# depressing expressing- is it too late for me?



## roze (Mar 20, 2004)

Hi,

I would appreciate some advice as becoming quite depressed about this; 

I gave birth on 6th June by c section - I tried to breastfeed in recovery but the baby did not latch on. I was given  a syringe to try and catch colostrum but could not squeeze any out. There was no sign of any breast milk appearing either until yestersday when my breasts became engorged.  Did not make any difference to baby so bought electric pump- first attempt produced 10 ml, second 30 ml, however expressed this morning for 1 hour and could not get 5ml.  Does this mean that I have missed the boat somehow and that it is over for me as far as b/f goes?  My breasts are tender but are now soft.  How can it be that everything looked so promising yesterday with full breasts and today there is nothing, yet I am supposed to be expressing 80 ml every couple of hours?

Has the c section caused any delay, should I have been expressing in hospital, or is this just something which happens?  My baby has tried to suck this morning but nothing comes out; I have stimulated some breast milk with the pump before putting her on and this has awakened some interest, however her attempts at sucking do not produce a response and it causes her considerable distress.

I have had a session with my midwife however nothing further gained, also spoken extensively to NCT support line however despite following instructions nothing gained there either.

She has been on baby milk since day 2- cup and spoon fed, not teat.

Is it possible to recover this situation or is it just too late now.

Many thanks,


roze


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## jeanette (May 3, 2003)

Hi Roze

Will get back to you tonight....children demanding  me!!

Jxx


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## jeanette (May 3, 2003)

Hi Roze

I hope I can help you hun 

Firstly, if you want to breast feed or express you need to make sure you are drinking plently (at least 3L day...if possible with a pint of full fat milk), eating well (no dieting & at least 500 calories more than what you would normally have) and resting. Make sure you have you feet up when expressing or bf and your back is straight and not bent over.

Now down to your breast milk:
- there are herbal remedies available to help with your milk production..pop down to your local health food store
- make sure you express when you are feeling relaxed...
- try and express at least once over night...this will produce prolactin which helps produce milk
- you need to express 6-8 times a day initially to kick start
- double pump (both breasts at the same time).

Having a section can delay your milk coming in. Its not over yet. It may just take a good week for things to happen. Keep expressing regularly.

Have skin to skin contact with your baby as well. Having your baby lie naked (except for nappy) on your breasts will help as well. Have her close by when expressing as well.

Your baby needs to learn how to breast feed...with a bottle they dont have much work to do and the milk is immediate.

Offer the breast before your baby is due a fed..if your baby is hungry she will want milk straight away.

Have a look at:

http://www.breastfeedingnetwork.org.uk/pdfs/BFNExpressing&Storing.pdf

Have a read and come back to me anytime if I have confused you!

Jxxx

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## roze (Mar 20, 2004)

Thanks Jeanette,

My visiting midwife has not been as postive saying that I have lost a critical week - however she is doing her best to help us.  Apparently I have ' flat nipples' which is why the baby is not interested as nothing to latch on to- I have used a syringe with the top cut off to try and draw out the nipple but this does not stay.  Apparently there were things I could have done ante natally ie Nipplettes? to help but not possible now-  I hope others can get some help from this experience as I was not aware of this before and no one in hospital diagnosed this. 

I have been using nursing nipple shields which have helped enormously so now the baby is feeding well from each breast however I have been told to supplement this with Aptimel formula at 90 ml each feed after 45 mins on the breast.  We tried cup feeding this in hospital and after but found this traumatic all round ( goes everywhere, risk of baby choking etc, her hands flail around and get in the way) so have resorted to a bottle using an Avent teat which is supposed to enable the combination of breast and bottle. Hope this is true!  This makes feeding a much calmer event which helps us all.  After the Aptimel I have to express the same breast for 15 minutes at a time.

I have the following questions that I would still appreciate your help with;

1)  When I expressed the first time I obtained 20 ml milk and ever since its usually much lower than this, ie 10 ml.  Is it the case that women need to express 90 ml x 6 ie 540ml per 24 hours in order to satisfy a 12 day old baby, the same as the formula dose?  If so I am well behind. The Avent pump info suggests that 60 ml can be expressed in 10 minutes- I could not do that in an hour.

2) The length of time it takes to feed our baby is around 90 minutes as she dozes off, has to be winded/reinterested in food, etc which inevitably reduces the time available for feeds, hence we are feeding her 5 times a day instead of 6.  Does this matter?  The midwife is adamant that it does and that 1 hour is enough for feeding in total. However it seems a shame to turf the baby off the breast once she is feeding just for the sake of protocol. What do you think I should do.

3) Does your recommendation for 6-8 time daily expressing take into account 5 breast feed sessions or is this in addition to this?

4 Finally, we are sterilising everything before each  feed however are you aware of any way to carry around sterilised nursing breast shields so that I can b/f her outside the home?  Can we sterilise and go, so to speak?

Many thanks for all your help and support- currently feeling a little terrorised by midwife and electric breastpump so much that I am really wondering whether b/f is really going to be worth it despite the well known and acknowledged health benefits from us both.  No doubt this is why so many women give up early,as well publicised this week.

Thanks again,

roze xx


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## jeanette (May 3, 2003)

Hi Roze

Hopefully I can answer your questions but im mindful that I dont want to overload or confuse you as your mw is currently involved and helping you.

1) the amount of milk is not always the same as formula milk. When molly was in special care they worked out that she need 180ml x her weight in kg divided by 6 (or however number of feeds per day). Expressing breast milk amounts & times vary from mum to mum. Have you looked at the herbal remedies?

2) Feeding shouldnt really take more than an hour as its tiring for you. However, bf can top up a lot during the day. She may be feeding like this to help you produce more milk.

3) If you baby is having 5 good bf then thats taken into account..so you would only need to express x3

I know its hard but remember you are doing everything that you can. Your baby has had benefits as she has had breast milk. Do whats best for you and your baby.

Stay in touch

Jxx


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