Baby News and Breastfeeding Question

[Paige]

My baby was born on Tuesday! He was 6lbs 3oz and 19.25in. All the other kids have been adjusting well and he and I are doing well.

 

It's been 10 years since I breastfed, and I can't remember what's normal. My milk came in yesterday and the engorgement is super painful. I know that's normal, but I don't seem to have a letdown yet. Is that normal for this early? I think a letdown reflex would help with the engorgement. I know baby is getting plenty to eat from his diapers, spit up, burps, etc. I can also pump and get about 4-5oz a time within 10min after he eats, but it does nothing to ease the pressure. I think I feel worse after he nurses than before he nurses. He's a little weak with anemia and the doctor recommended pumping and syringe feeding if he falls asleep too fast. He's lost a lot of weight and has had a problem with a blood type incompatibility with me, so I'm not just pumping for fun, bottles, or relief. 

 

Whether I pump or nurse, however, there's only drips. I recall feeling a burning surge of milk, when suddenly the breasts take off like a hose and start spraying, and I would leak/spray milk on both sides even if he only nursed on one. That isn't ever happening. I am used to soaking through pads on whatever side baby isn't nursing from and this time my pads stay dry. This is my 5th baby and I nursed them all and experienced the same letdown with each of them except new baby. Is it normal since my milk is just in, or is something wrong? I think baby would eat more if he didn't have to constantly work for it. The heavy letdown helped my preemies when they were weak because they could just sit and lap like kittens. I couldn't nurse them until they were over 3 weeks old, however, because of being in the NICU. I don't know what it would have been like with them the first week. 

 

Here's Baby at 1 day old!  :001_wub:

 

 

[ktgrok]

Has your thyroid been checked in the past month? Hyperthyroid can cause huge milk supply but trouble with let down. It's a serious issue. I'd ask for a thyroid test asap. It's one of the few blood tests that doesn't need to be done fasting, so you could get it done any time, which is nice :)

[ktgrok]

Also, try standing in a warm shower for a while and then massaging/hand expressing...sometimes that helps. 

[Paige]

Has your thyroid been checked in the past month? Hyperthyroid can cause huge milk supply but trouble with let down. It's a serious issue. I'd ask for a thyroid test asap. It's one of the few blood tests that doesn't need to be done fasting, so you could get it done any time, which is nice :)

 

I have been on thyroid meds for about a year. It's probably why I was pregnant when I thought I couldn't be.  ;)

 

It was just checked a week ago (before I had Baby) and it was perfect. I tend towards low thyroid.

[happypamama]

I would get the thyroid checked because of the postpartum hormonal changes, but I also think it might resolve in a couple of days, and maybe when your supply regulates a little more.  I don't always recall getting the burning thing early on, but I definitely remember it happening at some point, just maybe not in the first few days.  And for my preemie, I was exclusively pumping, and I don't recall getting the burning shooting letdown, but I could tell it was happening because milk would just start pouring into the bottles.

 

Get baby checked for lip and tongue tie too.  If you do a little massage or twiddle your nipples, will that get the letdown going?  If so, I'd definitely get baby checked to make sure he is stimulating the breast enough to make the letdown happen.

 

He's very lovely!  Congratulations!

[MercyA]

I had an inadequate milk supply and found out later that I had an undiagnosed thyroid problem.  :( It sounds like you're on top of that, though.

 

No advice, just wanted to say that he's absolutely beautiful. Congratulations!

[Paige]

I would get the thyroid checked because of the postpartum hormonal changes, but I also think it might resolve in a couple of days, and maybe when your supply regulates a little more. I don't always recall getting the burning thing early on, but I definitely remember it happening at some point, just maybe not in the first few days. And for my preemie, I was exclusively pumping, and I don't recall getting the burning shooting letdown, but I could tell it was happening because milk would just start pouring into the bottles.

 

Get baby checked for lip and tongue tie too. If you do a little massage or twiddle your nipples, will that get the letdown going? If so, I'd definitely get baby checked to make sure he is stimulating the breast enough to make the letdown happen.

 

He's very lovely! Congratulations!

I can’t stimulate letdown on my own either and when I pump milk never pours in. It’s just drip, drip, drip. But enough drips for about 4-5 oz. With my twins I had letdown while I exclusively pumped when they were in the hospital. I don’t remember when it started.

 

I also do not feel any uterine cramping which I was expecting to be bad after 5 kids. I felt some the first 24 hrs but none now, and I have hardly any bleeding anymore; almost none at 4 days out.

[Kassia]

Also no advice, but I wanted to say congratulations and comment on how beautiful your baby boy is! 

[Sandwalker]

Hi I'm a lactation consultant and RN. Congrats on baby!!

 

I have to run out right now, but there are some good tips in this link for helping letdown. https://www.romper.com/p/why-you-have-a-slow-let-down-plus-5-ways-to-speed-things-up-14517

[emoji173]

[hornblower]

Beautiful baby!!!! 

I think you need to be under the care of an Int'l Board Certified Lactation Consultant.  There are several things that are not adding up and require some tweaking. 

 Given baby's weight loss and possible anemia, I'd be concerned that production was not optimized in the early days.  There could be lots of things happening but I think I'd want an expert set of eyes to look examine the whole picture.  

Are you pumping with a hospital grade pump? 

 

Edited October 14, 2017 by hornblower

[eternalsummer]

Yeah, you're not letting down.  I wish I could tell you why.  I'd suspect hormonal levels of some description since you normally had great letdown and now neither pumping nor nursing ever makes it happen.

 

eta: congrats on the baby!  He is beautiful.

Edited October 14, 2017 by eternalsummer

[stephanier.1765]

A-dorable with a capital "A"! Congratulations! I have no advice but couldn't stop myself from posting after seeing such a sweet baby.

[Guest]

Beautiful, precious baby!

 

No advice on the breastfeeding. I was always an underwelming milk-maker. If they gave out grades for milk production, I would have earned a C-.

[hornblower]

first thing I'd try at the next feed is Jack Newman's breast compressions when baby slows down 

there are several videos on youtube. Here's one

[hornblower]

How was your delivery? Did you have significant blood loss? 

I'd also be wondering about the scant lochia. I'd want to r/o retained placental fragments or clots. 

[happypamama]

How was your delivery? Did you have significant blood loss? 

 

I'd also be wondering about the scant lochia. I'd want to r/o retained placental fragments or clots. 

And the lack of cramping too.  I recall afterpains for baby number five being pretty noticeable, and even the pump for baby six caused some cramping.  I was wondering about retained placenta or clots too.  But she says she is engorged, and she's obviously got milk if baby is making wet diapers but also pumping 4-5 ounces after he nurses.  I'll admit I'm a little perplexed.  I think talking to her doctor and/or an IBCLC is a really good idea.  

 

Paige, does your uterus feel like it's going down?  I recall after baby number three that about three days in, something didn't seem quite right, like my uterus wasn't shrinking much.  I was worried enough that I left a message for my midwife, but by the time she got back to me the next day, things had resolved because a large clot came out.  Not lemon-sized but still large.

Edited October 14, 2017 by happypamama

[ktgrok]

WAs the thyroid checked before or after birth? What was normal amount of meds while pregnant could be too much now that you aren't...that happened to a friend which is how I found out about the hyperthyroid/let down thing. My poor friend ended up with mastitis because she was making copius amounts of milk but not letting down. 

[Selkie]

Congratulations!!

[EmseB]

With no cramping and stopped lochia this early and lack of letdown I'd probably be going in for a check for retained placenta or something like that.

[Sandwalker]

Beautiful baby!!!!

I think you need to be under the care of an Int'l Board Certified Lactation Consultant. There are several things that are not adding up and require some tweaking.

 

Given baby's weight loss and possible anemia, I'd be concerned that production was not optimized in the early days. There could be lots of things happening but I think I'd want an expert set of eyes to look examine the whole picture.

 

Are you pumping with a hospital grade pump?

 

 

Well, I'm an IBCLC, but please continue.

[hornblower]

Well, I'm an IBCLC, but please continue.

 

I'm an IBCLC too :D 

[Paige]

How was your delivery? Did you have significant blood loss?

 

I'd also be wondering about the scant lochia. I'd want to r/o retained placental fragments or clots.

My delivery felt pretty fast. I was induced overnight w/ cervidil, then given pitocin the next morning, so obviously not too fast. But I went from telling the doctors I didn’t feel any contractions (they were on the monitor, though) and baby being +4 to having him in my arms in about 30min or less. He was pretty full of fluid because he didn’t get squeezed well.

 

I lost more blood during labor than I remember doing before and the doctor said it was a lot but I didn’t get a transfusion or anything. I had a succenturiate placenta so they were checking it out closely and said they thought they had everything. I’ve passed one huge clot- about the size of my hand and another a little smaller since coming home but the bleeding has been so light and I have no fever so I didn’t call the doctor.

 

With all my other kids I had oversupply and a very overactive letdown so this seems weird unless I’m forgetting the timeline. It’s also been 10yrs so things could have changed in me. I remember the aftercramps with my 4th were hell for weeks. I even asked for extra pain meds this time but haven’t needed any. I can’t tell if my uterus is down. It looks small but feels firmer and less jelly- like than I expected.

[Janeway]

Your baby is so beautiful!!!!!!!!!!!

[Paige]

WAs the thyroid checked before or after birth? What was normal amount of meds while pregnant could be too much now that you aren't...that happened to a friend which is how I found out about the hyperthyroid/let down thing. My poor friend ended up with mastitis because she was making copius amounts of milk but not letting down.

It was checked before but I’m on the lowest dose. Mastitis is a concern. I’ve never had it and don’t want it and know I need to keep the milk flowing to prevent it.

[ktgrok]

Light bleeding or no bleeding? None can mean a big clot is blocking the cervix.

[Paige]

Light bleeding or no bleeding? None can mean a big clot is blocking the cervix.

Very, very light? I could probably wear one pantyliner for over 24 hrs. I don’t, but I see little blood and haven’t since Baby was about 48hrs.

 

I’d feel a little weird calling the doctor and saying I need to come in because I have so little bleeding or pain. Nobody put that in the discharge papers. The doctor said something about getting some large clots out while she cleaned me up (sorry, it’s gross and tmi) so I thought maybe I was bleeding less because they got so much out in the beginning.

[ktgrok]

Very, very light? I could probably wear one pantyliner for over 24 hrs. I don’t, but I see little blood and haven’t since Baby was about 48hrs.

 

I’d feel a little weird calling the doctor and saying I need to come in because I have so little bleeding or pain. Nobody put that in the discharge papers. The doctor said something about getting some large clots out while she cleaned me up (sorry, it’s gross and tmi) so I thought maybe I was bleeding less because they got so much out in the beginning.

That actually was listed as a reason to call on the sheet the midwife gave me.

[eternalsummer]

Between the nonexistent let down and the lack of blood and pain, I'd call.  There's nothing wrong with calling, that's why doctors exist, is to make these calls when you're just not sure.  

[rebbyribs]

Very, very light? I could probably wear one pantyliner for over 24 hrs. I don’t, but I see little blood and haven’t since Baby was about 48hrs.

 

I’d feel a little weird calling the doctor and saying I need to come in because I have so little bleeding or pain. Nobody put that in the discharge papers. The doctor said something about getting some large clots out while she cleaned me up (sorry, it’s gross and tmi) so I thought maybe I was bleeding less because they got so much out in the beginning.

 

But this is your 5th baby and you know this isn't normal for you.  

[Starr]

Call the doctor. You will feel much better for doing so. When I worked for an OB we expected Mother’s to call with concerns, some were serious some were not. If things feel off you don’t want to miss something.

[heartlikealion]

What a sweet baby!!

 

My suggestion -- get on Facebook and see if there's a local LLL chapter. Their leaders will probably be able to answer your questions :) I had a wonderful group and even though I only made it to one or two meetings I got a lot of help and support online. The LLL leader for my group was a nurse and IBCLC. But other members were usually helpful, too.

 

My other suggestion is to feel for knots. You may need to rub a knot out.

Some people say don't even pump this early. Mainly because of nipple confusion/preferences I guess with the baby. They may get used to not working for it from the bottle the way you do from the breast.

 

Another possibility, is the baby not able to nurse properly due to an anatomical issue? Dd had lip and tongue tie and couldn't empty the breast. Some of those babies rely on the letdown to swallow and don't fully empty the breast which keeps mom feeling uncomfortable til she pumps. But since you are pumping and aren't seeing/feeling the letdown that may be a separate concern. I think it's normal to not necessarily experience that right away. I'll look on kellymom to see if I can find out. Don't take my word for it. I didn't have what I consider a normal breastfeeding journey, if there is one lol.

[Twigs]

Congratulations!!

[Another Lynn]

Congratulations!   :001_tt1:  and  :grouphug: .  

[Rosika]

He looks so sweet in the picture, and the "pose" makes him look so at peace. Congratulations! 

 

I hope you'll check in with your OB/GYN or midwife, and can quickly figure out how to address your milk situation. I had mastitis with my daughter, and it still brings me chills to remember how awful it felt. 

 

But yay! Baby!  :hurray:

[Guest]

Congratulations!!!

[RootAnn]

I'd call the doc first thing in the morning about the lack of cramping & bleeding.

 

But I'm posting because you have such a beautiful baby. Enjoy him. Give him a squeeze from us Hive Mommas.

[Sandwalker]

It would call to tell the OB about the lack of cramping/lochia. Since you had large clots after birth and the doc said he'd "cleaned you up", he may have gotten a lot of the blood out. Some c section moms hardly bleed at all because the docto r kind of cleans out the uterus. The fact that your uterus feels low down and firm is a good sign. Usually it would be boggy and high if you had retained products of conception. And you'd feel pain in most cases, too.

 

Sweet new babies! [emoji173]

[Mergath]

I agree that you should chat with your OB about this stuff, but my baby was born in mid-August and my experience was pretty similar to yours. Massive engorgement for the first week, not much for letdown but I could pump quite a bit of milk, and really light lochia.

 

The second week or so the engorgement went down, I started noticing a letdown, and the bleeding became much heavier. I was actually kind of smug about it that first week, thinking, "Oh yeah, I'm awesome, hardly any bleeding. I'm rocking this postpartum thing." :lol: Yeah... the bleeding was still so heavy five weeks in they had to do an ultrasound to make sure nothing was wrong. :glare:

 

The engorgement sucks, though. You have my sympathy. When my baby was nursing during that first week it felt like my nipples were filled with shards of glass. Breastfeeding doesn't hurt, my a**. After the engorgement went down the pain completely disappeared.

[heartlikealion]

I agree that you should chat with your OB about this stuff, but my baby was born in mid-August and my experience was pretty similar to yours. Massive engorgement for the first week, not much for letdown but I could pump quite a bit of milk, and really light lochia.

 

The second week or so the engorgement went down, I started noticing a letdown, and the bleeding became much heavier. I was actually kind of smug about it that first week, thinking, "Oh yeah, I'm awesome, hardly any bleeding. I'm rocking this postpartum thing." :lol: Yeah... the bleeding was still so heavy five weeks in they had to do an ultrasound to make sure nothing was wrong. :glare:

 

The engorgement sucks, though. You have my sympathy. When my baby was nursing during that first week it felt like my nipples were filled with shards of glass. Breastfeeding doesn't hurt, my a**. After the engorgement went down the pain completely disappeared.

 

Not liking the ultrasound thing, but the information. And I didn't realize you recently had a baby. Congrats :)