Formula top-up for BF baby.....

[GoodbyeToAllThat]

DD is 8 WO and EBF on demand. BF has been going really well and despite a slow start (traumatic forceps delivery and jaundice) she has been gaining weight along the 50th centile.  Plenty of wet heavy nappies each day and dirty nappies about every other day.

However, I'm currently having a massive confidence crisis and am really confused about advice to start an evening top-up with formula.

The average length between feeds in the day is 2-3 hours then she cluster feeds in the evening, sleeps for a couple of hours then pretty much cluster feeds throughout the night until c6am.  

I am getting very little sleep but am less concerned about this and more about the fact that she was weighed yesterday and had dropped a centile.    HV's advice was to start an evening top up with formula milk because she's not getting enough from me. 

I really feel under pressure to introduce some formula. My DH (who has been incredibly supportive of BF) has also suggested the same as he's worried that I can't survive on this amount of sleep (I can! I will!).  My DM and MIL have been telling me from the start that she needs formula as she feeds too often.  All my friends who have babies are FF and reckon that she will sleep/gain better if introduce a bottle in the evening.

  I went to Boots today to buy formula/bottles etc so that I'd have the option, only to realise I didn't have a clue what to get. I also suddenly felt really as it feels like I'm messing with something that's working really well and that DD and I enjoy and I'm worried about affecting my milk supply. 

On the other hand, I would love to have a bit of time in the evening (poor DH has cooked dinner every night since DD was born!). I have tried expressing so that DH can bottle feed but I've never been able to produce any milk.  Also, friends/family are making me feel like a stubborn old hippy for continuing with EBF.

I'd be so grateful for your advice.  Is introducing one bottle going to affect BF the rest of the time? If I do introduce a bottle, what brands are best and what milk?  What happens if I ignore the HV?

 I've been reading the feeding board since DD was born and have picked up such excellent advice but this is my first post. Sorry it's so long!

[bumbums]

Hello! Please ignore your HV! You are doing a fantastic job! Sack off the pumping too. Waste of time.

The feeding that your baby does in the evenings and trough the night is what sets up your milk supply for the following day. So starting a bottle then is the worst possible time. Also the milk you produce in the night is richer and fattier, and so your baby is getting great quality milk from you.

Prehaps she is still a little nocternal? Does she sleep through most of the day? A good thing to know is that tiny babies only have one long period of sleep in 24hrs, so try not to let her sleep for more than 3 and a half hours in one go through the day.

More good news is that the cluster feeding usually tails off at around 12-14weeks, although most babies will still have periods of the day when they want to suckle more.

Have you worked out how to feed her lying down? Make a safe bed for the both of you so you can feed and doze simultaneously.

How about attending your local La Leche League meeting? They can be a bit extreme earth mother in there mothering styles but will have masses of practical advice for you and its good to see people face to face some times.

Keep up the fantastic mothering!

[RitaMorgan]

Dropping one centile is ok though isn't it? It's only when they drop two that they refer you back to the doctor. Actually my ds dropped more than two and was still fine.

She might sleep better after some formula, but she might not. If you want to continue ebf you could consider expressing a bottle maybe?

2-3 hourly in the day isn't massively frequently - you could try offering feeds more frequently, and offering lots of boobs at each feed (swapping back and forth between sides everytime she stops until she won't take any more) to see if you can get some more day time milk into her.

Have you been to a breastfeeding group at all? A bf counsellor might be able to help you tweak her latch a bit and get her feeding more efficiently.

[tiktok]

OP, nothing you say makes me think your baby needs formula - her growth is normal (going down 2 centiles is within normal and your dd has gone down 1 only :) ) . Her behaviour is normal.

Giving formula undermines breastfeeding and as we know exclusive bf gives the best health outcomes, you'll obviously want to consider it carefully - one bottle is not going to make much difference to a happily bf, healthy baby unless she is one of the rare ones with an intolerance, but there is no evidence at all (in fact the opposite!) that giving formula leads to more sleep (there's a thread here now with a link to a study which shows this:

Breast-feeding Increases Sleep Duration of New Parents.

Journal of Perinatal & Neonatal Nursing. 21(3):200-206, July/September 2007.
Doan, Therese RN, IBCLC; Gardiner, Annelise; Gay, Caryl L.; Lee, Kathryn A. PhD, RN, FAAN

You can find it on the web.

I am puzzled why your HV says your dd is not getting enough from you - did she really mean that? Can't see why she said it!

[tiktok]

bakingmum - gotta disagree with you about Aptimil, sorry :) It's no better or worse than any other formula, just more expensive. Professionals sometimes recommend it if they know no better - it's marketed heavily to midwives and HVs. My personal opinion is that if an HCP recommends Aptimil (or any other brand) saying it's 'better', they're showing how little they know :) :)

[CitizenOscar]

Lots of my friends do this (one bottle of formula a day) and they are happy with it but I've never done it (DS is 16wks) and I don't see a difference in the sleeping patterns between the babies.

If you're happy to continue ebf, despite lack of sleep, then I'd say keep it up. There's no guarantee formula will make your baby sleep longer and it might affect your supply (not definitely, as I say, my friends haven't had trouble with their supply after introducing a bottle).

Good luck with whatever you decide.

[lilham]

I reckon the formula will make your LO sleep better is one of the most repeated myth forced on new mums. Followed by baby rice will make them sleep through. Talking to other mums in baby groups, there seems to have no correlation at all. Some of them are good sleepers, some of them aren't.

FWIW my EBF baby slept through from 11-12 wk, but prior to that she was horrid. Two or three times a night every night.

[GoodbyeToAllThat]

Thank you for all the replies!

bumbums Yes, I guess she is nocturnal and definitely sleeps better during the day. I don't think she's ever slept for more than 3 hours but will keep an eye on that. Sorry, forgot to say that we are co-sleeping/feeding lying done at night - I don't think I could have survived this long otherwise!

RitaMorgan i know you're right that 1 centile is fine - they want me to go back next week for another weighing so I'm probably panicking
that this is a downward trend. Have tried and failed miserably to
express but have been to my local BF group and was told the latch
was fine.

Tiktok Thank you for the reassurance about what is normal and the information about BF and sleeping - I will have a proper read of that
tonight. The HV's comment was in the context of frequent feeding from the evening into the night - she said that DD won't sleep if she's hungry. That, together with the failure to express, made me feel like I had a supply problem but have since read other threads to reassure me that's not the case.

CitizenOscar My supply being affected is exactly the risk I'm worried about. And I am happy to EBF and don't mind the sleep - this surely can't go on forever?!!


Thank you all for the replies - just writing it all out has helped
me gather my thoughts and I suddenly feel more supported than I have in ages. I think I'll carry on as I am at least until the next weighing and maybe challenge the HV a bit more if the same advice is given.

[GoodbyeToAllThat]

lilham Funny you should mention baby rice - I'd never heard of it but DM's latest advice (well meant I know) is that she's hungry and I should wean her ASAP using baby rice or watered down rusk. I may be new to all this but I knew to quietly ignore that one!

[FessaEst]

Both my DDs have been very smilar to the pattern you have described, cluster feeding in evening and frequently overnight for the first 3 months or so, and are both absolutely fine. I have never given bottles or formula and they have grown ok. I haven't weighed either of them very often, and go more by wet/dirty nappies, wakefulness & general demeanour. I never managed to get much expressing but can't have had a supply issue as DD1 was EBF for 6 months.

If you don't want to introduce a bottle, then don't. If your HV feels your baby needs more milk, then it may be that you need to increase feeding frequency during the day, and switch sides with each feed. There is no guarantee re: sleep as a straw poll of my NCT group would show - the best sleeper was a EBF baby, the worst sleeper (mine!) was an EBF baby, and the formula babies were at different points along that spectrum!!

You're doing really well, congratulations!

[posterofaghoul]

I'm not an expert but I was bullied into formula top ups and I'm now stuck with at least one a day which I hate.

It doesn't help my DD to sleep and she still wants boob after.

Don't let anyone make you move away from EBF unless you want to.

[orangeone]

Just wanted to add to the already excellent advice you have had, that your LO sounds totally normal. Just like you around 8 weeks I had DD weighed and because she had dropped 2 centiles (due to a tounge tie), the HV told me I didn't have enough milk, I needed to top her up with formula and the cluster feeding proved this. They also told me I had to return in a week for weighing and if she hadn't gained weight she should go onto formula.

What followed was a horrible week where I doubted myself as a mother, thought my stubborness to EBF after everything we had been through was going to put my DD at risk and slept even less than I had been.

Cue a sensible chat with my more experienced mum friend (3 under 5!) and lots of lurking on this forum and I made some sensible decisions that I have followed ever since:

1. Smile and nod at HV and then ignore the rubbish they spout.
   
2. Did not get my DD weighed more than Every couple of months just for my interest (one big poo right before weighing could really knock her down the chart!)
   
3. Watched for wet nappies and her general presentation, and if worried About her health took her to doctor not the HV (apart from one occasion when I slipped and took her only to be reminded of why I don't when she said teething doesn't exist and she should be on cows milk now she's 1 because 'extended BF' is bad for children!!)
   
4. Pumped at the same time every morning whilst baby slept nearby to get a regular supply up (took a few weeks to get anything though and only ever with a manual not electric pump).
   
5. Used milk from several days of 4. Above to give to DH To give to DD so I could sleep through every so often when needed the sleep to remain sane.
   

3 months on, DD slept from 11.30pm to 6.30pm most nights (unlike many FF friends babies).

16 months on, DD eats a good amount of food whilst still having 2 breastfeeds a day and appears to be growing fine.

The HV never chased me up for stopping getting her weighed every week and my stress decreased/confidence increased no end........

[orangeone]

And I never did top her up with formula.... :-)

[GoodbyeToAllThat]

Thank you Fessa & Orangeone for sharing your tips - it really helps to hear that you've been in similar situation and come through it fine. She's been feeding loads the last couple of days - almost like she knows she needs to pile on a few more ounces! Am laughing at the comment about huge poos affecting the weight - DD tends to save a big one up for just before each weighing, which I curse each time! Am definitely going to avoid frequent weight checks from now on as it's just too stressful.

Posterofaghoul - am sorry you're stuck with something you're not happy with and completely understand how you got there, "bullied" is exactly how it feels sometimes...