Does every BF count?

[Trying2Conceive]

Am asking this for a friend. She is having lots of trouble BF, bleeding, blocked ducts, pain making her cry through every feed etc. and is giving the odd bottle of expressed BM for some relief. She cannot express much though and so is going to switch the BM for formula. What she wants to know is, if formula ruins the natural balance of a baby's gut, is it worth continuing to BF if she is giving say one bottle a day of formula, or will the damage be done and she might as well switch to FF and stop all the pain? Please no advice on continuing to BF, she has made up her mind to give one bottle of formula a day, so any knowledge about continued benefits of BF when also using formula?

All and any breastmilk benefits the baby.
One bottle a day should not harm your friend's supply but may well change the baby's gut flora.
I had to top up DD with formula due to tongue tie, bad latch, long feeds ect and was told it would take two weeks of ebf to get this back to normal.
The main problem is the pain on feeding - this is not normal and should be checked. It is likely that the attachment can be improved and then your friend would have painless feeds and no need for the formula.

Thanks Medical. She has been to BF cafes and seen her MW but although they are able to help with the latch for the time she is with them, baby has other ideas when they are at home alone! She is so disappointed with it all that I don't think she actually wants to EBF anymore as she wants the security of knowing that if things don't improve, baby will take a bottle. We have both heard about the gut flora thing but unlike you she won't be going back to EBF so if it is going to change permanently, are there still enough benefits to BF to make it worth continuing with the majority of feeds?

Yes, every bf does count, her baby will still get lots of benefits from the bf so it?s definitely worth continuing, mix feeding is something that can work really well for a lot of people.

Definitely worth carrying on alongside FF - every feed will make a difference to her baby's health.

Has she been to a breastfeeding support group at all, or could you suggest she comes on here? It sounds like she might have an underlying issue which is causing the pain and other issues - they are not something she needs to just put up with.

There are still very many reasons to continue giving BM, even when giving formula, too. That one bottle will strip the coating that the BM gives to the gut, which protects against infection and helps to stop allergies starting. However, BM works in many ways, so introducing one risk does not take away from the other protective and supportive components of BM, such as:

• active, constantly updating immune support by passing the antibodies to the bugs that the mum and baby come across each day to the baby.
• Exactly the right mix of nutrition for the baby, in the most bio-available form, still with hundreds of components that we don't totally understand and are not replicated in formula
• Breastfeeding can significantly reduce a mother's risks of getting breast, ovarian and uterine cancers
• Lots of other lovely things like being able to feed to sleep, relaxing hormones in mum (when it's going well, clearly at the moment it's horrendous for her), better sleep etc.

It's definately worth her keeping going - but is she getting help from an actual breastfeeding counsellor? She sounds like she's having a terrible time :( Midwives don't generally have BFing training, and baby cafes may or may not have a qualified person there. I'd suggest she contacts her local NCT branch and gets their BFC to come over, or finds a lactation consultant in her region. :( What an awful start for her :(

Sorry, x-posted. Has the baby been checked for tongue tie?

La Leche League is good as well as looking at NCT groups.

www.laleche.org.uk/pages/groups/groups.htm

There are BF councellors at the BF cafe and I think they have told her that the baby is not latching on properly and help her with it while she is there but it is only on for 2 hours and then she has to go home. She used to feel a bit more positive after each visit but a few hours later she would be calling me in tears. Giving the bottle gives her relief as it allows her nipples to heal up a bit and this enables her to consider carrying on alongside FF. Baby is only a few weeks old so could get easier. She has lurked on here while pregnant but doesn't want to join as she is feeling vulnerable and exhausted and says she can't cope with any potential criticism, or even advice which she doesn't want, so I am acting as a filter (although I know you are all lovely )

Seeing her in this kind of anguish kind of makes me reconsider my username

I had exactly the same problems as your friend and it was really getting me down. I started mix feeding DS when he was around 8 weeks old and it really worked for us; I could relax a lot more knowing that I wasn't the sole provider for him (his Daddy's very hands-on and was keen to help) which meant I could get more rest. When you're better rested you can cope with the pain more, and it did start to get easier. I mix fed for around another 8 weeks before going to full-time formula, and found you really do have the best of both worlds. At the end of the day your friend has to do what she considers best for her and her baby, and I was always told that every drop of breast milk will benefit so she's already doing a great job.

Thanks for the links, will pass them on and hopefully she will get some more support to make BF easier when she does it. She will be happy to know that every BF counts!

Slinky is right. Poor thing, I hate seeing people in so much distress when they should be enjoying their babies :(

She's lucky to have an advocate like you.

OK so she has a plan for now. If the BFing cafe isn't working, she needs another plan if she wants to continue.

You could try googling for IBCLCs in your area - go up a notch in qualification. If the baby won't latch when she's not with someone to help, she needs to explain that so that they can work out why.

There may be an underlying problem that they can fix, but she may need to keep pushing at it (at a time when she's exhausted and vulnerable - I know, it's really hard, which is why you're being so fab).

Thanks all, am going over to see her this morning so will show her this and hopefully we can get someone organised to come over.

The problem is that this doesn't sound like the kind of problem which will go away by itself. Many of the initial difficulties will get better with time, yes, but if you are having latch issues they need to be sorted or it's likely to get worse rather than better.

It's unfortunate that the baby cafe is only on once a week :( If she phones up the NCT or La Leche League helpline she will be able to speak to a trained supporter over the phone, and in most areas they offer home visits as well. They will be nonjudgemental and supportive.

I really don't think she would encounter criticism here, posters in this section are very aware that new mums posting are most likely feeling vulnerable. If she's worried she'll be flamed for considering stopping breastfeeding, she won't be! There is a reason why the "breast and bottle feeding" is merged. I don't suggest she posts in AIBU

Does she know anybody in real life who has breastfed that she could speak to, for extra moral support? Anyone she has met up with from the baby cafe who is in a similar situation? Ante-natal classes etc? Is there a bumps & babies group nearby or anything like that? It sounds like you're being a great friend and really supportive (and don't underestimate that) but she needs all the support she can find at the moment and someone else who has breastfed or is breastfeeding would be really helpful in that mix. If she's anywhere near Warwickshire I know of loads of groups and a few people who I know would be happy to buddy up with a new mum.

I'm typing slowly today, sorry! Good plan :) Take lots of cake!

Organic - your statement 'that one bottle will strip the protective coating in the gut' - do you have evidence for this? I looked up the virgin gut theory on pubmed when I started mix feeding and could find nothing. There is lots of evidence that ff from birth creates a differed gut flora but not that formula introduced later does so. Could you tell me your reference? I'm interested because if there is solid evidence I won't mix feed my next!

It's worth remembering that the virgin gut theory is just a theory - it's counterproductive if it leads people to think that if their baby gets a drop of formula everything is ruined and you might as well give up breastfeeding. That's an awful lot of pressure to put on mothers.

Yes, exactly. I do entirely agree breast is best and women should be given all the help they need to bf successfully. And if it is a solid scientific theory women should be made aware of virgin gut. HOWEVER if it is not, it seems cruel to tell it to women who are struggling when mix feeding might mean they bf for much longer.

The summaries of research, and references, are all here:

drjaygordon.com/pediatricks/startingout/supplement.html

The research is quite clear (meaning, the virgin gut isn't just a theory), but while this part of breastfeeding can be undermined by "just one bottle", there are many, many more reasons to continue aside from this. Mix feeding is very well worth doing if exclusive breastfeeding really isn't possible, and certainly if mixed feeding allows BFing to continue it really does make a difference to both mum and baby.

How is your friend today, OP?

Thanks :)

:)

Thanks for all your advice. When I was there Friday we phoned LLL who were really helpful and supportive but there is not an awful lot you can do over the phone, friend was following their advice but was still not going well. Yesterday a friend of a friend who is training to be a BF counsellor came over and stayed for nearly 4 hours! In this time baby fed 3 times and friend said that after having someone help her position baby each time she was feeling more confident that she can do it herself correctly. She is giving a bottle of formula at around 3pm to give her nipples a chance to recover. I have told her that they should heal up quite quickly once baby is positioned right, is that right? Anyway, thanks again for all the help, now that she knows that BF is still beneficial even when mixed with FF she is happier to carry on.

Yes, when the baby is no longer damaging her nips they will recover quickly. Glad things are moving on for her :)