from breast to formula - demand versus volume, help!

[wateraddict]

DD is 6 weeks and I have taken the decision to move to formula. 6 home visits and 8 bf clinic days have shown my let down is excruciating. I can still cry with the pain during feeding and it is imprisoning both of us - I can't wail in public during a feed and I was really down and terrified of that affecting DD.

My GP recommended expressing with formula top up if needed and I felt better as soon as I decided this would help me to me a happy and relaxed Mummy. Perhaps I thought formula was magic! Now I'm feeling guilty all over again.

From 5 weeks I expressed and started to introduce formula. I could always get 120ml breastmilk for each feed. DD has always cluster fed in the am and early eve, then went longer at night, say 3-4 hours versus the 2-3. She still has the same pattern but formula fills her up no more then bf but you can't give the same volume per day my hv said and suggested giving a little water. She even brought up children with obesity in the same conversation and I am terrified if I feed formula on demand to the same volume as breastmilk I will overfeed her and give her health problems!

What is 'a little' water in terms of volume? When do I give it - replacing a feed with water, or starting a feed with water, or topping her up? Do I take the recommended 750 ml of feed and divide it by the typical 7-8 feeds a day she demands to prevent her having too much??

I'm just not sure how I can make DD go longer between feeds. If I'm out and about she can go for 4 hours no problem, with the movement of the pram etc. but I can't go out all the time. I also don't want to feed her so little she is hungry all the time. I feel like I am panicking a bit here - any suggestions?

Thanks

What a struggle :(

I don't understand what your HV means about not giving the same volume of milk per day - or why you have to extend the gaps between feeds?

The usual guidance is to try to match the demands of the baby with the intake of formula - it is easier to overfeed with a bottle (see another thread on this from last week) but you can avoid this by not insisting your baby finishes the bottle, by not sssuming she needs 200 mls each time and so on.

Water is generally not advised for bf or ff babies, not when they are on milk alone.

Most babies of 6 weeks do not show signs of incipient obesity :)

Oh - I have just realised, your HV meant you can't give your baby the same volume of formula as breastmilk....is that it? Normally, babies take more volume of formula than breastmilk, and one reason is they need the extra calories to digest the formula.

If you find the HV easy to talk to, can you ask her to help you work out a plan? Share your concerns about not letting your baby go hungry or get upset, and not over-feeding.

Or find an HV who you do relate to.

Hope you get some good help and support.

Isn't there some calculation you can do with formula based on the baby's weight to work out how much they need a day?

MoonUnit - yes, there is, but many babies need/ask for more or less than this .

(In imperial, it's 2.5 fl.oz per lb of body weight over a day)

Thanks so much tiktok I do appreciate your reply! I was able to give 120ml expressed milk 7x per day for the first week and 1x 150ml formula. MoonUnitAlpha, apparently for her weight she needs 750ml formula a day so this puts her over that amount by 110ml - not too much.

I don't mind going over 750ml on breastmilk but don't want to overfeed on formula. I am now mostly on formula. I know these figures are only a guide though, perhaps she genuinely needs more! She has put on 7-8oz a week since birth so is certainly thriving. I assumed that if I am to give the full 150ml formula feed I have to go longer between feeds or she'll end up on a litre of formula a day which sounds a lot.

I thought I might give 120ml forumla while DD is still being demand fed (at least she seems unable to go longer than 3 hours at the mo) and perhaps then when she seems to need more she can take more and go longer, then reduce the number of feeds. DD drains every bottle I give her, no matter what the amount so far so I hope this will help. Does that make sense?

I think you are right re HV and the plan. The problem is clinic is so busy you realise after that the info you have been given is only half the story and not enough to really manage on your own without more detail. My HV is nice, just overworked! I will go in with all my questions written out next week and see if that helps me to get more out of her in the short time we have.

It's a shame there is a pile of breastfeeding helplines and bf counsellors but there is a real difficulty fessing up that once you decide to move to formula, it's a bad thing and the support doesn't seem as obvious if it's there. I may also ring the bf team and see what they say. The local support is lovely for bf but you can't help feeling guilty/disappointed if bf doesn't work out.

Oh and I'm not thinking I have an obese 6 week old lol :)

I'm sure we'll get there, typical neurotic first time Mum I guess!

I think your HV is being very unfair by scaring you with "obesity" crap without offering up any evidence. It's now Saturday so I'm sure you'll have seen by now (up the walls, in your hair, down your bra) what happens when you "overfeed" from a bottle. Saying that a baby will "overfeed" on formula is just non-sensical. How is it logically possible that when drinking breastmilk the baby goes "hmmn, enough now" - and when drinking formula the baby goes "nom nom I'm gonna win the prize for the most I can eat". Does the stomach magically increase in volume by 10 times?

For the record at 6 weeks mine was having 7(+/-) feeds a day of 90ml. It wouldn't always go down and so sometimes he'd ask for feed number 8. He was a month premature though, but I'm pretty sure my HV said we should be aiming for 800ml at 8 weeks.

AlpinePony - certainly not nonsensical.

There was a thread about this last week.

www.mumsnet.com/Talk/breast_and_bottle_feeding/1086960-It-is-impossible-to-overfeed-a-FF-baby

It is a genuine concern, shows up in a lot of research.

The stomach does not increase in capacity by 10 times - of course it doesn't. But the stomach can hold more than it needs.

Read the thread and the links.

dd is 9 weeks and is mostly formula fed (2+ small brestfeeds a day). she has about 30ish ounces a day and I feed on demand so she doesnt have 6 5oz feeds or whatever iyswim?

She does weigh 13lb 7 though and was over 9lb at birth so probably heavier than average I think. She put on 15oz in the last 3 weeks (had her weighed on Thu). I dont really know if thats a good amount or not tbh!