Please help me reduce pumping and intro formula!

[cobweb1979]

I think I just need a bit of hand-holding and rational advice really!

My son is 8 weeks old today and I've been exclusively pumping. But with his reflux and my T1 diabetes it has, quite frankly, been a nightmare. I am exhausted and the effect on my blood sugars is making me ill.

I decided some time ago that I need to start reducing pumping sessions and start him on forumula. I have a freezer FULL of milk, so can keep getting breastmilk into him for quite a while longer if we mix feed. I know that this is best for both of us, but I just can't start :(

I'm down to 4 pumping sessions a day and my breasts are uncomfortable but not painful between sessions. I'm still putting the odd bit of milk into the freezer, even with just 4 sessions! I'm now strictly pumping for 10 mins on each breast rather than until the flow stops... but I'm stumped as to what to do next.

I'm not sure whether to reduce pumping time or try dropping a session. At the moment I'm pumping at (roughly) 3am, 9am, 3pm, 8pm (I go to bed at 9pm so the last one is kind of unmovable - long story but we are still doing shifts on the sofa with him).

I'm happy to keep one pumping session going if I can, although I realise that may not be possible and y supply may dry up.

The other problem is giving him a formula feed. I need to do it soon as we want to go to London, and at the moment we can only stay away from home for one feed as thats how long the EBM will keep. Plus I know it is best to introduce it slowly so want to do just one feed for a while before increasing the ratio. But I can't seem to set a date and just DO it! A friend told me to do it at the weekend as babies can react badly at first - her little one was violently sick, so it would obviously help if my husband was around! But the weekend has come and gone...

I know I just need to DO it, but even though I know it is the best thing for both of us, the mummy-guilt is so strong!

Not sure what I'm hoping for by posting, just needed to get it out.

It might be worth contacting one of the bf helplines? They aren't just there to try and get you to keep bf, they will also have advice on stopping. Or is there a bf group you could go to? There may well be someone there who has been through similar.

I went a few times to the local BF-ing clinic when we were still trying to get him on the breast so I guess I could go back there.

Is there no way you can get him to feed from the breast? Just asking, as I know mothers with extremely premature babies who have managed (with expert help) to introduce direct feeding after several months of expressing.

If that's not possible, then you could try drinking peppermint tea, which is supposed to reduce milk supply (at least all the midwives here in Germany say so).

I have no knowledge of how to introduce formula, but my midwife told us to give our babies a small amount of bm before the first tastes of solids, to reduce the likelihood of constipation. I would think it would also protect the stomach lining. Of course formula won't be as different to adjust to as solids, but I would think introducing it the same way would make it as easy as possible for your ds to digest.

(Just ignore all of this when someone turns up who actually knows what they are talking about .)

I'm not 100% sure about expressing. I would say drop the 3am one first as that must be the most disruptive for you, but then the hormones for milk production are stimulated more at night, so this might lead to less milk produced at the others - but then if you want to stop completely/drop down to just once, then that might not be a problem.

If you want to do this, I would do the 8pm one as late as possible, and then if you feel uncomfortable in the night, express off just enough to keep yourself comfortable, but don't go on for the full 10 mins unless you feel you need to. Keep this going for a week or two before trying to drop another.

The second session I would drop is the 3pm one, so you have 2 sessions, pretty spread out from each other. And then after that has settled down drop one of these, and then the other when you are ready.

This is just my gut feeling based on what I know - kellymom is usually fantastic so I've found the relevant page for you.

For the other things - yes it's worth looking at getting him back onto the breast again if that would make things easier for you. (You can still mixed-feed by doing this if you want to) Also the sofa shifts - is there any other option? Co-sleeping, or maybe raising the head of his cot/basket or letting him sleep in his pushchair or even on his front perhaps? Do post if you want any other suggestions, I'm sure others have been through this :)

And lastly please don't feel guilty. You have given him a fantastic start and the breastmilk you have given him so far will have made such a difference. Also stopping breastfeeding can cause hormone surges too which will make you feel emotional. Be kind to yourself :)

BF-ing would have the same effect on my blood sugars as pumping :( If it wasn't for the reflux I might be able to cope with that, but its hard to fit in all my blood tests and injections with holding him upright and trying to stop the screaming.

I don't feel comfortable co-sleeping because of the diabetes - if I hypo in my sleep I don't want to hurt him. The sleeping is getting a little better, he does on occasion sleep in his carrycot instead of on one of us or propped up on his pillow on the sofa, so we may be able to try his crib again (if we raise it up).

Good ideas on spacing out the pumping. Thanks.

So my baby-group reconvened at the pub today, and I stayed for lunch, so he HAD to have a carton of formula as I wasn't intending on staying out that long!

He drank it with no problems at all, but since we got home he has been quite sicky. Not bringing-his-whole-feed-up-reflux sick, but possiting a LOT.

Just wondering if he'll get used to it or if thats a sign we need to try a different brand?

It's a tricky one, as it's common for reflux babies to be worse on formula than BM. It's worth trying a few different brand I would have thought, it can't do any harm can it. Have you been prescribed anything for the reflux, there are a few different options, so if one doesn't work you can try another.

Good luck with this, I hope you gt to where you want to be with it. My guess like the others would be slowly. I'm no expert, but if it were me I'd reduce the amount at one session gradually day by day until it was cut out and then work on the next one etc.

One thought on the expressed milk you have, I wonder if it might actually be better for your baby to use up all the EBM first, so that your baby gets the longest period of exclusive breastmilk before introducing formula gradually as your stocks dwindle? My understanding is that the protection from infection that breastmilk provides is at its greatest when you are exclusively giving breastmilk. As freezing the milk reduces the immune components slightly, perhaps the greatest benefit might be from full on breastmilk for as long as possible? Just an idea to consider really, and I'm sure your little one will get lots of benefit either way.

Well done for pumping for so long and for building up a stock as well. You must be amazingly determined and have done such a great thing for your baby .

Ooops left the window open ages before finishing typing, so rather stupid cross-post by me, sorry.

PenguinArmy yes we are on gaviscon and Ranitidine, and have seen a small improvement. We have some coleif as well as he recently started screaming after a feed and having green poos, but the Dr said it is incredibly rare to be unable to digest lactose, so really just prescribed it to try. But you have to put it in warm milk, and we give it cold now (he just goes from fast asleep to screaming so fast we gave up warming it as he was getting so upset).

CharliesAngela I wondered about that, but the Dr and HV have said to phase it in, as he may not like it or need to get used to it - so going cold turkey might be a bit of a nightmare! I'm going to give him just one feed a day of formula for a week or so at least and see if he can keep it down.