To not really understand breastfeeding

[Nonomore2]

Hi all.
Please can I ask some advice on breastfeeding? I really need some advice.

I have a 11 week old baby. I’ve been Exclusively BreastFeeding him & it’s been going ok. He got back up to birth weight quickly but since then dropped a bracket in percentiles and now has steadied at the 9th percentile.

He seems hungry a lot in the evening. And fusses a lot at my breasts. When I can, I express earlier in the day and sometimes I give him these extra ounces in the evening and he always guzzles it down.

I am worried that he needs more than I can give him. I am contemplating giving him some formula.. just in the evening.

So, this is where I am very conflicted.
On the one hand, I know there are many benefits to Exclusively BF.
On the other hand, I really don’t want my son to be going hungry.

All the literature tells you about the benefits of EXCLUSIVELY breastfeeding. Are any of these benefits negated if I give him formula?
This is what I am trying to understand.
Does it actually cancel out any of the benefits?
Or do people warn against it more because it often means people stop breastfeeding sooner?

I’m worried he is hungry. If there is no downside to formula then I would give it to him.

Does anyone have any real knowledge in this area? Please can someone advise?
Thank you

As lots of PPs have said the evening cluster feeding is normal. There is no need to give a bottle of formula as your body will make enough to suit baby's requirements.
Have you got a breastfeeding support group near you? I found the one I used a lifesaver. It helped me understand what was going on and gave me the confidence to realise that my baby feeding habits were normal.

Both my DC fed a lot in the evenings and I encouraged it because it meant they slept for longer. DC1 used to do a lot of snacking the rest of the day, BF on and off with small feeds and small gaps. With DC2 I encouraged her to take bigger feeds, offering her both breasts each time and that worked really well. I also found that me eating a lot of Dairy Milk helped the DCs gain weight!

I think if you introduce formula it will affect your supply.

It may be that he is about to have a growth spurt. It can sometimes take milk production a couple of days to catch up when the baby demands more.

My concern would be that by expressing in the morning you are telling your body baby needs more at that time and by giving it to him in the evening, you are saying he needs less. I'm not sure how well I've explained that.

If you have an NCT or La Leche group locally, it might be worth talking to their breastfeeding counsellor to help you understand. If you want to mix feed, I'd also recommend getting some advice. You will then make an informed decision.

Breastfeeding is exhausting and can seem continuous in the early days but it does get easier.

Don't forget he's getting more than just milk from your breast. He's getting comfort, antibodies and your ever changing milk supply. Honestly I wouldn't worry. He's either having a growth spurt or some comfort. Does he have a dummy? There's benefit from exclusive breastfeeding for sure. Don't forget it's still early days.

Think I'm just going to be echoing others in saying his behaviour is totally normal. Sounds like he's cluster feeding. Pretty standard at his age and evenings especially.

Is there any reason why you're giving him expressed milk rather than letting him on the boob at night? The more he feeds from you, the more milk you'll produce at the times he wants it, e.g. in evening. At the moment your body is getting the signal that he doesn't need more evening milk because he's being topped up by the bottle.

Totally your choice but I can't see a reason that he needs formula at all.

Is there any reason why you're giving him expressed milk rather than letting him on the boob at night? The more he feeds from you, the more milk you'll produce at the times he wants it, e.g. in evening. At the moment your body is getting the signal that he doesn't need more evening milk because he's being topped up by the bottle.

This is so true.

Another one to say that seemingly endless feeding early evening is normal. Just settle yourself in with everything you need to hand and resign yourself to sitting there for a bit getting crumbs in your baby's hair while you snack. It doesn't mean you're not producing enough milk, honestly! It won't go on for ever and for me it was worth it in the end, for the convenience of breast feeding, the cost savings, never running out or having to go home to feed a hungry baby!

is the babys weight normal? I was told to keep an eye on the weight, that if it dropped below a specific % then the midwives would worry.

The OP said the baby as following the 9th percentile. This is fine. All 3 off my breastfed babies were born big and dropped to 25th percentile or thereabouts. I think it's normal for breastfeed to be a little lower than average. The main thing is he is keeping to his line now and it sounds like OP has been getting him weighed regularly and soeak to health visitor..

Totally normal for your baby to do this , he’s trying to up your supply so it will be little and often for a while. it calms down and then about 16 weeks it can happen again . You can provide everything he needs but your body has to adjust to it . You don’t need to top up with formula but getting through the cluster feeding is knackering .

Wow. This was my first post after 5+ years of reading and although I have seen the power of mumsnet for others it is quite something to experience it.
Thank you all so much for taking the time to reply.

Thank you for the reassurance that he is just doing normal cluster feeding.
I am happy in the evening to let him feed as much as he wants and take milk, comfort or whatever he needs. He is my first born and there is nothing more important to me (or more enjoyable) right now than caring for him.

He isn’t just feeding a lot at night. He tends to pull at my breast, get agitated, and tense, start crying. He seems to be very unsatisfied so I change breast until he does it there too. Then after a while I have to give up (as he has pulled lots at my nipples and I’m worried about damaging them and he is getting too upset) and take him off my breast.
This hasn’t just happened over a short period. It’s been happening for weeks and weeks. Some days, or nights really are better than others.

I appreciate all the comments about potentially damaging my supply. I haven’t been pumping every day.
For an experiment, I pumped 1 ounce a day for 5 days. I didn’t think that would make a huge impact on my supply. I gave it to him one evening when he was fussing at my breast. He drank it all on top of his normal feeding patterns. Could he really be so hungry on an average night that he gulps another 5ounces? This is what made me doubt my supply. @RubyBoots7 & @garethsouthgatesmrs - I hope this answers your valid points.

I am getting him weighed regularly. The HV was not concerned as they deem a one percentile drop as totally normal. He hasn’t dropped more than this.

@SinkGirl - I totally agree. Why do they make it so all-or-nothing. With such crap rates for breastfeeding it seems so shortsighted to be so concerned with promoting a Exclusively breastfeeding approach all the time. And thank you for link to virgen gut.. I will read more.

@pastabest great to hear it worked for you. Thank you for posting.

@User467, @BringBiscuits @JagerPlease
@ShackUp @Believeitornot @DaisyLand
@GummyGoddess @Claireshh
Thank you for the reassurance that his feeding habits are normal and the general advice.

@CountessVonBoobs & @AmIRightOrAMeringue
Thank you both very much for the considered and informative responses.

@AnElderlyLadyOfMediumHeight- thank you for taking the time. He tends to pull at my breast, stop feeding and just get agitated and tense. I’ll try and get him to re-latch but within ten seconds he starts getting frantic again. Interesting point about SIDS.

@TheChatsPyjamas - very interesting! I will read now. @Waterlemon - thank you.. will read the copious material on there!

@Dakinis your post is interesting. Your baby seemed more satisfied in the evening with formula. You say it probably wasn’t the best nutritionally but she seemed happy. I’m struggling to understand what the downside is of one bottle of formula every evening is (except from impacting supply, risk baby prefers it and it shortens the bf journey).
@Wispaismyfave your post is also super interesting. I’m wondering if that is what my boy needs. Thank you for sharing. It’s reassuring to see it can be done without a negative impact on supply.

• @MumW, @Vinorosso74 @Isadora2007

Thank you for advice/encouragement. I have found a local bf support group and will attend this week. Thank you for the prompt.

• thank You for all the reassyrance

@Lalliella thanks for your dairy milk recommendation! I will be sure to try that out immediately! I have been working my way through much chocolate but always keen to try more..

@Purpleartichoke - thank you for advice. I’m going to look into consultants and will seriously consider. It seems like a very worthwhile investment to get that one on one advice.

Bless you. I hope you get some support and maybe even some answers at your BF group. I made some close friends at our group who are still important in my life 8 years on.
I also found the evenings quite a fussy time in general for all my babies and a walk in the sling always helped a bit. Or a bath and some skin to skin also good. All the best to you and your boy.

I never had this problem (!) but I seem to dimly recall something about that kind of fussing being possibly due to oversupply/fast letdown? Kellymom might know more.

I wouldn't make feeding decisions at this stage based on a centile drop - a lot of babies 'catch down', and centile of birth is not necess reflective of the centile they 'find', if that makes sense. I had small and slow-gaining babies, and that can cause anxiety in HCPs, but they were fine - we are a small, light and slow-gaining family (how I wish the adult members still were ).

The fussing/pulling off might be due to oversupply/fast let down like a pp said.
Do they ever make a clicky sound while feeding? I used to lean back slightly to make it easier for DS. As his mouth got bigger he stopped fussing as it was more comfortable for him.

I also block fed to reduce my supply...but I wouldn't do this without talking to a professional first.

Well done mama! You’re doing an amazing job! I know the “fourth trimester” can feel like the twilight zone and just when you feel like throwing in the towel, things start to resemble some form of predictably; you can start having a shower at reasonable times, drink a hot cup of tea, eat lunch etc sonplease hang on in there!

Pp are absolutely right, cluster feeding: your body picks up the pathogens on your Baby’s skin which formulates tailor made breastmilk; this includes antibodies and vitamins that your baby needs right now, your body is also formulating the correct volume of milk your baby needs.

The volume will plateau until baby’s next growth spurt when baby will need to up your supply further to meet his growing needs. Similar patterns happen when baby is unwell, transferring pathogens to boost antibodies and vitamins in your milk.

Although it’s desperately draining, exhausting and I know you can just feel completely “touched out” - these mountains that your climbing right now are ensuring you have enough milk, the fussing at the breast, the pulling on and off, baby’s seeming frustration is all to ensure that breastfeeding can become established.

My only advice is to try and lie down on your side to feed, practice safe co-sleeping, and wrapping baby in a sling can also help calm things. Have easy things to eat, get help to sort the fridge soups, pre made wraps/tacos etc, even a big bag of tortillas and a bowl of guacamole/hummus that you can dip into, granola bars, along with chocolate, treats etc. Try and get into a series that you can binge watch and dip in and out of to give your mind a rest (Ozark, West world, big little lies are excellent right now)

The other thing that might help is lying as far back as you can to feed, and letting out the first “spray” of milk into a cloth, sometimes as your supply is becoming established, the let down can be forceful and it can make baby splutter and startle so it can help to discard the first few sprays of the feed until things settle.

You’re almost there OP, baby is just as shattered as you are, he’s working hard to get the supply he needs and I promise in a few months when you can skip out the door with a few nappies and not much else, if you fancy staying out later than planned, if you’re on a flight with a grouchy baby, your up in the night with a teething baby, your boobs will be your best parenting tool!

You’ve got this OP!!

Also I found expressing really interfering. Your body has to ‘learn’ your baby’s appetite, and expressing will confuse things . Producing milk is a delicate balance.

Sorry as if I haven’t rambled on enough! But unfortunately introducing a bottle will replace a feed. Then a cycle will start; it’s much easier for a baby to drink from a bottle, he doesn’t need to work for it, to drink from a breast the nipple has to be right at the back on the soft palate, the toungue underneath, working in tandem with the jaw to compress the milk ducts. A bottle simply drips in and fills baby much quicker and keeps him full for longer, which then throws your supply further out of whack as your milk will be ready for the next feed (say two hours later) but the bottle may fill him for four hours - so the one bottle of formula can then replace not only two breast feeds, but two “make more milk” signals as your breasts will not have any stimulation.

Also, I’m terms of digestion, it’s a spanner in the works, breast milk is easily digested and gentle on the digestive tract, formula is much harder to digest and can upset their tummies especially in comparison to the breastmilk feedings for the rest of baby’s day, the formula could make baby fussy - so many mamas have to try several formulas to find a good fit for their babies.

If you want to express, do it after baby has fed, you will stimulate another let down, don’t put too much pressure on yourself, just do what you can manage. You may not get as much as you do from pumping in the morning (as prolactin is higher overnight) but you can top up the same container in the fridge, then once it’s full you can use it from the fridge for up to 8 days (keep it in the back of the fridge) although after 3 days personally I would freeze it.

I didn’t really express much until dd was 4 months even with an electric double pump. I have read you can express to try up your supply but rather like you describe, I never got much out - 30 ml, which I think is about an oz. I never felt a let down, never leaked etc. Therefore I never had an abundance of milk.

A friend otoh got loads out at any time of day and she described how it was very easy for her to express a load off to feed her very hungry baby. So supplies do vary.

I am an early riser. By the time dd was 4 months, I had her in a bit of a routine. My supply was by then well established. I could express immediately then again about 20 mins later. By the time dd was a ut 5 months I was managing to get 180ml or a little more in the 2 sittings. I wouldn’t imagine you would get as much as that if you expressed before the first morning feed. But I found my milk was more in abundance first thing in the morning and dropped off to just being able to get off just 30 ml in the afternoon. I then could use this bottle to give dd a middle of the night feed.

I’m not suggesting that you give a night time bottle now or at 4 months as there is a risk of sids although reduced by 4 months (just explaining the amounts I got and when I found it easier to express). I did this as I wasn’t coping with the 4 nightly demands for milk so it took me perhaps a week to build up to being able to express that amount in the morning to give the night time feed.

As others have said, cluster feeding is very common and constant feeding during a growth spurt or neurological advance is normal. It’s a lovely time. I remember getting up the day following all of this exhausted but seeing dd had had an “upgrade”. I remember very excitedly discussing eachothers babies upgrades with my NCT friends. A magical time. Enjoy

Actually giving formula does somewhat "negate" the exclusive breastfeeding. I looked into this extensively with DC2 and apparently any formula will affect the microbiome of your baby's gut. I gave formula and it was a slippery slope to quitting after that. I regret it but like posters above say, it's not the end of the world. Exclusive breastfeeding is undoubtedly the best thing for a baby but you have to take your own well-being into account too.

I'm bf'ing twins.

I bf'd my first baby too and had a lot of milk (constantly leaking and spraying, he developed green explosive diarrhoea from lactose overload; I had to pump often, though judiciously, to stop extreme engorgement). So I was pretty sure I would have enough for two and so it has proved.

Anyway, for the first 10-12 weeks, evenings were really tough. Two grumbly fussy babies feeding in an on-off unrelaxed manner, grabbing at what seemed like empty breasts, screaming if I handed them to anyone else even to run to the loo. I really felt like I didn't have enough milk and they would sometimes take a bottle or part of a bottle which made me question it more. I also had a bit of trying-to-be-helpful input from others along the lines of "aren't they hungry?"

However, it started to resolve with time and I suppose three things: more established supply on my part, increasing maturity, stomach size maybe on their side, and for us, definitely working on improving daytime sleep.
I think that a lot of the fussiness was accumulated tiredness from the day.

However, I do very strongly feel that happily accepting a bottle is a great skill which improves everyone's life immensely. I would suggest giving a daily bottle of (ideally expressed) milk just to maintain this skill, but probably at a different time of day. Earlier in the day when you and the baby are in better humour.

I have now got one bottle refuser and it's going to cause me and her considerable difficulty when I return to work.

You sound lovely btw

peakypush I I have heard the same theories about the 'virgin gut' but personally figured that for me the flexibility of having a primarily breast fed baby that was also trained to have the occasional bottle of formula was worth any 'negation' in the assumed benefits of breastfeeding. Having that flexibility actually means I'm more likely to breastfeed for longer.

I'm able to express milk easily enough but find it a complete pain in the neck at the best of times and second time round virtually impossible with an inquisitive toddler hanging about. I've also discovered my milk goes funny once it's been frozen and the baby won't drink it so I can't build up a store either.

I'm perhaps different in that I always give a couple of ounces of formula at lunchtime just as a top up to breastfeeding rather than instead of. I do it purely to keep the baby familiar with the bottle so someone else can feed her if I ever need them to.

I think many people offer the formula at night in an attempt to get the baby to sleep longer which can then interfere with the evening clusterfeeding/supply building and possibly does compromise breastfeeding.

Pastabest I completely understand, I did the same thing as you. A mostly breastfed baby is of course going to benefit compared than a baby who is not breastfed at all.