Have been topping up with formula on pediatrician advice - will I ever be able to get back to exclusively breastfeeding?

[Wildpoppy]

Anyone done this? Our now three week old baby lost a lot of weight (20%) of birth weight) and is being slow to put it back on. On advice on pediatrician we have topped up with formula since she was 2 weeks old as the alternative was special care and tube feeding, and she is now starting to put on weight - she feeds from the breast each time first, often guzzling away for half an hour on each side and def getting milk as her mouth is all milky afterwards, and then takes between 60ml and 90ml form bottle most times (and occasionally rejects the bottle or takes less). I am keen to exclusively or mainly breastfeed though and want to get back to this once she has put on more weight (midwife advice is to wait until she is at birthweight first) - will I ever be able to do this? Has anyone else? I am also expressing when I get a moment in order to ensure breasts make enough milk but they only ever express about 30ml at a time though this is always after a feed so presumably she has got most of the milk out of them herself before this. But will I ever produce enough milk to satisfy her? Am feeling very sad I can't meet all her needs myself and also want to breastfeed not only for her health benefits but so I don't have to take bottles out with me all the time.

Am seeing breastfeeding counsellor and will ring helpline soon too but all advice welcome.

Yes, wildpoppy, you can get back to full bf. Good move to speak to bfc(s).

A 20 per cent weight loss is a lot, and suggests he was not feeding effectively and/or often enough - big thumbs down to whoever was caring for you at this time, as this should be spotted long before it becomes a crisis.

Yes, that needed dealing with as a matter of urgency - in the absence of donor milk or expressed milk from you, formula was needed.

Waiting until she is at birthweight may well be the best plan - and then you can make another plan to reduce the formula and to work on increasing your breastmilk. Expressing when you get a moment may not be enough - to protect the milk supply with a baby not yet feeding well you need to express at least 8 times in 24 hours inc at night.

60-90 mls of formula at each feed is quite a lot - it's easily as much as many 3 week olds are taking if they are fully formula fed - so you will need to reduce gradually when the time comes rather than expect breastfeeding to immediately replace it. Your plan of action could be discussed with the midwife, so you might (for example) not give as much at every feed. When you bf you need to aim to give your baby at least two and possibly three or four breasts at each feed. You can also consider breast compression (on the web). Key is consistency and motivation and hard work and lots of support from your nearest and dearest :)

Thank you tiktok that is really helpful. We were in hospital with multiple problems including suspected infection, low blood sugar and low temps plus choking on mucus and then difficulty feeding added to it so everything was overwhelming an I just feel like I've failed her with the feeding. But that advice is so helpful thank you. Every doctor and midwife we speak to gives me directly contradictory advice re how much formula, how often to express etc etc.

You'll get there. It sounds like we had a similar situation, but DD started in SCBU and was drip and tube fed for 3 days before switching to bottles and then breast with top-ups. We've now dropped formula completely and have dropped EBM bottles to convenience ones only, not regular top-ups. DD's weight gain is now catching up and HV and GP are very happy with her (she lost 15%).

Keep pumping and try waiting half an hour after a feed before pumping (or pumping again). Breast massage can really increase what you get too.

Maybe try a Medela Calma teat - they're expensive but with them the milk only flows when the baby is sucking. It means it's harder to overfeed with a bottle and is more like bfing.

Thanks japhrimel. Am pleased your baby now ok. Did you cut top up volume down slowly or just only top up every few feeds or how did you do it?

We reduced the number of top-ups as feeds got better. Expressing regularly helped keep my supply up and I just felt DD needed the top ups less and less.