AIBU to ignore HV and top up with formula?

[Thepursuitofhappiness]

I have a hungry (almost) EBF 6 week old baby. I want to continue breastfeeding, however I don't think he's getting enough milk.

I've not got the biggest breasts (32A before, now 34C and loving the increase!) and he can only go 2 hours max between feeds. Particularly in the evening r is insatiable, ill cluster feed from 4ish but he gets so frustrated that he can't get enough milk out after an hour of feeding that he's screaming.

He is on about the 5th centile at mo (dropped from 9th). Health visitor says this fine as putting on 4oz a week. Says I shouldn't top up with formula as this wont increase my supply. She is evangelical about breastfeeding.

I have tried everything to increase my supply. I've spoken to national breastfeeding support and attended a group. Eating loads (including midnight porridge) and drinking lots. Letting him empty each breast before putting him onto the other, then switch feeding. Lots of compression when he stops swallowing.

But I don't think it's enough. I hate not being able to fully satisfy him. He sleeps badly when not full up. I sleep badly as feeds take so long so only getting 4iah hours a night. I'm exhausted with the constant feeding and little sleep.

I tried topping up with formula (after an hour on the breasts) yesterday and it was amazing. He had a 5 hour sleep last night (-so did I!) he was happy and alert and satisfied afterwards.

So AIBU to ignore HV, have I embarked on a slope to the end of breastfeeding? Or how long should I persevere on EBF and the little sleep before I start top up??

She may be evangelical, but you are not happy. Do what YOU feel is right for YOU.

You might want to get this moved to the feeding forum?

What he is doing is normal.

You can only produce more milk if he continues to suckle. His stomach is tiny, so little and often is right. Breastmilk is more easily digested than formula, so he will need refills more often.

At six weeks he may well be coming up to a major growth spurt and to do this he needs to feed more from you.

I think a lot of people mix feed successfully, I did for a while. your problem may be getting him to take a bottle now though. At 6 weeks your supply should be established enough to introduce a bottle as your body will adjust.

As the pp saud, you have to do what makes you happy.

You are not being U, to do whatever you like. However I would report your op and ask for this thread to be moved to the feeding topic. You would get lots of helpful advice, from woman in your situation. Good luck

Your baby is normal and doing all the normal things a baby that age is expected to do. Breast size is irrelevant to milk production. Growth sounds good, 2hrs between feeds or less is normal at that age. So in those respects your HV is right. There is no problem with your supply, only your perception of what a newborn baby's behaviour should be like.

If you want to give formula, then that is entirely up to you .

Its your baby, your choice.

I found when I had my DS I didn't listen to a lot of what the HV or even the MW said. Most are reading from a textbook, and have no real experience. x

... shouldn't top up with formula as this wont increase my supply

Well, she is right. It won't increase your supply and can, I believe, adversely affect it. That is no reason to do what you feel is best for your baby though, but you do need to make the decision with full knowledge of the implications wrt your supply and the impact on breastfeeding.

Yep that is entirely normal, a 2 hour gap at that age between feeds sounds pretty impressive actually! It will settle down in a few weeks. Your supply will drop if you introduce formula, but it's obv your decision to make.

I think at 6 weeks, one bottle a day isn't going to hurt at all and if it gives you a break then brilliant. DH gives DS2 (13w) a bottle of ebm at around 6pm. If I couldn't express I would give formula.

There is a danger that if you top up every feed then your supply will dwindle as your DS will not be asking for enough milk from your breasts to keep up as he grows, also that he will begin to favour the bottle and take smaller amounts from your breast every time as he's waiting for the bottle to arrive.

Rather than top up you could just give over one feed a day wholly to bottle and bf the rest.

have you had him checked for tongue-tie?

I know lots of people who have successfully mix fed their babies do what feels best :)

I gave one bottle a night from quite early on, and carried on bf hte rest of the time till 6 months. It worked well for us, and I got 6 hours sleep in a block till the 2am feed as DH gave the bottle!

I don't think it has to be all or nothing.

I managed to mix feed and continue bf until 14 months. I did it because like yourself i didn't feel like i was producing enough milk and struggled with hourly feeds for first 3 months. I also had to go back to work when ds was 5 months and couldn't express. Still managed to bf 2-3 times daily for over a year. Your supply won't dwindle, just adjust to demand.

As others have said, it's up to YOU what YOU want to do.

I will repeat the others comments though:

Baby is tiny, they don't sleep for long hours at this age. It is completely normal to feed every 2 hours.

Baby has been with you for 9 months. They want their mum at night time. Consider co-sleeping (google it to be safe). Try feeding lying down.

6 weeks is a typical growth spurt age. Many of my friends and myself felt that our supply wasn't enough to satisfy. The truth of the matter is is that your supply can't dwindle if baby is sucking. Your production works on supply and demand, the more baby sucks, the more your body will produce.

The centile is normal. Some babies have to be on that one, that's the whole idea of it.

Have you tried to express milk and consider offering that as a top up? Would you consider milk from a Milk bank as a top up - there are other options to formula.

You can introduce formula but your body will eventually catch on that your baby isn't feeding as much from you, so eventually your supply may slow up (unless you express at the same time as giving the bottle, which then defeats the object of giving a bottle ).

It doesn't have to be all or nothing. Mix feeding is an option. Talk to the helplines to suss out a plan.

Baby sounds really normal. You sound stressed. That too is normal. Who in RL is helping you? Can you get some sleep during the day when baby naps? Look after yourself OP.

There is nothing wrong with formula. There is nothing to stop your giving formula.
The choice is entirely yours.

There is a huge growth spurt at six weeks. They develop a lot around this age, and they also feed more to increase your supply for the long term.

Six weeks is the 'panic point' for a lot of mums, who see the frantic feeding, the fact they are feeding more etc, and think immediately, and understandably, that they are not producing enough milk. It's not true :) Your baby is asking your body to make more for the future.

Your HV is correct in that if you introduce a bottle now, you will affect your supply.

It might be worth going to speak to your local peer support group, and have a chat with a breastfeeding specialist in person.

Yanbu it's up to you, but topping up is very likely to make you produce less milk and you may end up only ff very soon. If your ok with that that's fine but be prepared for it to happen.

I have an 8.5 week old and he had just started going longer between feeds now 2.5-3 hrs and the cluster feeding has pretty much stopped. Hold on tight as I'm sure you will see the same soon (I was having exactly the same experience as you!)

However if you are unhappy or just want to stop then let that be your decision and don't let anyone pressure you. Do what's best for you x

While there is no correlation between normal breast size and milk production, there is no way of knowing whether there is no problem with your supply in the evenings or not. If you have plenty of milk in the mornings and at night, (and your baby goes a longer time between feeds) but not in the evening, it would seem to be an evening problem.

Just to reassure you, a friend of mine was advised to give one FF in the evening when her supply was low and she continued to successfully BF for 3 years in days when that was considered far from normal. (She even had another baby in that time).

Do you have a breast pump? I've been in the same situation in the past couple of weeks. I ended up getting DD's dad to give her formula while I expressed. Obviously you still can't put your boobs away and go to sleep, but you don't have the fussing and screaming to contend with, and your supply is still being stimulated. Then, if you need to do it the next night, you can use the expressed milk instead of formula.

However I think I read somewhere that night feeds are really important for maintaining your supply in the early weeks, so if you find he's sleeping for 5+ hours every night without waking for a feed you might have to tweak things so he wakes and bfs more frequently, as hard as that will be for you when you're knackered!

Hi, like a lot of mums here I experienced almost exactly the same thing, feeding constantly and cluster feeding in the evening, I think there's a growth spurt at 6w, my lo now goes 2-3hrs between feeds but that only changed recently (5m), I think this is completely normal, if you let baby suck the milk will come. I read somewhere you have more milk at night and night feeding is a great way to boost supply. Gl

I agree that his feeding pattern sounds normal, so it's a case of doing what you want, as you have noticed he will probably be settled for longer with formula, but if you decide to carry on EBF not to worry as he does sound like he is getting enough milk.

FWIW I don't think your HV sounds breast obsessed, just that she's trying to be reassuring. She shouldn't have told you not to top up though, that's entirely your choice. I agree one bottle a day at this age probably won't mess up your supply at all, but you need to stick with that one bottle or introduce a second/third etc gradually and as far apart as possible but stick to what you've decided (ie breastfeed through growth spurts etc) or your supply will start to reduce if you use a bottle to get you through every tough period - then again, this isn't necessarily an issue, it's certainly a gentle way to wean off the breast, just as long as you're ready to do that.

Just to clear up some issues: -

Boob size is nothing to do with milk production as most of your breasts are made up of fat, the actual milk producing "equipment" doesn't take up much room at all (although it does increase boob size initially as you have noticed)

2 hours is on the long side for a gap between feeds at 6 weeks. By 12 weeks things should be increasing as the baby's tummy gets bigger.

WRT finishing boobs/switching boobs etc current advice is to follow the baby's cues, if they get fussy, switch them over, get fussy again, switch back, etc.

He doesn't sound like he has tongue tie to me. Tongue tied babies tend to be feeding literally constantly, they often spill milk when feeding, and their latch will hurt.

At around 12 weeks you'll switch from hormone driven supply to demand based supply and the baby will be more effective at getting milk out. You'll stop feeling "full" between feeds and your breasts will be soft and floppy most of the time. You may drop a cup size too, and stop leaking. Again, this is normal but doesn't mean your supply is reducing.

Oh yes I agree 6 weeks is hard. It gets easier from here on in.