To formula feed baby despite OH's objections.

[Herbie22]

DD is 5 weeks old and exclusively breast fed. I am finding this tough because she is either on the boob or upset.
This is my first baby so I'm not sure what I am doing. I think she might not be getting enough from me as she needs near constant feeds. I would like to top her up with formula as I literally do nothing all day/night but feed her. I know that it's hard work a newborn but I can't even walk down the road to the shops without her screaming. I don't get to see anyone and it is making me sad and lonely.

I tried to speak to OH about this and he said that he doesn't want her on formula. He said that I am making enough milk because she is gaining weight. I don't think she is gaining it fast enough though which worries me.
I also wonder if she would sleep better if she was formula fed. I am up nearly all night feeding her at the moment which is another reason I think I'm not producing enough milk as she won't settle.
I don't want to give up BF completely. Maybe just supplement her feeding but at the moment I feel like I've lost all my zest for life because all I do is sit either on the sofa or on my bed feeding. It is also damaging my relationship with OH as we can't even have dinner without DD wanting to be fed (though I do feed her just before) and I'm starting to resent him getting to do things, even popping to Tesco, without a baby attached to him.
I know I sound horribly ungrateful as I am so blessed to have DD! I just want to be able to do things other than feed her!

Tongue tie information

I'm pro baby feeding. By whatever means the parent decides. For whatever reason that may be.

All mine were solely bottle fed after the first few days (for three very different reasons - it was always my aim to bf) and they're all fine.

I'd start by making up by the guide for her weight then adjust by how much she actually drinks, also she may take more feeds but smaller than what it says.

I'd agree with that, especially when she's switching from almost constant breastfeeding it might take her a wee while to start taking fewer big feeds.

Make by weight but don't expect her to take it all.

nurturedchild.ca/index.php/2010/12/10/baby-led-bottle-feeding/

This is good to read op if you're giving bottles.

I've formula fed 3 babies, 2 from birth. I always followed the guideline on the tin, and found it pretty accurate, to within an ounce or so.
All of mine fell into a routine of feeding 3 hourly, taking a little bit extra in the evening, and sleeping through (or at least dropping the middle of the night feed), very quickly as well.
Good luck, OP.

Agree with namechange30 as someone who used to work in HV I would really urge you to see a lactation consultant to get a posterior tongue tie ruled out. To prevent future speech problems if nothing else.

As I said upthread my DD had both an anterior (front) TT which was so obvious I spotted it at birth along with most of the MWs who referred me straight away to the lactation consultant (still had to wait a week for her first snip!) but it was an osteopath who spotted the posterior (back) TT and I took her back to the lactation consultant who was a bit sheepish she hadn't seen it and did a second snip. All in all DD was 75% TT.

Your baby feeding constantly and weight faltering does sound like a milk transfer issue. I'm really surprised your HV has just recommended moving straight to introducing formula - when it would be worth getting posterior TT, reflux and allergies ruled out first. Although maybe she is thinking of it as a temporary thing to get baby's weight up while you investigate the other things?? (How are you coping? Perhaps she feels your mental health needs a break too? There's nothing wrong with that at all - I've been where you are and it almost broke me!!)

Either way, if you want to carry on BF then supply can always be increased at a later date so don't freak out about replacing BF with FF in the short term.

Did you see the GP about reflux? How did your baby respond to the formula milk? (In relation to a milk allergy I mean) did they vomit or get diarrhoea? Or a rash/eczema?

*My Mum gave me bottles that were made up in the morning and given throughout the day and I did the same for my son.

I don't know why people are advised that this is not a good way of doing it any more.

I am very cynical but I wonder if the person who advised the NHS of this policy of making bottles up as you go rather than all at once, was a major shareholder in the Tommee Tippee Perfect Prep Machine.*

I highly doubt it as the NHS doesn't recommend the Perfect Prep either. Anyway the guidelines for making formula milk correctly come from the WHO. <a class="break-all" href="https://www.google.co.uk/url?sa=t&source=web&rct=j&url=www.who.int/foodsafety/publications/micro/PIF_Bottle_en.pdf&ved=0ahUKEwiuhZfRxKnUAhVkIsAKHf_TCb4QFgh0MA4&usg=AFQjCNFMYjYWia9jNdV5o7gfGkelYs_Chg&sig2=mVL-ufULfaSFK7Fddba0xQ" rel="nofollow" target="_blank">www.google.co.uk/url?sa=t&source=web&rct=j&url=www.who.int/foodsafety/publications/micro/PIF_Bottle_en.pdf&ved=0ahUKEwiuhZfRxKnUAhVkIsAKHf_TCb4QFgh0MA4&usg=AFQjCNFMYjYWia9jNdV5o7gfGkelYs_Chg&sig2=mVL-ufULfaSFK7Fddba0xQ

I never understand the mindset of "it was OK to do it 30 years ago, why not now?" surely as science and research improve our knowledge it only makes sense that we update practices accordingly? The information is there for parents to make an informed choice, and plenty choose not to follow them for whatever reason, which is up to them, but it is important that parents at least know how to make bottles the correct way, and what the risks are if they don't.

OP - WHO state that ideally bottles should be made fresh and used straight away (not as much faff as it sounds at home, honest!) but CAN be cooled quickly and stored at the back of the fridge for 24 hours, so if that works better for you then do it!

When I had to give formula top-ups we used readymade formula for our and about, and made fresh if at home. But obviously ready made is expensive if you are giving a lot of bottles or exclusively formula feeding.

Good luck OP and never, ever feel you have failed your DD. You are doing an amazing job!

I never understand the mindset of "it was OK to do it 30 years ago, why not now?" surely as science and research improve our knowledge it only makes sense that we update practices accordingly?
Actually it was 15 years ago but generally speaking science and technology do move on but the NHS advising people not to make up bottles in advance unless they really have to is ridiculous advice.

It is almost as if they are trying to make FF harder than it needs to be.

I wouldn't mind if this was just a piece of advice that was suggested to new mums but I know of at least four young mums who were told by the HV that they should NEVER make bottles up in advice.

Yes to the issue of making it more difficult than it needs to be (and you then end up with two conflicting demands on the mother - feed on demand, but make each bottle as and when it is needed, including the 30 minute kettle cooling time! The thing about the "don't make them up in advance" advice is it totally fails to do a risk analysis of what options people will resort to in the real world.

The dangerous thing in this whole process is the formula powder - it is not sterile. So it needs to be made up with hot water. But a lot of people still think the danger lies in the water. So you get people thinking "well I can't make a batch of bottles once a day and keep them in the fridge because I've been told that's not safe, so I'll keep 6 bottles of boiled water in the fridge and mix the powder with the (cold) water as and when I need it." The latter practice is actually more dangerous than making 6 bottles, flash-cooling them by running them under the cold tap and putting them straight in the fridge.

In other words:
(A) Optimal - mind-read your baby, put the kettle on 30 minutes before they will cry, make the formula up with precisely 70 degree water, cool it under the tap and give to the baby just as he/she starts to cry.

(B) Sub-optimal but fairly low risk. Make a batch of 6 bottles with water at the correct temperature and shove them in the fridge.

(C) Potentially dangerous - mix unsterile powder with cold water and give to your baby.

In order to prevent people doing B, health professionals are pushing A as the only solution, not taking into account that if people are told not to do B what most of them will do is in fact C.

I spent a fucking fortune on ready-made UHT formula to sidestep the problem, but not everyone is in the fortunate position of having well-paid maternity cover.

herbie, my baby was just the same as your DD - needed a formula top-up. And my DP felt awful about it too, and worried she'd somehow failed.

Well, you have not failed. Your baby will be just fine and you are doing amazingly.

It would be totally ok if you never stopped feeding her formula. But, you might find you go back to EBF, anyway. We've just been away with DD (who's ten weeks) and she had a grand total of 50 mls of formula over four days (which she promptly spat up). Some people think you can't go onto formula feeding a baby and ever get back to having enough supply to do mostly or completely breast feeding, but you can. I'm not saying this to suggest you should want to get back to EBF, but only to reassure you that this isn't some irrevocable move to formula. It's just one stage in feeding your baby and it'll give her what she and you need right now. Next week things may all change again.

Hope this is helpful. I keep thinking of you and wishing you the best of luck.

The number of people I know who have used the little tubs for formula and mixed it with a bottle with cooled booked water is very high. A lot of people focus on the making fresh element rather than the fact the formula needs sterilised.

A lot of people focus on the making fresh element rather than the fact the formula needs sterilised
It is awful that this happens simply because things are not explained properly to people.

17 years ago, before I left the hospital with my son, a nurse took all of the people who were either already FF or wanted to know about FF into a room to show us how to make up bottles.

Correct me if I am wrong but I can't imagine that anywhere still does that today.

Well, we were told about how to make bottles at NCT - specifically, that it was really important not to think it was the water rather than the formula that was the bacteria risk! But no, no one showed us. I agree it's a problem.

Can someone explain the boiling the kettle part? Do I have to wait 30 minutes or do it before 30 minutes is up? Sorry!

You put a litre of water in the kettle (we put a pen mark on ours!). You wait for it to boil, then leave it 30 minutes - no more and no less. Then you pour it into a bottle. Then you add the powdered formula, shake it, and cool the lot quickly.

The reason is that the water must still be hot enough to kill all the bacteria in the formula, but not so hot it destroys the nutrients in the formula.

It is a right faff! But if you're doing five top-up feeds it should be a bit easier. Put the kettle on the moment the baby wants a feed. Put a timer on to beep for half an hour. Breastfeed for half an hour, then make the formula, then chill it, and you'll end up feeding the formula about 40 mins after you started breastfeeding. DD was a slow feeder so she went for this. Hopefully yours would too. Obviously your OH will need to be the one making up the feeds if he's in the house at the time.

Am I right in thinking the water has to be 70 degrees? If so could you mix 700ml boiled water with 300ml cold water? Or it might be worth investing in a kettle that you can set to boil at 70, 80, 90 or 100 degrees (we have one, not for that reason, but it's occurred to me that it could be handy!)

M0stly, brilliant post! I absolutely agree that the NHS seems to be trying to encourage bf by making FF sound much harder work than it needs to be.

Really unhelpful.

I thought the 30 minutes thing was "no more than 30 mins" as otherwise the water would be

I think that's right, assassinated.
There's also no reason why you shouldn't make a bottle up a little ahead of time, and cool it down and put it in the fridge, even if you don't want to make up a whole days supply. You may well find that it's easy to predict roughly when your baby will want the next feed.
Making up bottles isn't really a 'faff' at all, once you get used to it.

Sorry, 'faff' was my term! I admit I find it such. But it's absolutely manageable.

They do recommend you wait the full 30 minutes, for the reason I said upthread. But, I don't know how important it is. We're only sticklers about it because our DD was pretty ill, and losing a lot of weight, so we were concerned about the idea that formula made up too hot might be a bit less nourishing. It's pretty clearly explained on the formula we've bought and by the paeds doc we had, so it seemed worth doing. It's obviously not dangerous at all to make bottles up earlier, though, whereas later could be a danger.

FF logistics aside - which I know can make you feel overwhelmed when you already feel overwhelmed right now OP - but if your baby has silent reflux or cmpa or a TT, these issues won't magically go away on formula (and in the case of cmpa formula milk will make it worse) so I really would recommend you getting baby reviewed by a sympathetic GP (for silent reflux) and lactation consultant (for posterior TT).

One advantage to forumla milk with silent reflux is that you can add gavison to it (it's an absolute bastard to get into a breastfed baby) which helps to keep the milk 'down'.

My DDs reflux was pretty bad according to the Pediatrician and she needed 20mg omeprazole to achieve symptom control (ranitidine did bigger all, and in fact made her worse).

Having a difficult baby is so hard OP, don't feel that you've failed her please. I went to an education session by the hospital Dieticians for dairy-free weaning and I was the only mum out of about 30 others there who was still BF our 4-5 month old babies. Everyone else had stopped because the cmpa/reflux/colic had made them feel like they just couldn't cope with it.... it's really awful and unless you've been there I just don't think people can fully grasp what it's like.

You can do this!!

Agree with Absofrigginlootly please do make sure to get your baby checked out fully.

I'm also confused by your HV's advice, she said your baby needs 5 bottles of formula a day. Is she saying you should stop breastfeeding also? Rather than to mixed feed or supplement?

*I thought the 30 minutes thing was "no more than 30 mins" as otherwise the water would be