Substituting one breast feed for a formula feed

[Ecgwynn]

My DS is 7 weeks old and I have had difficulty with breastfeeding from the start - initially he lost too much weight so we were told to top him up with formula, weight now fine and going up but we are still topping him up with around 300ml of formula a day in 45ml chunks. I always give him the breast first and then see if he is still hungry when breasts are drained. Not experiencing any problems with 'nipple confusion' or anything.

Suspect my milk supply isn't quite sufficient - know latch etc is fine and not the problem.

I got a blocked duct a few weeks back and now have thrush and after visiting GP I have been prescribed cream for nipples and also medicine for DS's mouth. Have found breastfeeding painful from the start but the pain has been incredible since these problems started and I'm not sure how long I can continue.

To help alleviate this I am considering substituting one breast feed with a larger formula feed just to take some of the pressure off - tried this this afternoon and though he was hungry again not long afterwards, my breasts were a lot fuller for his next breastfeed - he got a lot more milk and went to sleep for a while!

Has anyone had experience with switching one breastfeed for a formula bottle feed in this way and can give me any advice? All the propaganda has made me feel bad for doing this but think it could really help both of us.

I gave him 180ml of formula for the larger feed btw - and his breastfeed after that which satisfied him took about an hour and fifteen minutes all in!

You don't need to worry at all about the propaganda side of things, but you do need to be aware that the only way to increase your supply to fully cater for his needs and not need to top up is to feed more. Actually having that full feeling sends signals that your breasts don't need to produce as much milk as it isn't being used so isn't necessarily a good thing. I know it must be so hard for you with the pain at the moment but doing one full formula feed will certainly not help with increasing your supply. Hopefully someone more experienced will be along soon to share some strategies but I just wanted to make sure you are aware of these points.

This is exactly what happened to me, thrush and all. We started giving DS a ff bottle before bed which was the time he suffered most from difficulty being satisfied. We started doing this at about 10 weeks but continued bf during day. Was still bfing 8 months later so I would say there's no problem with it affecting your supply if you replace one bf with a ff.

I agree with ag123.

Breastmilk supply increases when you feed. Sometimes feedings take a long time. The longer the baby feeds the more likelihood there is of getting fat laden milk which is what will add to weight so don't worry about taking a long time.

Here is the fab site Kellymom on thrush.

'Low milk supply' here.

Hi, I second Ecgwynn above. I had trouble with cracked nipples and a Jaundiced newborn not wanting to feed, it was a real crisis my milk was very low, I had to get my milk supply up quickly for him and get it into him or else he was going in under the lamps. I pumped, used a hand expresser, did that for days, got the baby on first and then pumped and gave him the rest by syringe or bottle. Introducing formula will inevitably drop your milk supply, its hard I know and it must be painful but hang in there, this will pass, if I were you and you really want to use formula to give you a break, do pump, otherwise it will be the beginning of the end for your breastfeeding....some may disagree but i'm still bfing a 20 month old so it worked.

Sorry meant to say I agree with ag123!

Yes one ff bottle might well not affect someone with a well established supply but the fact the OP in still topping up suggests that her supply is not yet fully established (don't worry OP it will be and I second kellymom as one of the best places to help with this) which is why I wanted to make sure that she was aware of the facts.

TBH the blocked duct and the thrush suggest that the latch may not be quite right (not your fault of course!). Sometimes thrush can be mis-diagnosed as any pain in bfing now seems to be attributed to thrush in some areas.

Have a look at this and this.

I also agree that the 'full' feeling isn't what you are looking for when bfing - that just means you have too much milk and your breasts are being told to dial back on the milk production. If you keep skipping feeds to get that full feeling, you will end up with longer and longer gaps between bfs to get it as milk production grinds to a halt.

The emptier* the breast the quicker more milk is made and also the fattier the milk is so the more frequently you feed, with more sides at each feed - you can go back to each side as many times as baby is happy to - the more milk you will make.

• A breast is never empty as the ducts all are at different stages of milk production (a bit like a staggered start race!) so even if one is down to the 'dregs' other ducts will be ready and waiting.

Would only add that 300 ml is a lot of formula for a 7 week old - not much room for breastfeeding to be sustained with that amount :(

Lots of good suggestions here about what to do to resolve this - more formula would put the tin lid on your choice to remain bf, I think.

I did mixed feeding too after supply problems, and was giving probably the same quantity as you at that stage. I agree with tiktok - that is a lot of formula, and I think the majority of what your baby is getting.

I tried reducing it, but DD was crying and hungry a lot so I continued with mixed feeding - breast and bottle at each feed. She is nearly 6 months now and I am still doing it, but I have gradually increased the formula over the months. It has worked for me and I am very happy to have breastfed, as I did consider stopping at one point.

Sorry, I should say, the point of my story is, formula doesn't mean you have to give up bf, but I don't think your supply will increase so you will end up having to increase the quantity of formula. As long as you're happy with that, it's fine.

180ml IMO is too much in one go at that age, unless your baby is huge. I don't think your baby will be satisfied with a breastfeed if he is used to having that much in one feed.

I felt a lot of pressure being the only person who could feed dd and at around 4 weeks introduced one bottle a day.
Initially that was expressed breast milk but I am rubbish at expressing so it quickly became a ff. dd is now nearly 5 months and is still bf except for one ff every day.

She feeds around every 2.5-3 hours with a bf but doesn't go as long as that even with a ff of 6oz.

It saved my sanity but I think you need to be careful with your own supply in the early days as everyone has said

I agree with the other posters, I think it could definitely be possible to introduce one bottle of formula a day with no problems, but it might be best to try phasing out the current top ups either first or while doing this.

This is a great blog post about the "feeling full" question.

When he has finished on both breasts, you can offer the first one again, and the second again, and the first one a third time, as many times as needed. It doesn't matter if it feels empty as milk will still be being made. It helps to imagine it a bit like a hot tap attached to a combi boiler. When you first turn it on, sometimes the water is warm as it's been sitting in the pipes since the last time you used it. However, when this leftover water runs out, it will run cold. Within a minute or two the boiler will kick in and you will get fresh hot water, as much as you need, you can't use it all up. Milk production is similar to this. At the start of a feed he gets the "leftovers" which have been slowly accumulating since the last feed, but once these are used up there is still milk there but it's made on demand rather than being sat there already.

The more milk you can remove from your breasts, the more milk you will make. You will probably find that if you offer your baby a bottle he will take it even if he is already full from breastfeeding - it's the nature of how bottles work. As a rule of thumb, if he's unsettled/still hungry try the breast first even if it feels empty. You can also try "breast compressions" which is where you put pressure on the breast to create the illusion for him of it being full - it increases the flow which mimicks what it feels like to feed from a "full" breast, and might be better for him if he's got used to the faster flow from a bottle.

I'm going through the same with my 7 wk DS 2. It is all very well , and more than likely very true for some to say you will compromise your supply- but with unbearable soreness due to a fussy baby tearing and clawing at the breast, pulling off etc(before intro of bottle) I found the only way to continue with BF was to introduce a ff not only for my sanity but to allow my nipples a respite. It makes all the difference to me. I'm risking diminishing my supply I know, which messes with my head- but so far so good, my boy is getting some mummy milk at least, which may just be enough for him when this growth spurt is over and he settles down- good luck and sorry not to have an answer, only empathy!

Good advice on here OP. I would try and cut down the top ups and bf as often as possible day and night for a few weeks so you can get the supply properly established. I do know how hard it is at the beginning but it becomes so easy after the first month, it really is worth it. Can you get to a bf clinic to get the latch checked? The supply and demand principle is so exact ime, you will never produce enough milk if you top up with formula. Good luck.