Thinking of mixed feeding - 6 weeks - help

[pingulingo]

hi, am hoping for some advice from people who mixed feed please or anyone who can help with my concerns of low supply.

Baby is nearly 7 wks, was 4.4 kg at birth and has been bf so far. He took 6 weeks to get back to birth weight and whilst we get a lot of wet/dirty nappies, he's not a "content baby". His weight gain is a gradually rising but flat line (not the curve you see on the charts) that has dropped him from 98th to 25th centile so far. I feed on demand, switch boobs,latch checked, take fenugreek, avoid caffiene and I express 2-4oz each morning which he gets last thing at night.

it started off that it was just cluster feeding in the evening, but since week 3 it's pretty constant cluster feeding all day. It's not uncommon to feed almost constant (except for small naps & nappy changes) from 7am - 12, biggish nap of 1-2 hours and then feed again constantly from afternoon - 11pm. During the night he gets bought back into bed for 1-2 feeds, usually 2am and 4am ish. He never falls off the boob, he will fall asleep on the boob but if I wake him he will always have more and from 4pm (bad day) 8pm (good day) he gets very frustrated and crying - and noticeably calms if I give him the ebm bottle which gets necked down, But recently the ebm of 2-4oz just doesn't seem enough and be still chews hands after and gets more and more frustrated on the breast as the day goes on. In the past few days sleep has reduced as baby is wanting to feed even more, as I guess this is 6-wk growth spurt - no noticeable further increase in supply so far tho.

I'm worried that I'm not producing enough milk - I had breast implants years ago and the surgeon said I had hypoplastic / tubular breasts then. I thought nothing more of it until having these bf concerns & reading that it can cause problems with supply. I've not mentioned this to the hv as I didn't want outside pressure influencing how I feed my baby and tried to crack on with increasing supply as much as poss. Now at stage that I can't see how he can feed much more though and I don't think he's a happy content baby - so worry he's hungry.

But I would like to know of others who have been in a similar situation, should i hang on in a bit longer and hope for for a sudden weight gain? Or look now at some kind of mixed feed or top up? how much do you give them at this age? And were you cautious in what formula type you use? I had lactose issues as a baby (had to hv enzymes added to milk to keep down) & dh has ibs, so I wonder if I am going to try a top up if i should try a lactose-free or easy-digest version?

I'm pessimistic of increasing supply much more, my dr is crap so the domperidone px would be a real fight, although if anyone has any other suggestions, I'd be grateful!

Thank you!

According to my formula tin baby should be having roughly 5oz each feed and 5 feeds in a 24 hour period. However all babies are different and it is difficult to tell when you're bf. I gave my baby a top up of formula on days when they seemed to feed forever to give myself a little break and in my case my supply was not affected as I bf for 5 months in each case. However I know they say ebf is best in order to get your supply on the up.

:( pingu....what a story. It certainly sounds like a genuine, physical struggle to make sufficient milk for your baby. The 'killer facts' in your post, to me, are three: i) your baby is not happy ii) a surgeon commented on the shape of your breasts and noted a lack of tissue iii) your baby's very slow weight gain.

www.mobimotherhood.org/MM/default.aspx is a website with loads of supportive and helpful info and experiences from mothers like yourself.

I have come across many women who have intro'd formula and who have kept it to a low amount, and continued to bf - you sound to me that you have the motivation and patience to know exactly what you are doing. Sometimes, formula enables the baby to suck better at the breast, because he has the energy to do so. Or a nursing supplementer used at the breast can work (even though fiddly).

Other people will post in response to you and I hope you get help.

Thanks for the link and advice. Sorry it was such an epic post, wasn't sure what the most important info was - so I included it all!

Hi pingu, I'm so sorry you're going through this. It does sound as if mixed feeding might help you. Could you add one formula top up, say at a certain time of day and see if that helps with his weight/satisfaction?

I had a horrible time - Tongue tie, no weight gain, top-ups, and I wish I had either given the top-up as a one-off rather than a small amount after each feed, because she started wanting the breast less and less. Either that or I wish I'd used an SNS. The good news is that we are still mixed feeding at 20 weeks, so it can work. It was hellish to get here though.

Hope things start to turn around!

Oh, and I can't really comment on intolerances, but I think I would try him on normal formula first, simply because it's cheaper and easier to find at corner shops, etc

if you mix feed, just make sure you decide which feed is bottle and stick to it so you don't mess your supply up. I do this and give last feed at night as bottle as dh is able to help (I have twins so we can do one each). Occasionally I give a bottle in the day if they seem unsettled after a feed or when out as dtd1 struggles with latch and is worse when we are out without feeding pillow - I offer boob and after a while give up and give bottle on days when she's not going on properly.

I was giving 2 bottles a day regularly but it was enough that allowed me a bit of rest so I have now dropped a bottle as my milk seems more established.

Hope that helps.

I had breast reduction surgery do have reduced number of milk ducts. I've had yo supplement since birth. Which I do with a Lact-Aid and.bottles too. I started off mixing up breast and bottle in same feed so nipple confusion wasn't an issue. So far so good.

On the formula side I was advised (you should check this) that formula for 0-6 months has more finely broken down lactose, and generally the more expensive the brand too. This makes it easier to digest and therefore less likely to cause intolerance issues if used with older babies. Mine is under 6 months so not had to investigate this yet.