Switching to formula, how do I go about it?

[izzybizzybuzzybees]

Hello.

My son has multiple food allergies and silent reflux and has an oral aversion meaning at 9 months he is on no solids at all. He is currently breastfed but I'm on an exclusion diet which is difficult and he also appears to still be reacting to foods through my milk, meaning he must have further allergies but we don't know what to yet. He also rarely reps. He goes to bed around 11pm with numerous wake ups and can feed almost hourly. I offered him bottles yesterday and he seemed to sleep better, possibly due to the fact there is less in the milk hurting him.

I think it might be time to switch to formula and wonder how best to do this. At present he will not tolerate a full bottle of neocate however I have managed to get the ratio of BM to neocate lower. He can now take 5oz neocate to 2oz formula.

He doesn't feed reliably from the breast, as in no specific pattern, so I cannot simply swap a BF for a formula feed. I have an electric pump and figured I can express as and when required to dwindle my supply but mot sure how to start. How often should I express and what quantities etc? Any advice?

Usually I would say pump to keep your supply going in case you want to go back to bfing but I think in your case, having had no sleep for eight months, it would be better to make a decision one way or the other. I would get him on to 100% neocate as soon as possible by reducing the proportion of BM or just going cold turkey on the BM. Realistically it may take a month or so before your milk dries up, especially as your are still feeding so frequently, so there is a way back to bf if you change your mind. However the exclusion diet you are on is quite extreme and to my mind difficult to handle at the same time as dealing with no sleep and handling his oral aversion which may be a drawn out process. With that in mind I would try and reduce the number of times you express per day quite quickly and just express a small amount if possible. Maybe express four times a day for 4 oz at first then size up whether this is too much or too little. I'm sure you have a better idea of how much milk he is taking ATM on which to base it.

izzy if you are comfortable making up bottles and storing them in the back of the fridge I would start by making up very small bottles and offering regularly. Offering very little and often means you avoid getting into a battle with him about it and he is more likely at some stage to give it a go. It also saves throwing away masses while you work out what he is on.

When my p moved to nutramigen I basically had a bottle on the go almost constantly. It lasts an hour once then have started it so I would just keep offering gently. It took her about 2 weeks for her to develop some sort of consistent eating habit. She was very much younger though.

Hi izzy, it must be such a tough decision but I am sure you are doing the right thing. If you are just expressing to let yourself stop lactating gently I would just express a little when you are feeling very full, as the more you express the more you will stimulate milk production. Just express enough to ease the pressure. If you want to maintain supply while you switch until you are sure, express both sides fully as close to 8 times a day as you can manage (Inc one at night). Really good luck.

Izzy when F was ebf, before I began to switch her across, she was having 7ish feeds a day. The first bottle I introduced was a mid-morning one. She would be nicely fed from me at 6ish, then when she started gettting hungry a few hours later, she was more accepting of a bottle (I know J is a monkey though). After a few days, she had a mid-morning bottle, and a lunchtime one. A few days later, we added in a mid-afternoon one. Initially she would only have 3 or 4 ozs a time, which was fine. Now she has only 4 feeds in 24 hours, but 7ozes each time.

Changing gradually (for me) seemed a nice easy way of going about it, as I have had v few problems with engorgement, and there was no shock to the system for either of us.

If you wanted to swap to bottles exclusively, then I would express to the point of comfort, perhaps at 7, 11, 3, 7, 10 - then gradually space out the time between them over a course of days/weeks.