.

I had a csection too, and my milk didn't come in until around day five and my poor nipples were so raw and bloody, but I got past it just fine, and have had a really easy time breastfeeding since!!

Your sister should get him checked for tongue tie - if she can afford it call out a lactation consultant to the house who is also trained to check and divide tongue tie.

I have had two babies with tt, both missed by the NHS midwives. It was only after the snip that they were able to feed properly.

I'm constantly going on about it but Google laid back breastfeeding and get her to give that a go. It helps the baby to get a good latch because it enables the to correctly use their inherent feeding reflexes and behaviours.

A newborn baby of that age has a stomach capacity of around 15ml. It needs filling frequently but not with lots at a time.

Put biological nurturing into YouTube it's laid back breastfeeding it will get her going it does take about 6 weeks to establish breastfeeding x

I know it's awful and it can be as a result of bad latch but cracked nipples are common I think- I had them, so did almost every other mum I know.

Yes to this. The searing pain only lasts a few days and only for the first baby. I like to think of it as akin to a guitarist developing callouses so the strings no longer hurt .

She really needs proper support from a trained person. This is not something that an Internet forum can help with. Get her on the phone to labour ward until they send someone, preferably a bf specialist, out.

You have had great advice from previous posters. If she really wants to bf she needs to ditch the formula and pump and perfect positioning of the baby and attachment to the breast. Poor attachment equals nipple trauma and poor stimulation and transfer of milk. Midwife or HV asap!

In the meantime, when baby latches gentle squeezing/hand expressing of boob can be a good way to get milk flowing and encourage baby to stay on. But yes, she needs some hands on support quickly, and if she has any funds to put into hiring a lactation consultant, that would be my top recommendation. Otherwise a BF support group or visit from an infant feeding specialist MW/HV.

Some of this advice - while absolutely well meaning and correct in certain situations - could actually be dangerous if this baby is really not getting any milk (which is possible). Remember internet support is no substitute for medical advice.

Agree with bertie. If he has dry nappies that is not a good sign, and with the engorged boobs suggests he isn't transferring milk. Simply putting him on the boob isn't going to do anything. She needs one to one support and a tongue tie practitioner to check him over.