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??

2 of my 3 had reflux and getting in a tiz over feeding like you describe was one of the things that they did. It might be worth investigating. Also with my first (with the benefit of hindsight and a lot more experience) I think I was trying to feed her when she was actually crying with tiredness. With her, I did start giving one FF in the evening when she was about 7 weeks and actually it worked really well. She was more settled and slept better. I got a break. The endless feeding and crying in the evenings stopped and because I was getting more rest my supply of milk was much better so she was more satisfied during the BF we still did.

You have to do what you feel is best remembering that you matter too.

1. All sounds perfectly normal

1. The size of your breast has zero correlation with the amount of milk you can produce; you produce as much as your baby needs

1. Post 6-weeks, it comes into its own and gets a hell of a lot easier

What everyone else said about size, supply etc, but just ask yourself...

Do you want to use formula? If you do, carry on topping up. But formula is not the magic answer (he was happy, alert etc - that won't happen every time).

Do you think you need to use formula? You don't. I have EBF 3 to 6 months and it definitely gets easier after 8-10 weeks or so.

YANBU to override your HV if that's what you decide is best for you but she makes good points about the impact of introducing top ups. I did exactly this with my first baby and for similar reasons (never sure he had enough, always seemed hungry in the early weeks, I had small boobs). The problem was that the more I ff the less confidence I had in my boobs ability to make enough to satisfy my baby and so I kind of got into a cycle where I gave him more and more top ups and my supply dropped, so I topped up even more until at about 9 months he stopped wanting the breast (which is fine but I happened to want to continue)

My 5 month old DS2 is ebf and I decided not to top up as this way so long as he gains weight I can feel confident he's getting plenty from me and my supply will increase with his demand. I find it so so so much easier not to have to carry around bottles and make up feeds so for me it was worth sticking through the non stop feeding of the early weeks.

If its important to you to breastfeed I would invest in a decent pump to up supply (I'd recommend the new Philip s advent electric one) and create a back up of extra milk in the freezer for when you want someone else to do the feed.

I haven't read all of the posts but you have to do what you think is right, but have you tried expressing during / after feeds as a way of increasing your milk?

I had twins and was worried about having enough milk to b/f them both. As others have said, I was told the middle of the night was quite important to stimulate supply so I was happy to do quite a few night feeds but when they started getting restless (can't remember at what stage it was but might have been a growth spurt about 6 weeks) I offered Twin 1 Breast 1, then offered Twin 2 Breast 2 whilst expressing from Breast 1, then when Twin 2 had finished on Breast 2, I expressed from Breast 2. I did this for a few days, then the same thing each time I felt they were having a growth spurt. Seemed to have the desired effect, had lots of milk.

Agree with all the 'do whatever you feel you need to do' comments ..... a happy mum = a (slightly) less whingy baby!
I had a very similar situation when my DD was 4 weeks ols and fwiw, this is what I did ..... (I was still under MW care - that's another story - but my MW suggested this way forwards and I didn't ever look back!)
I upped my own fat intake - just swapped skimmed for semi, didn't buy fat free etc to 'boost' my milk and ate as much chocolate and cake as I could get my little hads on!). I fed all day (as needed) and then in the evening (9-10ish) my husband gave DD a bottle of formula - it took ages to get it down her little neck yet made her sleep for a decent chunk of time (4-5 hours) ..... Which left me enough time to express what I would usually have fed her at that point (this made me feel like it wouldn't impact on my supply - who knows?!) and stick it in the freezer for use at a later date, get to bed and get a decent chunk of sleep ..... THIS CHANGED OUR WORLD!!

The frozen milk them became bottles as she became older - I think by the time she hit 6 months we'd only used two tins of formula.
At this point, unlike you, I honestly didn't care if all my milk dried up and I never fed again ......I would have been very happy to have totally given up BF at this point .... but having done this, I still feed now (albeit once a day) and DD is 16 months.
It seems that you are being given a lot of really good advice here - please, please do whatever you feel you need to do - you have done so incredibly well to get to this point ....... take each day as it comes and believe that if it feels right at the time then it most probably is .......!x

YANBU

Havent read all the replies but I think most are saying its your baby and you know him best. I have to agree! My dc2 was also a very hungry baby, feeding every 2 hours, crying for milk throughout the night and simply not content, so asked my hv who said its ultimately my decision but to wait until baby is a few weeks so breastfeeding is well established. I started combo feeding at two weeks and he was so so happier almost instantly. However he is naturally a hungry baby and was then downing a 4oz bottle still every two-three hours and i continued breastfeeding at night but the grizzling inbetween feeds stopped. Also had to wean a bit earlier due to his appetite.

However the cons I found are that combine feeding affected my milk supply quite abit and eventually stopped breastfeeding altogether after 6 months.

Good luck.whatever you decide.

It is one of those situations where you may not be able to have your cake and eat it too.

Hopefully you will be able to successfully mix feed but as you already know it can affect supply or your baby may start refusing breastfeeds.

You need to look at the situation without worrying about what other people say or think and decide what you think is best for your child. No one else can decide this for you. And your choice will always be the right thing to do.

Nothing wrong with topping up the odd feed with formula, especially the late evening one.

To be honest, you get more mixed replies here than in the feeding forum. There is Only One Law there, and that is that mixed feeding is a sin bigger than blue murder. But in my view, a happy mum and a happy baby is good, even if it means one formula top up per day.

Poodletip, yes he does have reflux (has gaviscon and ranitidine for it). No idea whether that is affecting his stress levels in the evenings but the formula feed seemed to chill him out no end. He's just slept for 6 hours after breast/formula combo. I'd gone to bed at 8pm too as pretty shattered so best sleep I've had in long time (5.5 hours). However ill do an express before I go to bed in future (at least for next few weeks) at 10 so my supply isn't affected.

It's totally normal for a BF baby to feed almost constantly in the beginning. Your baby's stomach is so tiny and doesn't get stretched like FF babies do.
I know it feels like forever but 6 weeks is such a short time, especially when you think of the lifetime of benefits you are giving by BF. (and not having to sort out all those bottles and buying FF!)
I honestly think this is the biggest reason lots of people stop BF, having unrealistic expectations of how intense it is in the beginning. I guess it might put people off trying if they knew!
Keep on trucking, it will settle and feel more manageable.
Maybe try a support group, I'm sure you'll find RL women saying the same as here

I think mixing feeds is a good idea personally, means you can get the babysitters in and have an instant supply if you are out with no bottles! (It would never happen with DC1, but more likely the more you have )
Mine all had hungry baby formula at bedtime - and loads of it .... zzzzzzzzzz ..........
The HV I am sure is well meaning - but I just don't get all this breast feeding nonsense, of course we know it is good for your baby - but equally, so is a calm happy Mum and a good nights sleep

My first child was like this and I found, by offering her bottles after each feed, that she needed more and more formula as the day went on, until she was taking a full bottle feed at night. Basically my supply was just not keeping up with demand. My instincts about when she was still hungry after a feed were exactly in tune with when she needed the biggest top-ups.
I did everything suggested by all the lactation experts before deciding to top up and held off for 6 weeks, but I do feel guilty as she started to grow properly after getting more milk, whereas before she had gained very very slowly and dropped through 2 centiles.
The thing that made me decide to top up was reading that the weeks and months after birth are a time of rapid brain growth and I did not want to restrict her nutrition. I do think the things my HV said about always producing the amount of milk your baby requires sounded like wishful thinking along the lines of 'everyone grows a baby that is the right size for them to deliver' - another thing that I found out the hard way wasn't always true!

All the women I know (me included) who have had to mix feed because our babies were still hungry, have been size 14 plus with child bearing hips and we've 'grown our babies big' BUT have had relatively small boobs.....so I do think boob size affect the amount of milk produced to some extent and logically why wouldn't it?

Apologies if somebody has already posted this, but the Kellymom website is a brilliant resource for bf-ing.

It has been suggested that the seeming variation in the quantity of milk you produce during the day is that the morning milk is more watery & high in sugar (and volume) and the evening milk has less water (i.e. less pee during the night!) but a much higher fat content. It's doing exactly what your baby's metabolism needs, but it gives the (mistaken) impression that you have less milk to offer.

DD1 cluster fed (without coming up for air) from 5pm to 8pm every evening for the first 4 months of her life. I watched all seven series of The West Wing. When I met President Bartlett I told him this, and that my baby (who was strapped to me at the time) nursed & slept to the sound of his voice for the 1st four months of her life.

Op, you should do what feels best for you and baby and it has fuck all to do with anyone else including the health visitor.

Everything you say in your op sounds so normal, especially the not sleeping and the evening cluster feeds. I do kind of wonder what you were expecting! I haven't had as many hours sleep in a row as you and my baby is almost a year.
I do wonder what you would post if you come back in 3 months time, but I suspect you may have stopped bf as I believe this can (note, can ) be a consequence of introducing formula. To answer the original question, of course yanbu to ignore HV if you disagree with her. Mine wanted me to introduce formula, just depends which one you get! The feeding threads are much better for practical advice than aibu, I'm always a bit about why people post bf/ff questions on here.

At this age I found I had loads of milk in the morning but got low in the evening. I would express in the morning and give the boy a bottle of expressed in the evening after he'd been on me for an hour or so.

At about 5 months I did introduce some formula but expressed whenever I did.

Buy some fennel tea bags and drink fennel tea through the day.
Fennel significantly increases breast milk supply.
So does coriander - coriander and carrot soup is good.

Sage dries up the milk supply, so avoid it (Sage & onion stuffing).

Coffee, cocoa & tea are to be avoided.