Help on how to do top ups and has anyone used Nanny Goat?

[Andanotherthing]

Hello there,

Had my twins weighed this week and DT1 had dropped to the 9th centile. HV concerned that he wasn't getting enough milk from me and advised me to start giving formula.

I tried to express milk for each feed instead (As he wasn't that interested in eating, kept pulling off even though there was milk there). He seemed to wolf it down from the bottle, but I really struggled to express from RB and so had to start top ups of formula in the end.

My question is whether it is better to give a small top up after each feed (Although he doesn't seem interested in bottle at night so it would just be 10am, 1pm , 4pm top ups), or whether I should replace one or two feeds with a bottle?

My other question is which formula to use? I have started on Aptimal but the list of ingredients (Including fish and soya!) made me shudder! I thought about Hipp Organic or maybe Nanny Goat.

Has anyone else used Nanny Goat or Hipp?

Sorry to ramble, I just have so many questions! Am gutted I couldn't carry on ExcBF DT!, am hoping I will be able to carry on with DT2.

[Sassyfrassy]

Is he losing weight or just not gaining as fast as the hv would like? Some hv's seems obsessed with weight charts but babie's weight gain does slow down and can swap centiles as well. Most importantly, does he seem well to you, are there plenty of wet nappies? It's always posssible that he is fine with what he is getting.

[tiktok]

Would be worth your while getting a second opinion on your twin's needs, OP.

Dropping to the 9th centile may not mean much - what was he on before? Is he healthy in all other respects?

[hunkermunker]

What reasons did the HV give for topping up?

Is DT1 losing weight or just not gaining enough to please the HV?

Are you breastfeeding him to a routine?

Can you ring one of the bf helplines and have a chat with someone who knows about bf? Your HV hasn't helped you much, has she - just telling you to "top up"?

The helplines are listed on the right hand side of this page

[margobambino]

It is a difficult decision. Organic formula doe not contain LCPs but gives you peace of mind as it is organic. I did use Nanny Goat, and there is an organic version of it available too (Holle goats milk based formula) but as far as I know goat milk based formulas are not suitable for under ones.
I had low milk supply from the beginning and topped up with Aptamil first 5-6 months (in which LCPs are more important). Afterwards tried different brands including Hipp organic. All of them were OK.
It was very difficult to accept the fact that I was not able to exclusively breastfeed my DS. I even had PND related to that. But now I can see that it was not that important. Please don't worry too much.
For the first question, I did give him small top ups after each feed, I mean I breastfed before each formula feed.

[margobambino]

By the way, my DS is now 2, I am still breastfeeding. He loves it and I do like breastfeeding too. But I feel still guilty about not giving him formula during the first 4 days, as I obviously had low milk supply and my poor little baby was hungry. I believe all this breastfeeding campaign makes us lose our sense of reality. Pediatrician came and said breastfeed first and then top up with formula if he is still hungry, but the midwives in the ward somehow persuaded me to not to top up. Listening to them was the most stupid thing I have ever done in my whole life.

[tiktok]

margobambino - the fact you avoided formula in those early days may well have ensured your supply was robust enough longer-term. Prolactin receptors appear to be laid down in the breasts in the first days after birth, and this process is undermined if formula is given, as bf becomes less frequent at a time when it needs to be frequent.

The midwives should have given you other help to support you and your baby, though. A hungry baby could have been topped up with more colostrum while waiting for milk to become better established.

I don't think the breastfeeding campaign (which campaign's that? Informing people about bf is surely not a campaign, is it?) is responsible for people losing touch with reality. What is missing is good education and training of HCPs - with that, mothers like you would get better, and non-conflicting, advice.

[CookieMonster2]

If you decide to go down the route of top ups the best way to do it is give a smaller top up after breastfeeds, but not necessarily every breast feed. I top up after 5 feeds a day, and I do this at set times of the day so the formula milk is always spread out throughout the day. If you have the rule that they only get the bottle after you are happy they have breast fed then this will reduce the chances of them giving up on the breast feeding.

I succesfully did this with my first who was breastfed until a year old, and am doing the same with my second. It can work really well if you get into a good routine.

Can't help with the choice of formula milk though I'm afraid!

[Andanotherthing]

Thanks everyone for your help - he has been gaining weight every week - never lost or stayed the same, but HV (Actually is a nurse not HV), worried because he has dropped 2 centiles.
Have taken him to GP who said he seems fine but also advised top ups (suggested he may be referred for "failure to thrive" if weight gain doesn't pick up). He is very alert but I did notice his activity levels had dropped, he seems more interested in sucking his fingers, but I think there is a tooth on the horizon!

I have been feeding the babes on a 3 hr routine, they have been going 5-6 hours at night between feeds, sometimes 7 hrs, and they don't wake up screaming - they wake up and lie there chatting until I feed them!

He has taken a few good top ups (took 5 oz today) but for example this afternoon he wasn't bothered about the bottle at all...

Feeding is taking ages as I am trying to express, feed him, give him EBM and then formula. I then feed his sister and try and get her to finish what he didn't have!

My RB seems to give milk very slowly, and I wonder if he is fed up of waiting for the milk as he seems to get frustrated on the RB!!

I think I have done the right thing, as I hate the thought if him being hungry - saying that the HV tried to get me to give formula in week 2 as she had never met anyone bfing twins exclusively before(They are 20 weeks), so I have kept going as long as I could!