Baby born Sunday morning, milk doesn't seem to be in yet

[jess, lukeys_mom]

My dear little niece was just born early Sunday morning. I was talking to my brother last night (Tues) and they had a few questions.

So far SIL's milk has not come in yet, which the hospital said is a little on the long side but nothing to really worry about. They were considering starting to pump to stimulate milk production and asked what I thought.  I thought that perhaps lo's suck is not hard enough or her latch is not complete, but they can't see a lactation consultant until Friday (the one on their plan is on vacation till then). I'm a little bit concerned that this might be too late?

Any thoughts about whether she should begin with pumping?

Further, they were advised in the hospital to feed her every two hours - even though her birth weight was normal (7 lbs 3 oz). They are trying to wake her during the day/night for this but it is dificult so far, I said in the night just let her sleep, and during the day rouse her around the 3 hour mark if she's still sleeping, but don't stress over it. Would love any other opinions though....

Thanks in advance 

[Samuel's mum]

I think if milk isn't in yet it is on the late side but not panic stations.
I would however contradict and agree with the hospital about feeding 2 hourly (maybe 2.5) and waking for feeds and not let her sleep longer than 3hrs at night. The danger with milk coming in late is dehydration and a very young baby is quick to get into a cycle of being sleepy and then too sleepy to feed and losing energy. A long interval at night would be a bad thing not a good thing right now. Also important to get milk stimulated.

I would have no problem with pumping and perhaps syringe feeding (after time at the breast) what they get to ensure energy levels stay up (stress no bottle though).

What are mum's feelings about the latch - clear swallowing? nipple discomfort? She could watch some Newman videos for latch review.

Important thing is to ask about nappies - poos should be pale and yellowy by now ideally. At least 4 wet nappies in 24 hours (putting tissue in nappy so they can tell perhaps).

Just to mention not EVERYONE gets really obvious engorgement when milk comes in. And milk does transition in - it's not BAM. Is this her first baby? In fact when mums feel engorgement it's sometimes after milk has already come in and for the first time supply is more than demand.

Congrats Auntie!

[Samuel's mum]

Oh and breast compression (see FAQ) can help if baby is sleepy at breast.

[Canwi]

I agree with Samuel's mum. 
Keep trying with the 2 -3 hourly feeds.  Not only is dehydration a potential problem, but jaundice can occur.  Babies need milk to be able to process the bilirubin from their bodies.  If they don't get enough, the bilirubin builds up causing jaundice.  A jaundiced baby is VERY sleepy and then the vicious cycle occurs.  Too sleepy, doesn't feed well, more build-up, too sleepy etc.

I would try pumping.  It's going to stimulate milk production.  With DS1 I had a lactation consultant tell me to feed baby first, then pump afterwards.  Kinda tricks the body into thinking that you are still feeding the LO.
Syringe feed or gently let baby "sip" from a cup.  This will help prevent nipple/flow confusion.

Some people's milk takes a bit longer to come in.  Stress won't help.  But that's so hard to do when you are worried about your baby, tired from birth etc etc.  Tell Mum to make sure that she is drinking lots, eating well and getting as much rest as is reasonably possible.

You are a fantastic SIL/sister to be looking for hep for them.  Keep up the support.  We all know how important that is.

[jess, lukeys_mom]

Thank you both, also for the congrats  it is very exciting to be an auntie but i can't believe my 'baby' brother has his own baby!

I am passing on your advice to them, I know they will also be greatful. They went to the ped today for a bilirubin test as lo has very slight jaundice but at this point nothing to worry about. Further the doc looked at the latch and felt like it was fine, so they will just keep an eye on it and go to the LC friday.  I'll keep you posted on how it goes

Thx again.

[Vicku]

Congrats on being an auntie!
My milk didn't 'come in' properly til day 5 and I had no problems after that so I hope your SIL and baby will be fine too.

[binxyboo]

Congrats Aunty!

How is the baby feeding in the meantime? I would be worried about the doc saying the latch looks fine, often they really don't have enough bf experience to determine that. Has the Mom began pumping etc? Friday is a long time away of baby is not feeding effectively at the breast. As Emma said, keeping an eye on those diapers is going to be very important.

[Jocasta]

I never noticed my milk come in with DD1.  I never felt engorged, and only knew there was actually milk there because I could hear her swallowing lol!  When she started doing longer stretches at night (around six weeks), I then felt engorged for the first time since she was born and had to start wearing breast pads.

With Mae - WOAH!  I remember putting a post up entitled "OMG THE PAIN!!!" lol.

I sure hope that things improve really soon.

[jess, lukeys_mom]

I never noticed my milk come in with DD1.  I never felt engorged, and only knew there was actually milk there because I could hear her swallowing lol!  When she started doing longer stretches at night (around six weeks), I then felt engorged for the first time since she was born and had to start wearing breast pads.

With Mae - WOAH!  I remember putting a post up entitled "OMG THE PAIN!!!" lol.

I sure hope that things improve really soon.

I think I remember that post, Jo  I was very similar with ds, it was so hard - and we went almost a year! (thx to these boards)

It is great to know that not everyone gets engorged and that it sometimes takes longer. I was under the impression that you always get the big bowling balls if things are going correctly. I will be sure to let them know about keeping an eye on the diapers.

Michelle, I am also weary of people saying the latch is good, even doctors. We had a maternity nurse at our house full time for the first 8 days of ds' life (part of our health insurance system in NL) and the two different people both told me latch was fine - the next week I had mastitis and ds wasn't gaining any weight. From that point I realized that just because the baby is sucking correctly doesn't mean they have enough breast or the right position.

[daybyday]

also wanted to add, my cousin just had a baby, and she didn't think her milk had come in either. We brought out the hand pump, and in 10 mins she pumped over an ounce...She was SHOCKED, as she was sure there was nothing coming out for baby to feed on...She did end up going to a BF'ing clinic and having "hands-on" support really helped...

Congrats again Auntie!

[jess, lukeys_mom]

Just an update - SIL's milk finally came in this morning, bowling ball boobies and all! They are breathing huge, happy sighs of relief and the little one's diapers now show she is getting nutrition. Their frequency show she's getting enough

Thanks again for your help and congrats...I am flying there next week and can't wait to get my hands on that little nugget!

[Mama2boys]

great news Jess...have a fab time in NYC.....and get us some baby girl dust

[Samuel's mum]

Glad things are 'shaping up' (ho ho). I hope you enjoy lovely cuddles with the little nugget.

[Canwi]

Yay! for the 'milk fairies'!!!!
Enjoy being the auntie "on-site".  So much fun.  All the cuddles and none of the responsibility!!

[Jocasta]

Fantastic news   give her a snuggle from me