Feeling so low - NICU, no colustrum

[User88181992]

Hi all
My beautiful baby was delivered via c section at 36 weeks late yesterday night and has been put in NICU due to low oxygen levels. Skin to skin was limited due to c section and then my son was whisked away to NICU. Due to a long labour, exhaustion and lateness, I had to go to bed without a chance to express colostrum.
Today I have been unable to produce colostrum, either alone or visiting my baby. He’s all tubed up and initially I was asked not to touch him. I am getting so wound up that this has meant oxytocin hasn’t been released and I’ve now missed the boat. I’ve tried and find myself getting upset - which is unhelpful I know.
the maternity unit have offered me use of a pump tomorrow but I read this isn’t suitable for colostrum.
Without getting to be close to my boy, can I still trigger a milk supply?
will milk still come in if there is no colostrum?

please be kind - it’s been a tough few days

Just keep going. I did it. You can do it. Go easy on yourself, but don't give up if you don't want to
Sometimes the body needs time to adjust.

Ps I used a pump and got colostrum. It comes out in tiny doses - don't worry about that. It's just thicker. When your milk comes in, it'll be easier.

Do you have a photo of him? They said that looking at that helps. Also when they change his clothes (if wearing) or blanket, try to get that to smell.

Recovering from a C section can affect milk production, don't be so hard on yourself, you are recovering from major surgery & your baby is in NICU. Concentrate on getting well, eat & drink as much as you can, could you ask for a muslin or something that has been touching your baby to smell & maybe get the oxytocin flowing?

If it doesn’t work OP don’t beat yourself up. As long as he gets fed, that is all that’s important to get him stronger. The main thing he needs from you is your presence and good vibes.

Thank you for the responses, everyone.

I can’t seem to find anything online to confirm whether my milk should still come in naturally within a few days even if colostrum hasn’t been forthcoming. Does anyone know?

excellent idea about borrowing a muslin- thank you

Pumps can work for colostrum. Definitely helpful to have a picture of your little one, and something to smell. Can you try expressing in the room next to your baby? A lot of SCBUs have screens they can set up to enable that. I'm not quite clear how much support he is needing. If he's actually intubated (breathing tube into the trachea) then skin to skin is tricky. but if he's just on oxygen or CPAP it's usually possible. Have you had a chat with the nurses about it?

Good luck, and congratulations.

I had a very similar story. - twice.
Baby delivered early, tried hard to pump. Did absolutely everything the midwives and breast feeding specialists suggested. All I ended up with was blood. Don't think I got any usable colostrum.
Really beat myself up about it the first time. Felt like a total failure but my eldest dd got a bottle and is mostly healthy and happy and sharp as a tac.
Second time, I was a little easier on myself and my second dd is also thriving.
Found out I had a benign tumour on my pituitary gland a couple of years later...that probably caused the early onset of labour and lack of milk but I had no clue when it was all happening.
Try your best but know your best is good enough. However, you manage to feed your baby is ok.
You and your baby will be ok.

Hiya, he is not intubated. He is on oxygen and being fed his meds and glucose through his belly button! It doesn’t seem an option to anything more than trace a finger on any exposed bit of skin I can reach. But I will certainly try to clarify tomorrow.
Oh I just feel so sad :(

Op congratulations on your new arrival, that sounds like it's not been the way you would have maybe wanted things to go and it sounds like you have been through a lot of stress mentally and physically.

I found breastfeeding and expressing colostrum to be quite an emotional thing. So I would have looked at pictures of my son, imagined holding him and being close to him etc when trying to express. I also tried to make sure when I was expressing I was somewhere warm and quiet where I wouldn't be disturbed and if I felt anxious I would have tried to do a meditation beforehand to calm myself. Sometimes if that didn't work I would have put on a familiar movie in the background.

Joining a bf support group was the best thing I ever did and is the reason why I managed to feed for so long. I would really recommend it as there will likely be other mums who really struggled in the beginning who can support you and for me, it took a bit of pressure off by helping me see that breastfeeding looks lots of different ways than just a baby on the breast. I also found that eating lots of oats really helped my supply so I had porridge once, sometimes twice a day. The amount of colostrum you produce is tiny initially because babies tummies are so small. It's supply and demand so working out a plan for pumping etc would be a good idea- have you been able to see an infant feeding specialist/lactation consultant at your hospital? They can loan special pumps and give you advice on how often. you also tend to produce more at night than during the day so I would have pumped in the wee hours of the morning and generally got a little more then.

At the end of the day, you've already done an incredible job bringing your baby safely into the world and you have both been through something huge. I had a section and even though I'd been able to harvest some colostrum before when ds arrived I got nothing initially (ds born at 9am) until that evening when I'd had the chance to rest and eat and drink properly by which point the midwives were already pushing me to give formula. So make sure that in the middle of all the craziness that you are meeting your own needs first - eat a good meal and keep yourself well hydrated.

I'd have another chat with the nurses/midwives to see if there's any way you can do skin to skin or maybe be supported to pump beside your baby in a private way?

Pump at hospital got me some milk after a c section! It was very yellow so lots of colostrum

Your milk doesn't necessarily come in straight away. Give it time, and congratulations x

Oh, love. Babies are so good at worrying you! I sincerely hope he rapidly improves, making all this easier. Umbilical lines can be a bit of a pain, but can be so useful if baby has not got good veins, or if they need higher concentration of glucose drips. It is worth having a chat about how to have more physical contact, and definitely ask about scent swapping. (The idea is that the smell of you will be comforting to your baby, just as the smell of him will help you with your milk)

OP I feel sad that you are sad. You’re exhausted, worried and perhaps comparing dreams of how the birth would be with reality
(that’s what I did). Try not to. C/s here and day 5 before milk came in. Colostrum was minimal, I did bf exclusively although due to “clinical need” I had to begin with formula for a few days but kept trying bf which worked. Healthy child here. Stay positive and tell yourself well done. Try to use these days apart to get sleep

Hi - congratulations on your beautiful baby and sorry this is such a stressful start.

Colostrum is hard to express regardless. There’s so little of it! Try during or after a hot shower (if you can get to one on post natal) and do try a pump. Have a look (if you haven’t already) on YouTube for some video guides.

Your milk will likely still come in. It is triggered by removal of the placenta and isn’t triggered by removal / expressing of colustrum. My SIL’s daughter was in NICU for four days and she didn’t see her for 36 hours. Still currently ebf at almost 7 months so don’t lose hope. I am pretty sure she didn’t start expressing colostrum until later in the stay.

Whilst I know how it feels to really really want to bf and have it feel all consuming if you can’t, please know that baby will still thrive if formula fed and it really won’t affect your bond or importance to his wellbeing.

Having a C-section can often mean that there's a small delay in milk production whilst your body "catches up" and realises you've given birth. Try the pump, and you absolutely must make sure you eat, drink and rest as much as you can too. You've been through a lot. You'll be holding your little one in your arms very soon. It'll be okay.

Blown away by all the lovely and helpful messages, especially this time of night! Thank you everyone. I feel a bit better now. Fresh start in the morning.

Nicu is just horrific.
I think if people havent experienced it they just dont get it. I was in for 3 weeks with my 2nd and remember saying at the time i dont know how i would have coped if it was my first. Its harrowing and so hard.

Summary of my experience / advice:

• you do you. Sleep when you need to, make sure you are eating well and try and rest / recover yourself. At the time the nurses made me feel like fucking shit for going back to my own home at night despite the fact i also had a 20m old at home who missed me and couldnt understand where mummy was.

• the pressure to produce breastmilk in NICU is crazy/insane/ not right/laughable. Its like some kind of religion. Propaganda posters everywhere!! I was able to laugh as it was my 2nd baby and id already been through the bf mill. My first would. Not. Latch. I was pumping 4-5 hrs to bottle feed her breastmilk. So i had already decided not to BF with no 2 and had taken medication before nicu admission so there was nothing to he done. It weirdly worked out better for me as my 2nd had cmpa which we caught v early as not bfing.
• with c sections milk takes longer to come in. Like 3-7 days
• there is prescription medication you can take to increase supply -nhs are often reluctant to prescribe it just insist if you want it.
• my experience was the hospital grade pump which weighed about 5kg and was a loud nightmare and was no better than 300g totally portable lanisoh pp which cost me about £80 and i could use anywhere and pop in the front pocket of a hoody
• Nicu gave me ptsd. Apparently not uncommon. When you are out, if you need it look into accessing 3 step rewind via your GP. It will help you process the trauma. I thought it was mumbo jumbo but it was life changing.
• this will pass. You will go home. Your baby will get bigger. Life will be better.

AT 37 weeks it took me over an hour to get 1 tiny ml, my baby was in NICU for a week with no holding for the first 24 hours. I had a section too. I breastfed her for 3 years… you can absolutely do it! Keep trying.. you’re doing really well.’

Congratulations OP . My two sons were both born ELCS over 20 years ago and went to NICU and I can honestly say that I cannot remember how or if i produced colostrum! I did breast feed for a few weeks. They are both in their twenties,have a fantastic relationship with them . Just concentrate on your recovery and you will be a brilliant Mummy. 💐

My baby was born at 34+1, but by vaginal delivery rather than c-section (not sure if this makes a difference). Skin to skin was also virtually non-existent as he was taken to NICU, like yours.

I was given a leaflet on hand expressing and a couple of syringes, but no other information and no conversation about breastfeeding, and I didn't realise at the time the importance of skin to skin or initiating breastfeeding/pumping early to encourage milk supply. I tried hand expressing but got nothing, and I didn't start pumping until more then 24 hours after he was born, when one of the NICU nurses talked to me about breastfeeding and I was given a hospital pump to use. I was devastated because I thought I'd missed my chance to breastfeed.

Pumping was hard and I got tiny amounts of colostrum and later runny amounts of milk. I never really got on with the pump to be honest, and my little one struggled to latch as he was so early. He was tube fed for around 10 days - a mixture of formula and breast milk/colostrum (though a higher percentage of formula as I didn't have much milk). He eventually did get the hang of latching using nipple shields to help him, and he was discharged after 2 weeks exclusively breastfeeding.

His weight gain was slow to begin with and we were under the infant feeding team for a long time, but we did manage to EBF for 4 months, then mixed feed (introduced formula on the advice of the hospital to encourage weight gain, although the infant feeding team had been telling me that there was no need to). I wish I'd gone to mixed feeding sooner really as my milk supply was never copious and I honestly think he thrived better on mixed feeding than EBF (he gained a lot of weight quite quickly, seemed to get stronger and then found breastfeeding easier. He also had prolonged jaundice until 4 months, which resolved almost immediately when I introduced formula, unsure if this was just coincidence or not).

He's just turned 3 now, and he's still breastfeeding (though I'm trying to gently encourage him to stop because, to be honest, I've been ready to stop for a long time now and I want my bloody boobs back).

Sorry for the long essay, but what I'm trying to say is that it is likely still possible for you to breastfeed, even if you've had a really slow start. It was possible for me. I felt terrible in NICU seeing all the posters about "golden hour" (which we never got) and seeing other mums producing what I perceived to be loads of milk, when I was only getting 10-15ml from each breast even after over a week. But we did eventually manage to breastfeed and I have a happy and healthy 3 year old now.

I do wish that I hadn't put so much pressure on myself though, and I wish I'd switched to mixed feeding sooner (but I felt under a lot of pressure, even from the feeding team, to persevere with EBF). If breastfeeding doesn't work out for you then so be it - you can still have amazing cuddles and an amazing bond with your baby without it. I know it's easier said than done, but try not to drive yourself mad over it, in a year it won't seem important, and your baby will be fine either way.

@OP This is so accurate.

My daughter was born at 24 weeks and spent 4 long months in the NICU. She was fully intubated for 28 days and I wasn't able to hold her for 3 weeks.

I tried everything to get my milk supply going. Both because I wanted to, but also due to the pressure from the staff in the NICU (i'dbe repeatedly asked throughout the day who would wax lyrical about the importance of producing my own milk).

I honestly went a little crazy and was obsessed as though the outcome depended upon me being able to produce milk. My milk never came and I have a very robust 3 yr old now.

Given your gestation I'm sure your milk / colostrum production should be fine.

Congratulations and I wish you and baby well. You can hand express next to your baby or alone but ideally hold something of baby's as you do it to try and stimulate oxytocin. Here are some videos. laleche.org.uk/antenatal-expression-of-colostrum/

Yes use the pump! I used one with my premmie. There should also be donor milk available.

So sorry to hear your beautiful baby is in the NICU.

Okay so I had a c section that was induced and my body wasn”t “ready” for feeding yet. I pumped and pumped and milk finally came. Mere drops but it did come. Also a small tip (sincere apologies if you know all this already) but the let down of milk won’t come if you are tense so try and relax as much as possible. And my breastfeeding nurse also said that due to the extra calories needed try to ensure your calorie intake is high enough. Best day of my life when I was medically prescribed cake!

So, your baby needs what it needs and please do try pumping if this is what you want to do as it can work. If you can’t get colostrum then keep going to get milk as it will give you that wonderful bonding experience.

Best of luck to you!

I’m sending hugs because NICU is so, so tough. Both my babies were NICU babies and it’s still the hardest and worst bit of parenting I’ve experienced (my eldest is nearly 3). My experience sounds very similar to yours and it took me ages to be able to think about my first child’s birth without feeling upset. It does get better and easier though I promise.

1 day in is still really early, especially because baby was a bit premature and you had a c-section followed by being separated from baby.
For the first couple of days it took me nearly an hour to get even a few ml of colostrum (I ended up with a massive oversupply so it didn’t have any long term impact).
My younger child is now 8 months old and exclusively breastfed apart from solids, so you can still have a successful breastfeeding experience even with a tricky start.
My eldest never latched and I exclusively pumped for a few months (which I hated and really regret- with the benefit of hindsight and perspective I think formula would have been better because breastmilk wasn’t worth the amount of stress and pressure I felt, I really wish I’d relaxed and just enjoyed that time with my baby. He ended up on formula eventually anyway and he’s still a really healthy and happy child).

Some things I found that helped include:

• Staying really well hydrated and making sure I was eating enough (your body needs calories to recover as well as producing milk).
• Using a combination of the pump and hand expression in the first few days (hand expression is gentler and I found it helped trigger the letdown).
• Watching videos of my baby (choose one where baby is calm and sleeping) and having an item of their clothing I could smell.
• Pumping/expressing after a shower
• Trying to get as much sleep/rest as possible. You might find that milk comes in more quickly once you’re home and you can relax.

Breastfeeding is lovely BUT it also isn’t everything. I have exactly the same bond with my baby who never latched as I do with my baby who breastfed constantly. Look after yourself and prioritize your mental health (traumatic deliveries and NICU stays are hard) and enjoying time with your baby.