9 week old baby - usually breastfed but has formula with Childminder 2 days a week.........

[looneytune]

Hi ladies, please can you help me out here?

I'm a childminder who started with an 8 week old baby last week. Baby is mainly BF at home, sometimes has formula before bed although think they are pretty much back to BF at night now.

When mum signed up, she was hoping to give me EBM for feeds but arrived with formula as baby rejects breast milk from the bottle, but will have formula. So the 2 x 4.5 hour days I did last week, she had formula from a bottle.

Mum collected today and I explained baby had been unsettled and only happy in certain positions earlier which made me think she has an upset tummy. Wasn't sure if it was because on a different formula today but I wanted the mum to know baby wasn't as settled as last week so we could talk through what it might have been. Turns out baby was very sleepy after the 2nd session with me which is apparently unlike her and later that day, baby projectile vomited up lots of milk (most ever done) and was better after that. Understandably this worried mum and we've talked about what to do about the feeds. I suggested that tomorrow I have breastmilk in a bottle and I'll try my hardest to get baby to have this before switching to formula. Obviously this would be the best thing for baby BUT if she doesn't, any advice about the formula feeds? I've suggested mum phones the HV up for advice about the mixed feeding etc. but I was wondering if good old mumsnet had any words of wisdom???

I'm so worried mum is going to think it's something to do with me and not the milk and so desperately hope I can get baby to have breast milk from a bottle.

I'm babbling now I know, just wondered if anyone had any advice/idea's/experiences of certain formula's causing digestive problems etc???? I BF my own ds and only mixed formula on occasions when he was bigger. The other babies who have started with me this young (5 weeks and 8 weeks) were on 100% formula when they started so I've never experienced this particular situation and just want to help.

TIA

[jamsambam]

wel..and this is just my experience ...when my ds2 was born, nearly 7 years ago now, he was bottle fed from day one. at about 7 weeks he picked up a gastro bug and went right off SMA, even a mouthful of it would make him projectile vomit, hilariously into the pocket of a med students white coat !!

but, afte a brief hospital spell it was put down to an allergy to that perticular milk. he was prescribed a soya alternative and happly stayed on that untill almost a year old when he went over to normal soya milk, then to goats milk and now at nearly 7 he is finally able to tolerate dairy.

I wasnt able to BF so it wasnt the combination ofthe two, but as i understand it, Breast Milk is much richer than formula so maybe the baby just didnt liek the wateryness of formula .

I would ask the mum to realy look at what milk is fed when and what reation the baby has. Sorry its not a medical awnser!!

[kiskideesameanoldmother]

Possibly the baby vomited after that feed because he was lying down shortly after the feed and he had indigestion. formula digests a lot slower than breastmilk and giving in a bottle, they may swallow more air so more likely to cause a problem? just passing on some thoughts.

It is ambiguous to say that breastmilk is 'richer' than formula as the previous poster says. BM is much more easily digestible than formula and all the 'ingredients' in breastmilk is more bioavailable than those in formula and there are certainly a lot more 'ingredients' in BM. But on a density level, it is certainly 'thinner' than formula - with formula looking 'richer'.

Because formula is harder to digest than BM comes my speculation above that it was indigestion for the baby?

[kiskideesameanoldmother]

I think your advice to her to have you try to give the baby EBM is a great one btw. Sometimes babies will take it off a carer but not a mother.

[Pixiefish]

My dd2 is mainly breastfed but has half a bottle of formula at night for medical reasons and she used to vomit that up most of the time- obviously no use as she wasn't getting the milk so I switched to Dr Brown bottles and it's much better- she's not sick as much as she was on the other bottles.

[looneytune]

Thanks for all the advice, keep anything new coming as all good info I'll try the EBM if they bring that tomorrow, then will look at other possibilities if that doesn't work. I don't think mum has ever tried EBM in a bottle, it's the dad who has always given this and he said baby won't have it. I'll persevere and fingers crossed baby will take it!

[chipmonkey]

Just a thought, if the baby will have formula but refuses EBM, might the Mum have a problem with too much lipase in her milk which means it tastes fine when freshly expressed but develops a soapy "gone-off" flavour after a few hours or after having been frozen. The best way of testing for this is to taste the freshly expressed milk and then taste it 24 hours later or after defrosting. If it tastes awful, then the milk needs to be scalded before storing. There is loads of advice on this on the LLL forums or Kellymom site. The scalding means that some of the antibodies are destroyed but it is still better than formula and would be easier on baby's stomach. Now, it is possible that the Mum does not have this problem but the fact that baby will take formula out of a bottle but not EBM would make me suspicious.

[looneytune]

Interesting, never heard of that so will definitely see what happens tomorrow and if baby won't take milk, get mum to check this

Another thing that's confused me is that the baby was so sleepy. My experience of babies with discomfort due to digestion is that they cry in pain. Well from what I remember, baby slept quite a bit on this day she was very sick (no diary in bag so couldn't refer back) and mum has just emailed back and confirmed baby was very sleepy from 3-8pm too which is a long time for her, normally much more active. Then baby was sick and back to her normal alert self. So not sure if this was a one off her not being well or whether it's normal for some babies to be this sleepy when they are suffering with digestive problems?

[chipmonkey]

Formula is heavier than breastmilk so a baby who is used to bf might very well be sleepier on formula as it is harder work to digest.

[looneytune]

Yeah, that's what I thought but she was fine after her first day and apparently today too and it's a new one for me. Maybe I shouldn't focus too much on that one day last week and just see what happens the more I have her. At least I can try EBM tomorrow and see what happens. Will keep you posted

Thanks for your help!

[NorthernLurker]

don't want to sound too grovelling but looney -I've read this thread and if you were my childminder I would be chuffed to bits that you were caring so much for my baby and looking after her with such loving care! Hope you get this sorted

[looneytune]

Bless you, what a nice thing to say I just want to get to the bottom of what upset baby for baby's sake and also so that mum doesn't think it's anything to do with me personally. Baby is so tiny still and I don't like to think of them suffering. Wish me luck with the EBM tomorrow!!!

[chipmonkey]

That's exactly what I was thinking, too!

[looneytune]

YIPPEEEEEEEEEE, baby went straight for EBM in bottle for me and had 2 and quarter oz's

[NorthernLurker]

great work

[looneytune]

And mum was really pleased as this is the first time she's collected her baby and they've been like they normally are i.e. alert and not all sleepy like the other 3 days I've had them. We're putting it down to formula making her more sleepy and I've asked for 2 x EBM for each day next week so that I don't have to give formula at all and we can see if she remains her normal self. I told the mum I was worried she was worried it was me rather than the milk. I must admit to have had trouble sleeping through thinking about it (having said that, I'm 23 weeks pg and sleeping is a problem due to that anyway!).

One thing I'm confused about though.........I told mum how baby was full of wind and brought loads up but suffered with last bit. She said this is normal, even when breastfeeding. I'm just surprised about breastfeeding causing so much wind as I thought it was bottles that did that??? Anyone know anything about this?

Thanks again everyone

[Pixiefish]

My dd hardly has any wind with breastmilk although she does get it if she guzzles.

I would still try the Dr Brown's bottles as they do reduce wind and colic

[looneytune]

Thanks for the advice. Just that mum said she gets it's from actual breastfeeding too which I'd never come across. She has the tommy tippy (I think) bottles so will mention these others

[kiskideesameanoldmother]

around this age i vaguely remember my dd being windy and think now it was connected to fast letdown (i remember her popping off, gagging on milk and spraying her eye with milk!). Either the letdown calmed down or dd learnt how to cope with it over time.

I would still get different bottles. I used MAM ultivent which I found very good (not windy) or like others are saying, Dr Browns. btw, i think Avent bottles are notorious for wind.

[chipmonkey]

Playtex disposable bottles are also good for wind as tehy collapse as the baby feeds.
Ditto what kiskidee said about fast letdown, had trouble with that with ds1 but not the others.

[looneytune]

Thanks for that, very helpful to know. At least I know mum is happy that the formula was behind her baby turning sleepy, EBM it is now Will mention the bottles etc, thanks!