Ask Judy: My Milk Still Hasn’t Come In – Is There Anything I Can Do?

Dear Judy, 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 appointment 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 pediatrician 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 didn’t know until my 3rd trimester, and was given Iron Sulfate via IV in the hospital.

Sadly, at day 16, my milk still hasn’t 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 breast 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 breastfeed? In other words, 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 haven’t 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 a month 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. 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 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

15 comments to Ask Judy: My Milk Still Hasn’t Come In – Is There Anything I Can Do?

  • Jaimie

    My only advice right now besides hiring an IBCLC, is for supplementing use an SNS or similar. This way, baby is getting food, but continuing to stimulate the breasts at the same time…

  • Theresa

    Hi Laura!
    You absolutely CAN DO IT! I had similar experience with delayed and insufficient milk with both my kids. I am not a lactation consultant.
    Here’s what I did: With my first I took Fenugreek. Eventually my milk came in and I was supplying about 80% of my daughter’s needs and even stopped the Fenugreek after a couple of months. Our breast feeding relationship lasted well above 2 years! (with supplementing and foods of course)

    With my son I had other problems, listed on Judy’s Blog under “With perseverance it can be done” but I have to say that supply was an issue as my milk 1) delayed and 2) either because of my latch issues or tendency to not make enough (who knows) I was barely pumping 2 ounces at 6 weeks. I found an herbalist and bought Blessed Thistle weed and boiled it and started drinking 3-5 cups of it (chilled cause it tastes awful – i also added some chamomile for flavor) per day, along with my Fenugreek and I saw a big difference in my milk. Eventually I also tried the much debated about Domperidone which is not available in the United States, but you may contact certain pharmacies to get it dispensed for you. I am copying a portion of the email I received from canada, Dr Jack Newman, world renowned lactation expert, google him and see his site. He is a pediatrician by trade and does also do email consults for free. I used the inhouse pharmacy but it takes a while. I did it for a month and stopped.

    Domperidone (Motilium) could be helpful in this situation. Contact your physician to get a prescription. If your physician is not familiar with using this medication, please ask him/her to contact me or go to our website for information about domperidone.


    I stopped the Domperidone and breast fed exclusively and my son is now starting solids, in the 95% and happy. My daughter did well and even with supplementation I am sure she benefitted.

    Also, Jack Newman shows ways to massage your breasts during feedings and it is said this also simulates pumping. My lactation consultant really helped me perfect that.

    And as Judy mentions, there is no replacement for hands on help. I got lots and it really helped. Get a good consultant to work with you and help your latch as well as easing your fears. Some women have managed to succeed after months. You are doing great.

    Good luck! This is a trying time but it can be done!

  • Annette

    I agree with speaking with an IBCLC on a regular basis and maybe seeking help out from a local La Leche League Leader for moral support. Those groups can be amazing. My son was born at 40 weeks 2 days and he weighed in only at 5.5lbs. I had him at a birthing center so by the time we got him to a pediatrician three days later he went down to 4.12lbs. It was NO BIG DEAL! Some babies are just smaller than others and mine continues to be so at 10 months he’s still only weighing 15lbs but he’s healthy, happy and meeting ALL his milestones (not mention he’s a super fast crawler!!). Don’t let others make you feel bad about your baby, you’re his mom and will always know these best thing to do for him and it will always be the right thing!!

  • jenn

    hire an LC immediately and keep putting him to the breast! i agree with judy, any milk you give your son is a gift, particularly because he came so early, and the pump is not an indicator of how much milk your son is actually drinking straight from the tap. i would also suggest mother’s milk tea, oatmeal, and lots and lots and LOTS of water.

    hang in there! breastfeeding doesn’t have to be all or nothing. just keeping doing the best you can.

  • Yep, contact an LC today.

    Things to do at home. Increase your protein intake. Also, take note of how much fluid you are consuming. If you are under-hydrated, it will stunt production.

    Keep feeding that baby. Then pump 5-10 mins afterwards. Supply and demand. The more you demand from your breasts the more they will produce.

    Also check out She is an awesome resource for breastfeeding.

  • Definitely talk to an IBCLC as soon as you can. They will be able to help assess what’s going on with you and the baby and figure out what to do next.

    One immediate Q: How’s your bleeding? If you’re still having full-flow, pad soaking bleeding, you might have some retained placenta, which will keep your body from switching over to producing mature milk. If that’s the case, get to your OB ASAP to get checked out.

  • I agree about finding an IBCLC. There are many things you could try. I always took about 7-10 days for my milk to fully come in. It was almost torturous, but I was luckily seeing a wonderful LC and have an amazing family doctor who supported me.

    I took Fenugreek and Blessed Thistle. Together they are supposed to be more effective.

    Earth Mama Angel baby makes a wonderful Mother’s Milk Tea.

    Oatmeal can also help with milk supply, although bringing it in I am not as sure about. Couldn’t help though.

    Nutritious meals and protein shakes might help nourish your body so it can nourish your baby. This is important for as long as you are a mother. Take care of yourself.

    Nurse constantly and on demand, then follow with pumping. See if your hospital or clinic rents hospital-grade pumps. It is worth it in the beginning.

    Lots and lots of water!

    Good luck.

  • […] This post was mentioned on Twitter by Judy Masucci, Judy Masucci. Judy Masucci said: Hi everyone, this is Judy. I just received a comment on my blog from a mom who really needs some advice. She is… […]

  • I would also be concerned that there may be retained placental fragments. How is this mom’s bleeding? She doesn’t say. If it’s still quite heavy, she may want to visit her OBGYN. She may need a D&C.

  • Amy West, CLC

    First and foremost: GET TO AN IBCLC. Now. Call your local LLL, find resources, but you need an IBCLC. Not a CLC, not an LLL leader, but an IBCLC who is trained and board-certified to address complex issues like the ones you’re facing.

    You are doing great! Has anyone told you that? You’re working on it, and you’re committed to it. That’s half the battle!

    I’d like to know if baby was weighed on the same scale each time, and if those scales have been properly calibrated (and how long ago the last calibration was). It’s not unheard of for scales to go years between calibration and for them to vary widely. That 12% is just a number – it’s not a sentence as to your success or failure at breastfeeding.

    The jury is out on this subject, but some speculate that because of the excessive fluids given to c/s moms (via IV), their babies have extra weight to lose.

    Vaginal birth squeezes excess fluid out of newborns as they come down the birth canal. So, when a c/s baby hasn’t been through that process, they’re born with more fluid in their bodies than vaginal birth babies. They therefore usually lose more weight, as they’re urinating that extra fluid out in the days following birth.

    Is baby wetting and stooling enough? That’s a far more reliable predictor.

    Next, please disregard the info above about Domperidone. There are side-effects with any medication, and to recommend it without having your full medical history, let alone without an exam, isn’t a good plan. If Domperidone would apply well to your situation, your doctor (who will need to prescribe it) and lactation consultant need to make that call. It’s really important to find and address the reason behind your lack of production, not just get milk flowing without understanding the delay.

    As Cass asks above, I’d be curious about your bleeding. Even tiny, tiny, tiny fragments of retained placenta can be enough to upset the hormonal process that needs to happen for milk to be made. Placenta is a major source of progesterone and when it’s delivered, the severe drop in in that hormone makes way for prolactin to signal the milk synthesis process.

    “Things to do at home. Increase your protein intake. Also, take note of how much fluid you are consuming. If you are under-hydrated, it will stunt production.” That’s actually not true. Unless your diet is severely stunted and you’re severely malnourished, your diet is almost certainly just fine. Drinking extra water doesn’t lead to more milk, either. Eat a healthy diet, drink to thirst, and you’ll be fine. Are there any habits like smoking at play here?

    Being small isn’t a diagnosis. Make sure he’s being measured on the WHO growth charts for breastfed babies. When babies fall on the far end of either spectrum, it’s something to take note of and make sure there’s not an underlying issue at play. But being small and otherwise healthy is just fine.

    Use an SNS to supplement. I don’t like the Medela one; if you can, use the Lact-Aid.

    There’s a support group called MOBI (you can google to find it). There are lots of moms there who have faced similar challenges. If you find you need support from moms who’ve “been there”, try them.

    As above, the pump is a terrible way to measure production. Babies are much more efficient and extract milk in a completely different manner than a pump!

    To clarify one point, milk doesn’t “come in” like we typically describe it. Our breasts aren’t fleshy bottles or holding tanks for milk; they don’t need to “fill up” to feed the baby (and actually, allowing them to get full sends a hormonal signal to your body to cut production!).

    “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.” Everything Judy said here is spot-on. There are a lot of possible causes of delayed Lactogenesis II, and only your doctor and a lactation consultant can really sort that out for you. At home methods aren’t going to fix what’s going on here.

    And what Judy said about any amount of breast milk being a gift is really important! Even small amounts of breastmilk make it easier for your baby to digest the supplemental formula. (For your formula, I’d recommend an organic – generic is 100% as good as brand – and preferably without synthetic DHA/ARA additives.)

    Put baby to breast when he’s still sleepy. When you see rapid eye movement (when his eyes are closed), it’s actually a sign of hunger in newborns. When he’s sleepy and not fussing, his biological drive to breastfeed can take over, and he’ll have a better chance at a good latch. You can also try simulating the birth experience by filling a tub with warm water, and doing skin-to-skin time with him.

    Keep baby skin-to-skin (bare skin to bare skin) as much as you can. It signals your body to produce more milk. Let him have free access to your breasts as much as possible, too. Just his contact with your breasts stimulates milk production. Allowing him to nurse or fidget with them on-demand is great.

    Keep us posted! And good luck!

  • Laura E

    2010/11/18 at 10:47 pm

    Hi Judy –

    Your last sentence really hit me square in the heart, and the pang I felt was so real, it reminded me of the genuine kindness of strangers. Firstly, thank you for your empathy, and for responding so quickly. As one who rarely comments on my personal issues, I have found myself needing advice and help now more than ever, as I step into my new life stage role of motherhood. And as a perfectionist, at work and at home, it truly has taken its toll not being able to feed my child. And as I write that, I re-read your response, and realize your words are truer and ring more loudly than the first few times I read them: “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.” And thus, I trudge on, though sad to report, with little change. I took your advice and visited with an IBCLC, though I cannot afford to take her advice on getting a medical grade breast pump to help the extraction process. I wish I had known that you could rent these before I went and bought a significantly expensive but not top of the line Medela pump. I suppose you get what you pay for, as I learned my pump just isn’t up for what I need from it, namely more suction. And as a result of buying it, I cannot afford the surprisingly high cost to rent ($70 per month with an upfront cost of $50 for the tubing and other parts).
    Also, another point you brought up “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),” helped me realize that I hadn’t mentioned to my lactation consultant nor my pediatrician that I have a non-critical but still invasive mass in the left frontal lobe of my brain. Unfortunately, the surgery to remove it isn’t until January as I had no idea that it might prevent my efforts to breastfeed.
    But again, hadn’t you responded with such informative and loving information, I wouldn’t have known where to turn or what information to share with the professionals trying to help me.
    Thank you Judy. You have left an indeliable mark on my soul.


  • Talk to your doctor about getting your thyroid checked. Post-partum hypothyroiditis is extremely common and can cause issues with your milk. I learned that the hard way. Above all – don’t feel bad – you are doing everything you can to give your baby everything. There is nothing to feel bad about!

  • Kim

    You can do it! You can do it! Two things that I wished I understood BEFORE. 1. You CAN increase your milk supply. 2. Breastfeeding does not have to be black and white. You do not have to a)fully feed your baby to have a wonderful bonding and feeding experience or b)just give up. The gray areas are just as rewarding as a typical non-issue filled breastfeeding experience.

    I also had low milk supply. I increased my milk supply through pumping which we measured through the baby’s eating BC I NEVER pumped more than a few drops. My consultant just kept reminding me that babies get more than the machine. She was right. Although we couldn’t stop supplement less, we started being able to supplementing less.

    It was a hard road, but I breastfed *and* supplemented for a year. Only weaned at a year because my son weaned himself because after all of that work…I was certainly not ready to give up. LOL

    Definitely find a consultant and if you can a support group of other moms that are having breastfeeding issues. (There are LOTS of us. Not everyone has the *same* issue, but you will be able to relate.) It doesn’t say what area of the country, but if you happen by chance to be in the Boston area, contact me. I can give you the name of a great support group run through one of the Suburban Hospital.

    I still get together twice a month with the moms from my bfeeding support group. It was a really neat bond that made being a mom a little easier.

    Good Luck!

  • Sarah

    I am having the same problem right now on day 14. Seems nothing I’ve one helps. Were you ever able to fully breastfeed?

  • HI Sarah, please read the other comments on this post – there is a lot of really great information there for resources. And please get yourself to a lactation consultant (IBCLC board certified) – they will help you to determine why it is that your milk is so delayed. Best of luck and please let us know how it works out — Judy

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