slow / no let down

I have no feeling of let down and flow is very slow, the only thing I can think that may be affecting it is my anemia. I've tried tea / lactation cookies and finally switching to increase supply, which has happened, but bubs is still only taking 20-30mls in a 40 min feed (guessing from how much less formula / EBM he takes and how much I easily express). I don't let down from his crying or running water or any of the things that would usually work; this is bubs no. 4. I'm feeding lying down with a nipple shield, tried warm cloth and hand massage increases the flow but I have to do it constantly. Does anyone have any other suggestions before I dry out the girls and switch to formula? Really wanted to b/f but at my wits end and tired of constantly expressing :wall:

Expressing is not a good measure of how much milk you have - just because you don't express much doesn't mean you don't have much milk (everyone is different when it comes to expressing, from what I've been told).

Better indicators of whether you have enough milk:
* Is he satisfied after you feed him?
* Does he have enough wet & dirty nappies?
* Is he gaining weight?

How old is your bub? Is it possible that you are just not feeling the let down? It took a month or two before I actually 'felt' the let-down. Do you notice a change in your bub's sucking (ie. changing from quick little sucks before let-down to slow deep sucks after let down??).

Expressing is not a good measure of how much milk you have - just because you don't express much doesn't mean you don't have much milk (everyone is different when it comes to expressing, from what I've been told).

Better indicators of whether you have enough milk:
* Is he satisfied after you feed him?
* Does he have enough wet & dirty nappies?
* Is he gaining weight?

How old is your bub? Is it possible that you are just not feeling the let down? It took a month or two before I actually 'felt' the let-down. Do you notice a change in your bub's sucking (ie. changing from quick little sucks before let-down to slow deep sucks after let down??).

Expressing is not a good measure of how much milk you have - just because you don't express much doesn't mean you don't have much milk (everyone is different when it comes to expressing, from what I've been told).

Better indicators of whether you have enough milk:
* Is he satisfied after you feed him?
* Does he have enough wet & dirty nappies?
* Is he gaining weight?

How old is your bub? Is it possible that you are just not feeling the let down? It took a month or two before I actually 'felt' the let-down. Do you notice a change in your bub's sucking (ie. changing from quick little sucks before let-down to slow deep sucks after let down??).

Hi, Sel,

It sounds like you are doing a great job under some difficult circumstances. Some more information will help us to give some more appropriate suggestions. I wonder, have you breastfed your other children? How old is your baby now? It might be a long story, but what has been happening with your baby and breastfeeding? Can you share a bit with us? Many mothers (about 30% ) never feel a letdown, yet they breastfeed just fine. The letdown can be an elusive thing - the more you want it to happen, the more you are waiting to "feel" it, the more elusive it can be. yet the baby suckling at the breast will always get it to happen.

Talk again soon
Barb

I'm not having any problems expressing, it's the fact I'm expressing so much; regardless of whether I've fed him or not, I am expressing about the same amounts (currently 100mls). Bubs is two weeks old, it's not just not feeling let down, there's no dripping or leaking, which is odd, well for me. No change in sucking for the 20 -30 minutes on each side (or 10 minutes when I was switching). Expressed for 3 months for bubs no 1 (rejected the breast) and bubs 2 & 3 breastfed with no problems.

Started off with bubs on the breast after birth, then put him on for colustrum, noticed early day 2 that he hadn't peed for over 12 hours, the midwives checked that he was attaching okay etc and suggest I express and feed with a syringe. Since being home the milk came in but only able to express 20mls and put him on the breast and then top up with formula :(, still kept trying him on but by this time started using the nipple shield as he kept pulling off and I cut down the time to 40-50 min as it was causing damage; started fenugreek tea and lactation cookies, supply increased to 50mls and still had to top him up. Rang ANA and advised to switch feed to increase supply which I've done and now expressing 100, but still having to top him up with EBM after a 40-50 min feed, can't feed him any longer on the breast as it starts to sting like he's sucking and nothing is coming out??? It's been 10 years since bubs no 3, but apart from the anemia, I can't figure out why I don't seem to let down at all, where in the past I would let down from bubs crying, from the shower running and the other breast while feeding. I really just don't know what else to try, I can't keep feeding him and then expressing anyway and I can't keep him on much longer than what I do as it just starts to sting.

Hi, Sel,

At 2 weeks of age you have every chance of getting these early problems sorted and breastfeeding for as long as you and your baby wish to. the fact that you are expressing so much means that your letdown reflex is working just fine - even if you can't feel anything. Before your milk "lets down" you can usually only get a few dribbles in the pump - after your milk lets down it tends to spurt and you can get a good amount quite quickly. Even though things felt different for you with your last lactation, don't worry - your body is still working fine!
Most women tend to have relatively too much milk for their baby in the early days. That might be why you can still get quite a bit out at the end of the feed. a two week old baby wouldn't really need more than 100mls per feed - that would be a big feed. Tell me, do you know what your baby weighs now? Is he back to his birthweight?
I don't think the way you are estimating how much milk he is getting is very accurate. Do you give him one breast at a time, or both? Try this, feed on one breast for 10-20 mins. Change nappy, burp etc. Offer him the other side. Then, just cuddle him (rock, sing) until he goes to sleep. A sling is good for this. If you offer him milk in a bottle, he will probably take it -but he probably doesn't need it!
Newborn babies will usually need 8-12 feeds in 24hours, but if they are shorter, it can be a bit easier to manage. It would really be worth seeing a Lactation Consultant to watch you feed and offer you some support.
Warm Regards
Barb

I don't use a pump, I express by hand from the back of the breast; the further forward towards the nipple the less I can get out. I also tried expressing a bit first into a bottle to get things going and then feed him, but this didn?t seem to work either, he just sucks away and doesn?t seem to be swallowing a lot unless I am massaging the breast. He will take 60-80mls from the bottle afterwards, I have been feeling better the last couple of days and supply has improved; I always offer both breasts and each for 20-30 minutes; he won?t go to sleep and both breasts are mostly full (feels like maybe he?s getting a little), he just sucks his hands and cries until we feed him but he does pull off the bottle when he?s full. Birth weight 3570 kg discharge weight at 4 days 3240 kg weight 11 days 3720 kg.

The reason I started expressing was because he hadn?t had a wet nappy for over 12 hours and I had been putting him on for 2 hour feeds. I rang and booked in at the local health centre when I got home, but there is a 2 week waiting list and my hubby goes back to work next week, so I can?t keep up the feeding and then expressing.

He?s a big eater and a big sleeper and cluster feeds in the evenings. So I can try to just b/f feed him and not offer a bottle, from 4pm onwards when he normally has smaller bottles every couple of hours and I would assume the 4-5 hour sleeps would stop and he?ll need to continue feeding more often.

I?ll talk to my hubby about a Lactation Consultant, he?s had to put up with me crying over getting bubs to feed, so at this stage he?s more than happy for me to change to formula. Also he knows that I?m reluctant because I come off a 40-50 min feed with both breasts still pretty much full, and have been reluctant to spend $$$ if I?m just not letting down and nothing can be done about it, but I want to breast feed bubs and can?t bring myself to dry up (Also bubs does love being on the boob). Thanks for all your help Barb.

Hi,

It is hard to get all the information and a full picture of what is happening via internet forums like this. Nearly every breastfeeding problem can be solved. As I said, it seems unlikely to be your letdown - the letdown reflex is one of those cast iron reflexes - almost infallible, but not always felt Expressing wouldn't yield much either if that is the case, more likely to be the baby's ability to remove milk from the breast. An LC might cost $80-100 to come to your home, assess the situation, make a plan and offer ongoing support. Formula is $20 per tin - an LC is a small investment in the future.
good luck with it all
Warm Regards
Barb

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the letdown reflex is one of those cast iron reflexes - almost infallible

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Thanks for that Barb, I guess this is what I really need to know before going down the path of getting help to get things fixed. I struggle on with my first, finally to spend the day in a centre and she still rejected the breast; it's not just the $$$ it's me being able to handle the emotional side (I'm on PND meds) and having enough determination, otherwise I may as well give up now, ifykwim.

I tried a different tack last night and instead of expressing any, just put the nipple shield on bubs straight on, 10 min later and when I pulled him off inside the nipple shield was completely clean and dry, so he's definitely not getting any milk on his own. Will make a couple of phone calls to local health and the b/f centre at the hospital today. :D