Planning to breastfeed after primary lactation failure the first time around - advice please.

[Loki17]

I do not want to start a bun fight about how people feed their baby. This is a personal issue and I need a bit of help but I don't want a bf vs ff argument.

I was diagnosed with primary lactation failure with my dd. I failed to lactate (after failing to dialate during labour and needing intervention) so my dd was bottle fed after losing weight and GP intervention. She thrived, she is healthy and bright and I am very grateful that formula was available when breast feeding failed. However, I wanted to breastfeed and felt like a failure at the time. I'm now 8 weeks pregnant and I'd like to breastfeed this time. My gp said that my problems shouldn't reoccur again. I will always wonder with my dd if I got the right advice or could have done things differently. This time I want to go I'm with a plan to give myself the best chance of being able to breastfeed my baby. Does anyone have any tips to help me encourage my milk supply? Last time, I didn't produce any colostrum during pregnancy - is there anything I can do to stimulate milk production? Thanks in advance.

I'm not an expert at all but perhaps you could work out what your window is for trying to BF after the birth a) before you start formula and b) after you start formula (I have heard women managing to start up BF at a later stage). Perhaps midwife\GP\health visitor could give you guidance on this. This is my experience which may or may not be relevant - with me I felt very much like nothing was happening initially and I had to encourage my newborn to have a go as he didn't seem that bothered, he then got very hungry and there was a lot of all night \day sucking and then a few days later my boobs went massive and it was fine, I think the whole process is fairly mysterious and I don't feel I did anything in particular to make it happen, I think it was just that my newborn got the hang of it which obviously is totally out of anyone s control, but like I say I'm not an expert, I would say it would be good to reassure yourself about what the gp has said, focus on how this time is new and anything could happen, perhaps avoid a load of visitors after the birth if you think that will stress you out (but have them if not) and do the whole skin to skin and rocking your newborn loads, maybe be fairly glued to them. I was lucky on the postnatal ward as a wonderful kiwi trainee midwife spent some time with me helping me to try and latch my son on for the first time, we tickled his feet to wake him up a bit holding him over my nipple - he only had a bit of a go as was tired after birth but on the night after birth he went wild for it (ouch!). So im not sure if that was a bit of training for him and then when he woke up and was v hungry he knew what to do, I'm really not sure, it might have been all the crying that set the wheels in motion in my boobs, I was also eating a LOT of cake - have heard cake is good for BF but I was just doing it to stay awake, not sure if that helped, so maybe make sure you eat very well in the days after the birth. He was tired after the birth and took a day for his temp to get to normal initially so the first day nothing really happened on BF front. Perhaps part of this is reassuring yourself that either way it will be totally fine, I remember finding it very stressful initially and you don't need extra stress. If you do FF then it is great you know all about that so the back up option will be easier to sort out if needed. Sorry about my ramble here, sure you will get lots of good advice. Try all the BF and parenting charity helplines for advice too.

I have never heard of this (and I have a lot of breastfeeding training /experience, personal and work).
Did you produce any milk whatsoever?
In your situation (if you can afford it) I would see a lactation consultant antenatally and postnatally, as they are the experts in this field and will he able to offer the most appropriate advice. Did you lose a lot of blood? For some women this can affect supply. The birth shouldn't have affected it, as it the loss of the placenta that releases the lactation hormones and not dilation.
General things I would ensure: feeding completely on demand, no supplements or dummies, ensuring latch is perfect, lots of skin to skin, earing and drinking well/plenty.
If you do all this and still have a supply issue, then domperidone and fenugreek can be taken and can sometimes help; but a good lactation consultant will probably give you loads more advice and confidence. Good luck x

Had to have a Google as never heard it it and like to be in the know. This article from kellymom is informative:
kellymom.com/bf/got-milk/supply-worries/insufficient-glandular-tissue/
From what I have read, if you had true primary lactation failure due to a physiological issue, then it seems unlikely that you would be able to breastfeed and you may want to consider a supplementation device.
However, true lactation failure isn't common and there may have been other factors contributing to your previous breastfeeding experience, which is why I would speak to an experienced lactation consultant.

I've not got any advice but I'm really interested by your experience. I couldn't feed my son, my milk came in (my boobs were huge) but nothing would come out, manually or with a pump or with him trying to latch on.
I gave up on day 6. He was in nicu at thE time so it had been a fairly rough few days! I was induced and I'm not sure there was anything natural going on in my body (drip did all the work, then ventouse to actually deliver him, then the injection to remove my placenta) so I'm really interested in the link between that and milk supply. Thanks you have given me some food for thought!

I'm not 37 weeks pregnant and not planning on attempting bf this time. I think the memories of nicu are too strong and actually bottle feeding worked really well for us,

Good luck, I hope you have more success this time kxxx

Later in your pregnancy, say few weeks before your due date, start to gently massage your nipples in the bath / shower. You should start to be able to squeeze out a couple of drops. Babies don't need much to start with.

I had a really hard time delivering the placenta do I wonder if that was a factor? It wouldn't come away and was manually removed in the end. I had two lots of the drug that they give you to help and still nothing. With the feeding, dd latched on straight after birth for two hours. Then nothing for about 24 hours, then whenever I fed her she would latch and then cry and get frustrated when the milk didn't come. I supplemented with formula on midwife advice after she lost weight. She said that my milk would come in, so to keep trying her on both sides before trying formula which I did. I tried expressing too but couldn't get anything with the pump. I had her on my boobs as often as possible and kept waiting for my boobs to engorge they didn't. I went to the gp when dd was 3 weeks old and sobbed because I couldn't feed her. The gp looked at my medical notes and diagnosed primary lactation failure. She said to stop and give her formula so I did. She said my boobs would go really hard when I stopped and might be painful but they didn't at all. I will always wonder if I did the wrong thing by starting formula in the first place. I know I didn't eat or drink properly because I was so overwhelmed I forgot. It was our first baby and we were naive. DH was so thrilled he wanted to show her off to the world and I felt superhuman after giving birth so we went out and had visitors round straight away which, in hindsight, was stupid. I will always wonder if bf failed because I didn't rest enough or I missed those early cues for feeding. I crashed hard at about day 6 and then just did what the medical people told me to do because dd cried constantly and she lost weight and I was scared. I will not be making those mistakes this time around. I felt pressured to 'bounce back' from giving birth. This time around, my pil will be on holiday when baby is due. They were the worst culprits for making me feel I had to let them visit whenever they pleased and go to a birthday party the day after I gave birth. They constantly wanted to hold dd and I didn't feel I could say no. This time it will be different. Thank you for your advice and for reading. Writing this down is really helpful.

I think most of us make similar mistakes after the birth of our first!
From what you have said, the only thing that could have been done differently (and the MW should have been advising you this) is hand expressing in that first 24 hours to stimulate milk production and if baby doesn't latch to give colostrum via syringe /cup. 24 hours is a long time to ho without a feed. There are YouTube videos on how to do it and should mimic a baby's feeding pattern I.e. 10-12 times in 24 hours. You only get small amounts at first (a few mls, but baby's tummy is very small).
I sound like a broken record, but do see a lactation consultant. You can then be confident that you have done everything and if the same thing happens again (which if true lactation failure, it is likely), you will know that you have done everything possible and will have no moments of 'what if'.

I have breast hypoplasia, diagnosed after my DD failed to gain weight. It's also known as insufficient glandular tissue, and is to do with the shape, not size of your breasts.

I'm surprised that a PP has not heard of it - there are at least three of us with babies the same age in my small town, put in touch with each other by our lactation consultant. I suspect many women just move to formula without fully understanding why BF didn't work.

The give away sign is minimal breast changes during pregnancy, as well as poor weight gain in the baby, despite excellent breastfeeding management (good latch etc).

Things I did - took fenugreek and domperidone, fed as often as possible. I mix fed my daughter until she was 2, even tandem feeding with my son.

I had very similar problems with my son and only mix fed him until 6 months, as with a toddler I didn't have the time or energy to devote to full on breastfeeding. Yes, I do feel guilty about that.

Subsequent pregnancies can increase your laxational tissues but realistically you will be unlikely to be able to manage exclusive BF. I used a supplemental nursing system for a while but it's a bit faffy.

I have to go out today but will be around this evening if you have more questions.

Thanks both. I will see a lactation consultation. Your post gives me hope Very. I will probably have lots of questions as my due date nears.

You want an IBCLC lactation consultant. I would get in touch with the La Leche League through their national helpline. They should help you find an IBCLC as well as local peer support.

Think I haven't heard of it as in my area of work I deal with 'the norm' and any specific issues I would refer on. I supported one mum who had a lot of breast tissue removed (reduction) and she managed to breastfeed exclusively for a couple of weeks- she expressed and used domperidone, however her milk production peaked and as baby was growing she couldn't produce any more milk. She continued to breastfeed but also used a breastfeeding supplementation device with formula.
Good luck op x

Great advice lumpyspacecow. Op if you start hand expressing a few drops regularly before baby arrives it will give you a chance to get to know your breasts and should get things going in time for baby. Of course you won't get much before birth.

Colostrum and milk production are two separate biological pathways, so producing colostrum is no indicator of how much milk you can go on to produce.

The best advice, as recommended up thread, is to find a good lactation consultant who has experience of IGT. Otherwise in real life you will get a lot of advice that just doesn't work for you.