formula for bf baby - help!

[fishie]

just been to see paed - ds is 23 weeks and has fallen off the centiles - he's always been teetering along the bottom, but has started to drop further. he's fully bf, every 2-3 hours round the clock. paed says give him high calorie formula once a day for a fortnight in addition to full bf.

i've been resisting hv over this for ages, but since now so close to 6 months will just treat this as an early introduction of new food /solids. going to see hv at 1pm to discuss which formula to use. i know nothing about any of this, so please advise:

it seems a bit late to introduce a bottle, cup feed or should i try bottle?
what time of day would be best for this extra feed?
i've never been able to express (no opportunity with 2 hourly feeds!) so presumably should start now?
is there a major problem with introducing formula that i'm missing?

H ave you tried expressing just after a feed. Especially in the morning, when your hormone levels are most responsive. When ds wasn't gaining weight, that was what I was encouraged to do and to give every second feed as EBM. I culd then see that he drinking plenty - and still not gaining weight any faster. But he was still happy, healthy and alert - so I learned to have confidence that he was just following his own growth curves.

He started on the 91st, dropped to below the curves, chuntered along just underneath them before gradually starting - at c. 3 months - to start moving back thru them, followed the 25th for a while and now (aged 5) is alomost eactly average (not sure, as I don't measure him much any more - but comared to the other kids at school, he looks healthy! )

In terms of your question: not sure abut the bottle question, as ds was used to bottles of EBM from an early age (the excellent consultant paediaitrican told me to stop worrying aobut his weight and to stop the faff of expressing, but as I was going back to work at 6 months, it suited me to mainiain the habit - and I continued to b/f till he was 13 months).

Not sure waht time of day would be best - perhaps late at night, so that you could get some extra sleep (thiat is, if your dp will feed him). Or alternatively, you could also use that time to express and then have that aviailalbe to supplement the feeds.

There si no major problem with introducing formula at this age - you have done really well ot get this far. The only "problem" is if you don't want to.

ah prettybird thanks. nope he has always had all the milk, besides i am keen for a rest occasionally so didn't pursue expressing

i don't set much store by these bloodty charts, but do not like the downward trend. he has had 5 months to catch up a bit but is rather small and growing very slowly.

How big are you and your ds' father? if you are both small, then he will be small.

Is your baby happy and elert? I'm not adovcating going against what a paediatrician has suggested - but if it weren't for the grwoth charts, would you have takne him to the doctor's?

Paediatricians often seem very keen on giving formula milk; I don't know whether it's because they want to be sure exactly how much milk the baby is getting at a feed, but in my experience they don't have much understanding of breast-feeding, or the reasons why mothers might not want to give formula. They tend to insist on formula merely for the convenience of seeing how much milk is being taken, and to me that's not a good enough reason to give formula if you are not happy about it.

Hopefully you'll have been given some good advice by your HV. It might also be worth ringing someone like the NCT breastfeeding line, or the breast feeding counsellor at your hospital, for advice - they know far more about feeding babies than paediatricians do.

Hi

I have been where you are (three times!). DS1 was born small and dropped to a very low weight (4 something) and I ended up giving formula at three weeks, which quickly led to complete bottle feeding, it turned out he was lactose intol. DS2 was combination fed until 4 months, his weight slowed and I panicked and introduced formula, I wish I hadn't but news mums DO panic.

DS3 was very different tho. His weight also fell rapidly, or at least he hardly gained. However, in the meantime I had undertaken the Unicef BFI Breast friendly course at work. I resisted all pressure to give formula, and fortunately my HV had done the course with me and trusted me. After 6 months I introduced some formula (by choice), he also turned out to be lactose intol and he was quickly put on Enfamil Lactofree formula. he had this once a day, but was 90% BF until 15 months. He is still small: the Paeds decided it was purely related to my Dh's family genetics. But I am so glad that I stuck by the BF, he is a really healthy boy now and doesn't have the exzma that his brothers and I have.

You can buy supplementers that allow your baby to receive the formula alongside BF (I think you can get one here medela (under supplemental feeding), but I would recommend cup feeding- the best thing I found to use was the lid of an Avent bottle.

miracle at baby clinic! hv said you don't want to give formula do you and i said no of course not. she said don't then, put him on solids. i am so happy of course, that doesn'tsolve the tinyness problem, but at least don't have to go down the formula route, which i really wasn't keen to do. and i've got an 'official' sanction that i'm not starving poor ds.

no pb, i wouldn't have gone other than charts, but the seed of doubt and worry was planted and grew we are not small parents (if only!) either, is a mystery.

wwb, was shocked actually, thought a paediatrician would be last person to reccomend ff. she assured me was very pro bf, as she wrote "mother will comply" then crossed it out and wrote "agrees" in the notes i'm also amazed that at no stage of 20-odd weigh ins has anyone mentioned a bf counsellor.

my dd was formula fed (she hated breastmilk!!!) and she was still tiny, they got worried about her but i didnt, she never liked formula milk much either but would drink it where as breast milk she blatently refused. she didnt drink what they said she should and never put on as much weight as they said she should, but she was putting on weight and progressing as she should so i didnt worry too much. she is now 11mth and on full fat cows milk she will drink over what they say she should and shes climbing back up there, i knew she'd do it in her own time.

remember they are all different! and to have averages some need to be above and some need to be below, its just how it works. if hes happy and healthy (other than the weight) just enjoy him!!!

oh one thing tho, food doesnt have as many calories as milk does so if you wean him he might start lessing his weight gain (if you get me) even more.

if you do decide to give formula just to help aptamil is most like breastmilk and has prebiotics and stuff to help with their digestion. dd always found it fine and she still had the stools of a breastfed baby.

hope it all goes ok!

Can I just be controversial and say that Aptimil is most definitely not the most like breastmilk - it's all hype and advertising.

well my daughter has the same type bowel movements as a breastfed baby, and she isnt so thats all i can say

Of course you can Hunker.. as far as I know there actually doesn't seem to have been any independent research done into which formula is closest to breastmilk, so all we have to go on is the manufacturers claims which of course are not worth the paper or website they're written on.
Or do you know something I don't Hunker?

fishie,glad you've got the confidence to avoid the formula route.
Can I just say that even the solids he'll take at this early age won't have anything like the calories of breastmilk?

ooh hello i missed this earlier. yes, i do, but really feel that hv advised me knowing ds, rather than following the charts and am quite touched that she has gone against the paediatrician's advice having referred me there in the first place. i'm not all that worried about his weight or size, but.... [overanxiousfirsttimemumalert] he's got a hernia and will prob have an op soon so i was innocently keen to have an extra opinion. what a fool eh

oops, yes i do know, and care