Vanessa writes of a 6 d.o. infant, baby #6 in birth order, and mother says
her milk did not come in and there is "not a drop" of milk there.

Rule #1 is feed the baby. Please do not delay in doing this. This can be a
very bad downward spiral. Use donor milk as first choice. Use nursing
supplementer if baby will latch. (of course mother can choose other
alternates as well or use whatever is needed to get milk in the baby).
Rule #2 is support the milk supply - you need to have the mother see her
primary hcp to evaluate for retained placental fragments, r/o Sheehan's
syndrome (did she have excess blood loss or hypotension at the birth?),
endocrine dysfunction (thyroid, pituitary, diabetes). She can continue
regular pumping. With 5 previous successful lactations, surely something is
amiss. BTW, In cases like this, where there is virtually no milk, I have not
seen success w/ use of herbs or prescription galactagogues (metoclopramide).
Rule #3 is fix the breastfeeding. (Well these are sort of how I've adapted
Coach Smith's wonderful rules.) That is, get the mom and baby bf together
again. Which she can actually be doing w/ the supplementer. But I say this
because some use cup, finger feeding, or bottle as the alternate in step 1.
Good luck helping this mother.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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