Should she give big bf baby a bottle - advice needed please x

[devotion]

My sister has four month old baby who is fully bf, he is a really big baby and so podgy you could make cakes out of him - gorgeous

Only problem is he feeds every 2-3 hours and feeds up to about 11pm and then again during the night. She is absolutely wrecked.

She bf her first son until 1 years old and plans to do the same.

I feel really sorry for her and tonight she has called saying her breasts hurt so much as he has fed all evening, she has a pea shaped lump above her nipple and a white patch on her nipple which sounds lile nipple trauma.

I know she should massage and feed from tne boob with the lump to unblock the duct and keep an eye incase it turns to masitus but because it sounds like her nipple has trauma wouldnt that make it worse?

They do say you dont need to supplement bf babies but do you think in this case she needs to maybe give him some formula in the evening to give her breasts a break? He cant be getting much anyway if he is feeding all evening, her breasts dont get a break most nights.

I feel like she needs something to help her cope now.

Any advice would be really appreciated.

Many thanks

my baby is also a similar age and feeds every 2-3 hours also but she goes to sleep by 8pm and feeds once in the night so i know its quite common for bf babies feed this regular but surely not all evening and then in the night too a few times?

If she introduces formula in the evening it will reduce her milk supply, if he is feeding a lot then her breasts will catch up.

The white patch on her nipple could be due to a poor latch or could be a sign of thrush.

At 4 months he is still very young and 4 hourly feeds are pretty normal, with cluster feeding during the evening. Ths should settle down after her breasts have caught up.

Her breasts can cope with a large baby's appetite- they could feed twins and even triplets so all she needs to do is keep offering and things will improve. introducing formula is risky as it will decrease milk supply, and baby might decide he prefers the bottle instead, or may not want it at all.

It's tough at this age but things do get easier, she deserves a big pat on the back and maybe you can suggest she sets up a feeding station in front of the telly with some good mags, the remote, plenty of snacks and drinks to get her through these cluster feeds during the evening?

the white patch combined with the lump means that the duct is blocked at the nipple end,very common,she needs to sterilise a needle and pop the bit on the nipple,shouldn't hurt,she just needs to break the plug there .It isn't nipple trauma,its just a bit of milk thickened blocking the duct where the milk leaves the nipple.she should feed straight afterwards and the lump should drain.A wrung out hot flannel over the breast before unplugging should help.Look at "plugged duct" on Kellymom. I don't think she should formula feed if she wants to continue bf,my dds both fed easily this often,dd2 more,at that age,it is normal,although exhausting.

Hi devotion,

I think 4 months is a classic growth spurt time so this could be a temporary feeding frenzy. If he's feeding all evening he could be building up yout sister's supply.

Painful breasts? Is it the nipple or the actual breast? How does the latch look?

I think you're right about massaging the lump out to prevent mastitis. Laying on hot flannels can help too.

I would get your sister to get ring one of the breastfeeding helplines for more advice.

I found that co-sleeping helped me to cope with the exhaustion of nightfeeds. i know it doesn't suit everyone but it could be worth a try.

Assuming your sister has a reasonable latch, her breasts don't need a break and TBH if she has a blocked duct it would be increase her chance of it getting worse if she tried to space her baby's feeds.

Feeding every 2/3 hours is totally normally for a little baby (and some that are not so little too) Ditto cluster feeds in the evening and through the night.

There are various things she could do to seek help. See her doctor about the trauma on her nipple, visit local breastfeeding support group to get advice on her latch.

Does she co-sleep ? This is one way that she could get more sleep, by feeding lying down and resting/sleeping at the same time.

Has your sister asked for help ?

thank you for all your advice.

i've just rang her and read them out to her, she is going to call a bf line tomorrow.

she does not think its a growth spurt as he does it every night.

Hi
breast fed babies generally feed more regularly than bottle fed as there is less bulk to the milk. It is not uncommon to be feeding every 2-3hours still at this age. Demand feeding is as it says feeding to the demands of your baby. As previously suggested hot flannels or hot showers onto the breast may help with the lump as a duct could be blocked. She should try and keep to breast only if she can to keep her supply to meet babies demand

If your nephew has got this deliciously "podgy" on his mum's breastmilk up to this point, she clearly IS making enough for him!

Sounds like he's going through a growth spurt too, so your sister really needs to keep going with feeding on demand as this will ensure the supply she has matches your nephew's needs. Feeding frenzies usually produce the desired results in around 48 hours, babies are very good at this if they have unrestricted access!

If you introduce formula into this finely balanced process, you run the risk that milk supply will start to dip as your body will assume that the excess it produces is not needed as it has not been consumed and subsequently it will produce less....

Also, you really need to keep everything flowing if there's any kind of blockage -I would suggest she gets the latch checked as soon as possible but keep feeding in the meantime. See your local LLL group for help.

And yes, it's hard, hard going in the middle of a patch like this (been there, got the milk-stained t-shirt) but in a week or so, things are often very different.

Feeding lying down can also help with night time feeds, and feeling less wrecked in the morning.

If baby is feeding all night maybe he is using them as a teether rather than getting food? I think the hardest thing about bf isthe guilt about whether to do it or not. My 2 older children were both bottle fed as they werent latching on, feeding all day and also my son lost over a pound in weight as he just wouldnt feed at all. my youngest i bf for 18 months and was a natural. but is the worst for sleeping by herself and even now at almost 3 is in our bed every night. it was so hard dealing with professionals telling me to bf and not listening to the problems i was having. if your boobs are that sore at 4 months you have a problem with feeding as they really shouldnt be please get checked out. hope this helps.