My Milk Hasn’t Come In Yet, What Should I Do?

Dear Judy.
My daughter was born four days ago. Unfortunately, I had to have an emergency c-section because I suddenly showed the symptoms of preeclampsia (forcing an induction) and the baby’s stats didn’t look good. We found out later that she had a calcified placenta, so that’s why she is so tiny.

I was wondering if you could give me some breastfeeding advice.

Because she’s so tiny and she was dehydrated, the doctor asked us to supplement. I breastfeed her first and then we supplement. I think this shouldn’t cause a problem like nipple confusion because (so far) she’s sucking and eager to breastfeed first. She’s not a big fan of the bottle. But I’m concerned that my milk hasn’t come in yet. She was born four days ago and although my breasts look bigger and fuller, I haven’t had any sort of let down or flow of milk. I still produce colostrum.

I’ve been pumping and taking warm showers to get my milk to come in, but nothing has worked. Could you suggest any new ways to get my milk to come in? Should I be concerned, considering tomorrow is the 5th day?

Thanks for your help.

A Concerned New Mom

Thanks for sending in your note and CONGRATS on your new baby girl! I am so happy for you!! I’m sorry about the complications, but glad that everything worked out well in the end.

For supplementing – I would say nurse, nurse, nurse and don’t supplement – your body needs all of the stimulation you can give it to help your milk come in nice and strong. Lay down with your baby skin-to-skin and try to keep her attached to your breast as much as possible. Every time she drinks from the bottle, that is needed stimulation that your body isn’t getting to tell it to make milk. Five to six days for your milk to come in is pretty common. My milk took six days to come in with my son. If you feel you need to supplement, use a supplemental feeding system (your pediatrician can probably give you one). This will allow your baby to still be nursing while she is getting the supplement. So that even though she is getting a supplement, your breasts are still getting the needed stimulation for them to produce milk.

Thanks so much, Judy. You’re totally right. I kind of ditched supplementing today and left her on my breast all day. It looks like it’s working, because I feel like my milk has come in, but I don’t feel the let down sensation as strongly as I did with my first child. Is that possible? It looks like she’s eating and satisfied, I just don’t feel a let down.

Yes, it is very possible that you wouldn’t feel the let down sensation. To be honest, I have never felt one. When I used to pump, I could tell when my milk was letting down because I could see it in the pump, but I have never felt it – some women feel it more than others – and I think it is perfectly possible that you would feel it differently with one child vs another.

I’m so happy that you guys are doing better after spending the day nursing today. Please call or email me anytime. I am more than happy to help.

Thanks for all the breastfeeding advice over the weekend. I basically sat in bed all weekend, with the baby at my breast. My milk came in Saturday night/Sunday morning and she was very happy and I was very relieved. She’s got her days and nights mixed up, so we’re hanging out now. She’s breastfeeding, of course.

She’s really small because her placenta was calcified, thanks to my preeclampsia. The doctor says she’s probably going to eat 24/7 to make up for the slow start. That’s very true so far.

Your advice really helped because I didn’t realize that I may not feel the let down. I don’t feel it now, but I used to feel it when I nursed my son. How weird.

Thanks for e-mailing me and and for all of your advice … That’s why I ordered from your store … a real person on the other end of the e-mail.

10 comments to My Milk Hasn’t Come In Yet, What Should I Do?

  • I’m glad this solution worked for you and for this mom. It’s good to know that for many mothers and babies, things take a while to get going.
    Still, if a mother chooses this route, she and the baby need to be closely followed, and the mother would need to keep an eye on the baby’s diapers to be sure that there is copious, clear urine and that baby is alert and nursing well.
    I would be hesitant to tell a mother over the internet, or even over the phone, that her baby doesn’t need a supplement. I would go over the signs that baby is getting enough milk, suggest a doctor’s visit if she’s not sure, but not advise her one way or the other. Readers of my blog know that I’m no fan of early supplements, to put it mildly. But this situation has the possibility of becoming life-threatening.

  • Mommy News

    Thank you for your reply. You are absolutely correct – watching the baby closely for wet diapers is key and I would only recommend this for a few days prior to consulting with a DR. For this mom, it was exactly what she needed to make her milk come in, but if she had contacted me again and said her milk still hadn’t come in, then I would have recommended that she consult with her Dr again. Thanks for pointing that out. – Judy

  • I’m so glad you mentioned that it can take a week for milk to “come in” – which is actually an inaccurate statement. There is milk in the breast before the baby arrives, when we speak of milk “coming in” we are talking not about colostrum but about transitional milk – the white stuff that increases dramatically in volume a few days postpartum.

    Carrie at Nursing Bras’s last blog post..Breastfeeding: Tips for Large Breasted Moms

  • This was a really informative post. Thank you for sharing.

    Melodie’s last blog post..Would Hannah Rosin Have Made A “Case Against Breastfeeding” If She Was Canadian?

  • [...] turns into a flood of creamy white milk. For some moms, it takes even longer for milk to come is as Mommy News and Views shares with us a correspondence with one of her [...]

  • [...] piece of advice is to stop the bottles as quickly as possible- they are hurting your supply. Read this blog post about a client of mine who had supply issues. Her Dr and pediatrician gave her bad advice and were [...]

  • Laura E

    Through my tears after reading this, I must add how much I appreciate all of the mothers for sharing their experiences. I am now at 16 days post the birth of my beautiful son – After he was born, albeit early and at just 6.485 lbs ( I was preeclamptic and had a c-section), my baby lost 12% of his weight at his first appt. with the pediatrician ( 4 days after his birth). While he passed meconium in his diapers on a regular basis, his weight was certainly a concern. My nurse and ped. told me to add a supplement and start taking Fenugreek, which I did. He couldn’t even get his circumcision because of his low weight and the doctor made me feel like the worst mother ever. He must have commented at least 4 times about his excessive rooting and his lack of surplus body fat, making me feel even worse than I was making myself feel over not being able to provide and bond in this most special of ways during feeding.
    I should add I am anemic, which I didnt know until my 3rd trimester, and was given Iron Sulfate via IV in the hospital.
    Sadly, at day 16, my milk still hasnt dropped. I pump no more than .5 to 1 ounce between both breasts in the morning only, and very little each time after. My baby gets very cranky at the best since introducing supplement, and I fear it is because he isn’t able to get any milk from me. Since we added the supplement, he is up to 5 lbs 13 ounces.
    Is it too late for me to breast feed, ie – is this all a sign that my full milk supply is just not going to come in? Most posts here and on other sites seem to state the longest period without milk is about 1 week. I havent seen anyone talk about a time period as long as mine without milk.
    Is there anything else I can do?

  • Hi Laura, I am so sorry that you are going through such a difficult time. It absolutely isn’t too late to start breastfeeding! I read a story recently (and I can’t remember where or I would send you a link) about a mom whose milk took over 3 weeks to come in – and she was able to nurse no problem. You can also read this story – it is about some of the causes for delayed onset of milk production and it was very eye-opening for me: http://blog.mothersboutique.com/older-moms-and-overweight-moms-may-have-delayed-breastmilk-production/ – I don’t know if you fall into one of the categories, but I did and it really helped me to understand what was going on with my body. The first thing I would recommend is that you get yourself to a good (IBCLC) lactation consultant – and make sure they are IBCLC certified. Then find out if there is a “reason” why your milk hasn’t come in (there could be something that is causing it either with your body or with the way your baby is latching). And work with her to get your milk flowing. Any amount of milk that you can give your baby is a gift – so even if you have to supplement to keep up, it is worth the effort to provide your baby with your breast milk. You can do it. And remember, the pump is not nearly as efficient as your baby at getting the milk out, so don’t judge how much you are able to produce by your pump. Please come back and let us know how it goes. You are a great mom – no matter what happens with your milk. <> — Judy

  • Miguel

    My wife has a similar problem. Our baby was born five days ago and she still has not produced any milk. Our baby had been hospitalized for losing over 14% of her body weight. We attempted to manual aspirate and use a breast pump but nothing came out of her breast. My wife was diagnosed with a pituitary tumor which prevented her initially from getting pregnant. She was given cabercalin and it shrunk the tumor. Therefore she was able to get pregnant. The she had a proactive sack in one of her best that was removed approximately 30 days before becoming pregnant. During her pregnancy she had a colchotasist pregnancy. Should I be concerned? What should I do? Also our baby is not having bowel movements, only two since birth. She is urinating quite frequently. Please help if possible.

  • Hi Miguel,

    I would suggest that you take your baby to your pediatrician to make sure everything is OK and that your wife speak with a lactation consultant. I am not qualified to help out with your situation, but I am sure that between your doctor and the lactation consultant, you will be able to get the advice that you need. Best of luck to you and congratulations on your new baby.

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