Honestly, WWYD?

[addictedtofrazzles]

I have a 2 week old DS2 who is just nudging above the 99th percentile (having regained + his birth weight). I am bf and having to give formula top ups to satisfy his hunger. The problem I have is that he does 20 mins on each breast and then has 1-3 oz top up (depending on the time of day). I have a fast let down and with such a large volume of liquid, he is then projectile vomiting an enormous amount (mostly over my brand new carpet !)...

However, he has a bottle of formula at 10pm (I express to give him in the night) - about 4 oz - and settles quickly and sleeps well.

Is there ever a case for feeding your baby formula so that their bodies can have less volume but be satisfied after a feed?

I understand the health benefits of bm, but that aside, could formula actually be 'better' (I know some may suggest feeding little and often, but I have an active 21 month old DS1, who is less keen to spend all day watching me feed his brother!).

Alternatively, has anyone experienced this and able to offer a solution!?

Greater minds than mine will surely be along in a minute, but I was wondering if you'd tried omitting the formula top-up and seeing if he still vomits? It could be a simple issue of him guzzling too great a volume all at once. I know that you mentioned that he seemed like he wasn't satisfied by the breastfeed - how does he signal this? Is he still crying, still rooting?

I have a fast let down and I tend to quickly hand-express some milk into a towel (!) just before I feed DD as this seems to take the edge off it. When she was younger I also would pull her off the breast part way through a feed and give her a quick burp because I noticed that my let down sometimes caused her to swallow air at the same time, which itself made a massive vomit more likely.

I don't know if any of this is helpful, but I hope you find the right solution for you.

Is he hungry or could it be comfort sucking? Could he have reflux or wind and is feeding to relieve the pain (but then overfeeds?)

My DS used to feed a lot (91st+ centile after being born around 75th) and it was because he had reflux. Plus my overactive letdown didn't help.

You should try only using one breast per feed if you have a fast letdown. I do this - I have a ridiculously fast flow! It means he'll get more fat content and hopefully be more satisfied.

Are his nappies green? This could indicate too much foremilk (watery stuff at the start of a feed)

You raelly don't need to give any formula at all as your breasts can make enough milk for twins, even triplets so a very large baby is easy for them. Formula will reduce the amount of milk you make in the long run and it isn't better as it changes the type of bacteria in a breastfed babies but to less favourable bacteria. It tajes several weeks of exclusve BFing to change it back again.

Formula may keep him fuller for longer as it is like a burger and chips rather than a healthy salad so harder to digest. Your let-down will settle down over time- hvae you tried feeding him layong down? This way he will have more control over how much milk he is getting.

The time he spends feeding and the frequency he feeds for will imrpove as he gets older too, it's still early days yet. It is common for young babies to vomti but if he is projectile vomiting then he may need to be checked out as he could have a problem with his digestion.

Yes, I agree with TheBreast. Also formula has the same calorie content as breastmilk - it's just harder to digest.

Although I can't feed lying down because of my fast letdown - DS would find it too hard and choke (even now at 9 months ). It is better if DS's head is above my nipple and I leaned back.

Since you've asked us to be honest - my honest answer is I would cut out the formula, not the breast milk.

I would be talking to a bfc about the fast let down for more tips, though you'll get some great ones here.

I have big babies too, and have had the occasional midwife/HV suggest they might need formula top up's but I've always made enough milk for them to continue to grow and thrive.

DH is a big guy, who struggles with his weight, and was ff. I want my sons to be big tall strong but not fat men, and I know that giving them my milk rather than formula like DH got will give them a better chance.

Thanks so much for your replies.

He could well have reflux (probably silent) - his brother did and I understand it can get worse with subsequent children? He is grunting, impossible to wind, hates lying flat for a bf...I am keeping an eye on it and if it gets worse will go to the paed.

As for comfort sucking and signalling that he is still hungry after a bf - I always give him a dummy after the bf but about 5-10 mins later he is rooting and gnawing his hands. If I then give the formula he a) loves drinking from the bottle (perhaps because he is more upright?) and b) settles/falls asleep straight away.

why are you topping him up after every feed?

it's very hard for a baby to stop the flow of milk from a bottle and they will drink a lot, even if they aren't necessarily hungry. it may be overeating causing him to be sick.

formula milk is based on what? yep, breastmilk. formula aspires to be breastmilk.
so why would you need to replace the breastmilk with a product that is trying to hard to be like it?

do you see hwat i mean?

personally i would cut out the top-ups and just feed on demand

do you feed him until he comes off the breast by himself?

I would say to keep offering the breast when he gnaws and roots as he needs to put in his orders for more breastmilk. He may well be going through a growth spurt and this ususally happens in the evening for several days so I would be very careful about offering formula now as he may decide that he prefers that to your breastmilk and refuse to take any milk from you. Formula is easier for him right now and this will be threatening your supply.

It will take a few days to get it back up to meet his needs but keep offering the breast and switch sides frequently.

If he is still fussing for more try and distract him for 10minutes and it will allow your supply to build up again so that it comes out faster for him. early morning feeding is the best time to stimulate your milk supply as that's when your hormones are at their highest.

If you expressed at this time then you could save the milk and give it to him during the evening when he seems extra hungry.

Can you try and feed him more upright?

Also he's only two weeks old - I know my DS fed all the time at that age. Killer. It should settle down soon.

I think you should keep him on the same boob for longer otherwise you'll make the letdown worse as it's probably accompanied by oversupply.

So many of you mums are truly amazing to persevere so long at something that is so hard - I can definitely try lying down for a feed but in reality, I can't do that when I am out and about with my toddler!

I am not worried about his growth - he has regained and exceeded his birth weight. TBH, I am also not worried about the long term implications of his weight as we eat healthily as a family and my DS1 eats a very balanced diet (he was ff as he had latching issues).

What I am finding stressful is that he clearly can't cope with so much fluid. Additionally, I find that the amount of time it takes to feed him (1.5 hours, including waking him mid-feed, changing nappies, winding, offering top up) and I need to give attention to another child!

I feel like the only mum of 2 who finds this all a bit hard to coordinate and find a solution to!

frazzles - this sounds like a clear cut case of over-generous supply. No need for formula at all. Search one-sided or block feeding in the mumsnet archives, and/or call a bf helpline. This is not a difficult situation to turn round at all, I promise

no, you aren't the only one. it IS hard.

my second son was a real velcro baby. very unhappy a lot of the time, so even when i wasn't feeding him most of my attention was on him, and it's very difficult balancing it all..

i have to admit that in the first few weeks we did spend an awful lot of time sat on the sofa watching dvds. or visiting grandma!!!

honestly though, formula top-ups do pose a threat to your supply long term, esp given at every single feed so early on

i would work on at least reducing them. babies can learn fairly quickly that after a feed comes a bottle, and they'll just drink it even if they don't want it.

it might be worth, if you can, to have a few days at home. set up on the sofa, lots of books to hand, some dvds, other little toys and games to keep eldest child entertained and just feed on demand.

For the reasons above i would ditch the formula.

Keep him on one boob for a whole feed. This will give him creamier milk and stimulate production (the more a breast is "emptied" the more milk it makes)

thebreastmilksonme just realised my advice contradicts yours...am sure i read on kellymom to keep each boob going for a long time to increase production?... Am on my phone so can't check and link...sorry...

I don't think supply is the problem here. My DS did this - would feed for 1.5 hours as a time and still fuss. In the end I'd get DH to take him after a marathon session to settle. I used to think I didn't have enough milk until I got him weighed and realised he was fine.

However once I started block feeding it really helped. Basically you need to stay on one boob per feed. Don't switch during a feed. If the flow still seems a bit mad after a couple of days, try using the same boob two feeds in a row.

My oversupply was so extreme I did this for 12 hour blocks in the end!!! (so same boob and only switched after 12 hours).

Sorry to clarify - I don't think this is a case of under supply! More like too much.

One more thing I've remembered - reflux symptoms in BF babies can actually be caused by oversupply. So if you tackle that first you might solve the problem.

I just wanted to let you know that it's REALLY hard juggling a 2 week old with feeding issues and a toddler. I've been there and looking back, it was hard core HARD and I'm surprised we managed to muddle through but we did. Can you ask friends to take the toddler off your hands for a few hours a day every so often? It really helps you to just get your head together and gather a bit of mental energy to deal with the feeding problems.
Just remember you're doing a fab job.

Also - it's hard juggling a toddler and breastfeeding but it will get easier, sooner rather than later. Thongs will settle down, it's still early days.

Thongs? Thongs????

Things - damn you predictive text

My DS did lots of projectile vomitting, mainly when he'd had too much volume too quickly.... has calmed down by 8 weeks though.

What helped?

-Feeding him while he was sitting up and pulling him off to burp him.

-Carrying him upright in sling after a feed.

-One sided feeding so he got better balance of hindmilk.

• Not letting him lie down after a feed.

I am not really sure why you need to give formula to satisfy hunger though? Sounds as if you have more than enough milk.

A few suggestions for dealing with toddlers whilst breastfeeding a baby

(I have 4 DC of 7 and under, all breastfed, so I've worked out some strategies by this stage!)

• get a good wrap sling. I like the Moby. My babies have always responded well to being upright. Popping them in the sling between feeds keeps the baby content, and your arms are free to play with the older child. By around 6 weeks I could bf each baby in the sling too.

• Piles of books on whatever things your toddler is into (DS1 it was diggers) We went to the library loads, and every time the baby had a feed, he got a couple of stories. Meant he looked forward to feed times!

I'm in a rush but will post some more a bit later if you think its helpful.

Thank you for all the time you have spent to reply - I am really grateful.

Lots to look into/try/think about... I am going to sleep now before my middle of the night wake up call! How could I forget how exhausting this newborn stuff is?!

Moonface- I read the Op a bit further down as saying that he is still hungry after a feed and gnaws his fists and continues to root so to me it sounds like baby is not having his hunger satisfied then she gives him a bottle so I suggested ways to increase her milk supply after a feed. A fast let down doesn't happen all of the time, especially after a recent feed in the evening so I was suggesting ways to encourage another let-down so that baby would have more milk without the need for top-ups.

I see! We were at cross purposes really!