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??

I wish I had had a HV who was evangelical about BF. After a PPH, EMCS and a baby with undiagnosed 75% tongue tie we needed all the help we could get. Instead mine insisted we topped up with formula (we didn't). My crappy rocky start meant my supply was damaged anyway and I still need to take domperidone now to successfully BF my 14-month old.

Anyway, many people have said it already. Your baby is behaving normally and the first couple of months of breastfeeding are definitely the hardest. If you persevere and nail it though, chances are it will get much much easier and become very rewarding.

If you want to introduce formula that is your choice, but go into it with eyes open: it won't do your supply any favours and could undermine breastfeeding in the future. Your HV is (highly unusually in my opinion) one of the correct ones and is giving you the right info. Do, however, insist on a check for tongue tie if you haven't already. Good luck.

Hi OP
I have mix fed my second child practically since the beginning, without really thinking about it. I can't see any effect on my supply whatsoever. Some days, if I am out, I leave her with DH and she can have 3 bottles, other days I just breast feed her all day. I don't really understand the relationship between introducing and supply, though - I've always thought that if you put the baby to the breast, there'll be milk there, in the same way that you don't run out of blood?? Am probably wrong though! I know what you mean about just needing a physical break, and for me, bottles provide that. Very best of luck, and congratulations!

Also if you are a small person (I'm guessing so at 32A bra size) then it follows that your baby will be small. Most babies move centile lines from birth because birth weight is more to do with gestation and size of the mother - you're supposed to take their 2 week weight as a starting point and it's OK for them to cross 2 lines.

I was in your situation and some weeks dd was putting on nothing in a week. By 10 weeks people in the street were assuming she was prem. That was the tipping point for me and I started to top up with formula and she was fully formula fed within a month, happy and growing.

The guilt I felt about switching to formula was massive but it was right for us.

Sorry for the slight hijack but I understand feeding 2hourly or more and cluster feeding are both normal but baby getting frustrated and crying while suckling like OP describes?? Surely that's not ideal? If he wants to feed and your offering both boobs then the first again and he's frustrated what can you do.

hi what I did was expressed in the morning when I had plenty and gave that bottle at 6. I breastfed at 4 and 7.30 in the afternoon too - he was a hungry little bugger. just another option for you to consider - it was a bit of a faff but I was a bit precious about wanting to ebf. when I look back at photos I can't believe I was so obsessed about supply - he is like a little round ball!

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

That's correct information, it's up to you. If you are happy to let Breastfeeding peter out that's your choice. If you were more worried about protecting your supply level then you might not risk it. Your baby only has one way to tell your body to make more milk, and that's hanging out on the boob. Size of breast has nothing to do with supply, btw; size of breast has to do with fat storage on your body, little else.

I have a friend who combi fed until her son was 14 months; she fed on demand mornings/evenings from 6 weeks with bottles inbetween (she had to go back to work and couldn't express). I think the trick is to be very consistent about when they have bottle & when they have breast.

I don't think you should top up either, sounds like baby is increasing his supply by cluster feeding, and by taking that demand away (ie. bottle feed), your boobs will make less milk, thus making him more hungry and frustrated which can lead to a quickly descending spiral of him refusing the breast as the bottle is quicker & easier.

Think of breastfeeding as your only job for baby, others can change nappies, do washing and tidy the house. Prioritise feeding over all these things, as much as you can, take baby to bed and lay there for hours and hours, dozing and feeding whenever he wants. The more he sucks, the more milk you'll make - and don't worry about boob size, my friend who was barely an A cup made heaps of milk, even though her cup size barely increased (baby tummy is the size of a marble at birth, leading to a golf ball at 12w - so boobs don't need to be that big to hold a feed... most of the boob is fat).

As others have said, that sounds like a perfectly normal EBF feeding pattern so don't worry. However, if you're not happy, that's reason enough to top up if you want to. You don't need anybody's permission but if you think it's a move you may regret later, then do talk to someone you feel comfortable with first and make sure you're absolutely certain. That way you can have total confidence in whichever decision you make and won't feel you were pushed one way or the other.

She is telling the truth because she doesn't want you to stop for the 'wrong' reasons: that you think something is not working. If you don't want to do it, that is of course the only reason you need.

I agree with everyone else. What you describe sounds totally normal for a baby that age. Your breast size makes no difference at all to feeding; my mum fed me and my brother for two years each with 30AA boobs! And we were chubby babies.

But having said that, if you want to use formula, of course that is fine. Your health visitor is right that replacing feeds with formula this early on would probably affect your supply unless you expressed it.

But as long as you are aware of all this and still want to use formula, of course you are not being remotely unreasonable! And my friend successfully introduced one evening bottle at about three months and continued breastfeeding for 28 months so it is possible to mix feed long term if that's what you choose to do.

Congratulations on your new baby, by the way!!

badguider Some babies are just fussy though. Sometimes it's wind (can wind between boobs!) or teething (can apply teething gel before feeding) - teething especially as they want to feed for comfort/the pain relief it provides but then by feeding they're putting pressure on their gums which hurts them and they can't understand because this is the way they make the pain go away! It's a horrible feeling - think being sunburnt and unable to lie down/sit in a cold bath or being pregnant and unable to lie on your front when that's the way you usually sleep.

I too had this evening problem in the early weeks (not at any other time of day or night) and I did persevere but the entire evening was taken up with feeding. I wouldn't worry about your baby sleeping 5 hours at night - you will be lucky if he does this every night. EBF DS regularly went 3 -4 hours, and sometimes 5 hours between feeds, both day and night with no harm to supply - I just had an awful lot of milk when he did decide to wake up and it could be rather uncomfortable. I do remember one awful evening when DS was 4 weeks of constant feeding and grizzling and general unsettleness that finally finished at midnight, followed by 5 hours sleep, one feed then a further 4 hours sleep. A baby having to feed every 40 minutes just sounds very unlucky to me.

They call the first 6 weeks of BF "boot camp" :) if you've got this far it does get easier, in the next couple of weeks you might find it gets slightly better, big jump at 3 months to it being much easier, then you might get hit by the 4 month sleep regression and then the trying-to-delay-weaning bit which isn't much fun, but then once you start weaning and it gets underway breastfeeding becomes the easiest thing in the world.

boob size really has nothing to do with bf. I was a 32h (before 32ff) and still produced little milk I also had a vey greedy baby

My hv went on and on that I would as we all produce enough milk for our babies but it did not happen so I topped up I think it is a personal choice and I do not believe that all women produce enough milk this is why feeding was often shared with sisters and other female famiy members, just as not all women can give birth naturally sometimes our bodies do not do what is expected

my mum had to do the same with me I too was a greedy baby and she once passed out feeding me as I was just taking too much from her she then topped up and both of us were much happier

As others have said, it sounds like your baby is doing fine and is perfectly normal.

A drop from the 9th to 5th percentiles is not significant if the baby is putting on weight and otherwise doing well.

The size of your breasts does not influence how much milk you make.

Of course if you really want to top up with formula, then that's your decision, but based on your OP, it is probably not necessary and may detrimentally effect how much milk you produce (which I assume is completely the opposite to what you want).

It is hard having a new baby. I haven't forgotton the sleepless nights. All of my babies dropped centiles - quite spectacally - going from the 50th at birth - to right off the bottom of the lowest curve in the case of dd2. I continued to EBF and she is now a healthy, very slim, 7 year old.

Agree with the others about 6 weeks being the hardest point. Just to give you an example when dd was 6 weeks old it was the general election. Being naive we thought it would be lovely to walk to the polling station (5 mins away) as a family. Dh came home from work early and as soon as dd stopped feeding long enough for me to get my shoes on, off we went. We made it to the polling station for 9:25pm with dh coming home at 4pm!

After that I just gave into the cluster feeding, developed an addiction to several soap operas and spent the evenings on the sofa moving only to swap breast sides.

One thing - are you being busy during the day? If you are rushing about trying to keep up with the housework and the shopping then you are not giving yourself the best chance to produce the milk. My theory is that if you have a 6 week old and your house is not about to be shut down by environmental health then you are doing too much.

Try an afternoon sleep and make sure that you are eating a high fat diet. You produce more hormone for milk production asleep, I struggled until I got the nap in.

Physical exertion doesn't affect milk production, Mummy.

Neither does a high fat diet, or sleep!

YANBU and should supplement with formula immediately. Always start each feed on a breast until it seems empty, switch to other breast until it seems empty then top-up with formula to satisfy your distraught baby. I was advised to do this by a HV btw.
Many people do mixed feeding for several months without issues. It does mean that your breastfeeding will probably finish earlier than for an exclusively breast-fed baby though but the child's contentedness and health is much more important than an inflexible doctrine from a bfn. Good luck, your life is about to get easier.

It sounds normal to me. Particularly evening cluster feeding. You might have a supply problem, but nothing you have said would indicate that.

It depends on what you want to do though.
Some people are able to introduce a bottle a day (normally at bedtime) without losing supply, but one friend who did this did end up stopping bfing before she was ready.

Topping up after every feed will stop your body from knowing to increase your supply as your baby grows and will be an almighty faff. So if you do want to supplement I would recommend one bottle a day at the same time. Also, on the days when your baby wants to feed more (because of growth spurts) you will need to offer more breast not another bottle or eventually you will end up 100% ff (unless of course that is what you want).
It is completely your choice but your hv is giving you correct information.

If you can stick with it do, it sounds normal, breast feeding does get easier, you are nearly through the hard bit.