I was doing so well - is topping up so bad?

[monkeypuzzeltree]

Have a 6 day old DS, my second child. With DD bf was a nightmare and fell apart due to late TT diagnosed, and by then I was a broken woman!

Didn't have any expectations on it this time, but DS came out having read the bf books, latched on and got on with it - cannot believe it still!! However although I am feeding him every 2 hours and have lots of milk when it gets to the evenings he's just not satisfied. Last night I fed for half hour each side then ten mins later, I did it all over again, so 2 hours of feeding later and he still wanted more! I was shattered, ended up giving him 50 ml of formula. Then he slept!

So my question really is, is that normal? I know he's feeding we'll, I can hear it going down, how can he eat that much?! I just worry that if I don't top him up for the occasional feed I'm going to end up with really bashed nipples and bfing will fall apart entirely.

Was feeling so proud that I can do this this time, bit deflating to put all the effort in and it's still not enough! Would live to hear if this is normal!! Many thanks.

Entirely, absolutely, 100% normal. Keep going you are doing amazingly!

If you want to persevere with bf though beware of top ups so early, it will affect your supply.

Go with what works for you ...as long as your baby is having milk he will be happy. If an evening top up feed gives you the rest that you need to continue bf the rest of the time then everyone's a winner!

monkey, the pattern you describe is indeed utterly normal for a young baby and it's worth celebrating because it shows several things:

• your baby loves bf
• your baby loves being close to you
• your baby 'knows' that he needs to feed often to 'drive' your milk production

Feeding - however it's done - is not just about the milk. It's about closeness and responsiveness and building relationships. It sounds as if you are interpreting his need to feed with only small gaps between the feeds, over an extended period of time, as 'oh my God, my baby is hungry and I may not have enough milk for him!'

The quickest way for that to become true is to give formula. Giving formula interferes with this process of the baby driving the supply, and the body stops producing the milk....this is especially likely to happen in the early days and weeks.

As a one off, your supply will not be affected. But if every time you think 'oh my God,my baby is hungry and I may not have enough milk for him!' you give a top up, you undermine breastfeeding, and you will create the situation you dread.

If your nipples are sore/damaged then this can be fixed.

Sounds like an issue with confidence - maybe a bf support group will help?

This is definitely normal and sounds like everything is going great. The constant feeding is expected at times and can be a combination of a few things - comfort, upping your supply as he grows, and part of a growth spurt, and also filling himself up with the higher fat content milk you produce later in the day (can be in small amounts hence the 'empty' feeling you might get).

If you're not experiencing pain then just keep on doing what you're doing. If you are experiencing pain then a breastfeeding consultant could help with latch.

blondie - she's not 'a winner' if the to up leads to her stopping bf, which is what she doesn't want to do :(

Some people can manage to 'combination feed' from this early on. For most people, though, early top ups lead to no breastfeeding at all (see UK Infant Feeding Survey - babies who started having topups of formula in the first week are three times more likely to have completely stopped all bf by the age of 3 weeks).

Congrats on your new DS and well done for making such a good start to BF.

What you are experiencing is absolutely normal! It's called cluster feeding. They grow out of it soon enough. As AuntPepita said, a formula top-up in these crucial early days can mess things up, or it can be OK. But there is a risk.

If he's latched on properly and doesn't have a TT then your nipples should be fine. A bit of soreness can sometimes happen but cracks, pain etc are not normal and a sign that something needs to be done. I understand your concern after your last experience!

Here is some info that might help you. If you're struggling then any of the BF helplines (NCT, LLL etc) will be able to give you information and help you figure things out.

DS did exactly this at that age. I listened to advice (here and in RL) and learned to trust that he knew what he was doing and was not feeding exclusively to satisfy hunger.

I didn't top up, the feeds got further apart and I certainly didn't get bashed nipples.

I know it's not for everyone but I still feed 18mo DS now.

Listen to TikTok, she is v wise about bf'ing and her advice helped us lots.

Ps. The biggest lesson for me was learning not to over think it. Much easier said than done, for me at least...

Tiktok - I made the point that adding one top up feed in the evening may get the OP some rest, which is also v important for supply .

Fwiw I ebf for 2 weeks, then added top ups and carried on bf till 7 months. Top ups do not mean the end of breast feeding for all mothers...

Thank you so much for your support - I didn't have the day 4 tears this time but this brought a proud tear to my eye!

I hear the issues with supply, that was a main concern of mine. However not sure what else I can do after 2 hours of feeding, I can continue to let him suck but surely there is nothing left!? Not sure how else I would have settled him otherwise?

Nipples are not too bad, only one small cut, but that was dh's fault, he made a loud mouse and DS got a fright and snatched off! I'm just keen that they stay that way, am wearing breast shells to keep them in good condition and because totally inverted nips was the big issue last time - these have been a life saver . No longer inverted, they can orob be seen from space now

I don't want to argue blondie :)

Rest has nothing to do with supply - really. Nothing. It can be important for mother's well-being, for sure, but it won't make any difference to milk production.

I specifically didn't say 'top ups mean the end of breastfeeding for all mothers', and explained that some mothers find they can combination despite the top ups. Clearly it worked for you just fine, but yours is not a typical story.

Tiktok: What of I top up with expressed milk? Still felt like there was some left after morn feed so expressed and got 2 oz! Surely I'm encouraging supply that way too? I guess I don't just mean formula whn topping up just out of a bottle rather than me!

monkey, you have milk, even after two hours on-and-off feeding....honest you do! The breasts may feel flatter and softer but with 'active bf' but they always have milk in, and when the breasts feel less full the milk is creamier. Breasts are like rivers not lakes - milk is being made at all times, and production speeds up when the breasts are less full, and slows down when they are fuller....stopping altogether if you don't keep on feeding.

You can top up with ebm....but why do so? It is a lot easier to breastfeed direct, instead of messing about with bottles, pumps, teats - you can keep the ebm frozen and use it later if you have to leave your baby with a carer for some reason in the next few months, or to mix with other foods when you baby has solids :)

And giving ebm can interfere with supply, too.

If you give ebm, and your baby lengthens the gap between feeds as a result, you are still undermining the production of milk.

Got it, you're right I think confidence that I really am actually doing it this time is part of it! Using the bottle was more to give me a rest after a 2 hour marathon. Didn't appreciate that there is always something there! So I'll use the expressing for comfort if need be and save it - made me laugh thinking of him getting to solids- he'll be wanting a cheese sandwich for lunch at the rate he's going!

Am feeling quite smug this morning that I managed to feed lying down in the night - we could not be in a more different place than with DD!

Congrats and good luck monkey it is such a hard time but passes quickly! Tiktok's advice is brilliant as usual!

As a slight hijack but still on topic...this thing about there being no milk left after lOng feeds, breasts being "empty" etc seems to me to be the biggest misconception/difficulty out there- anyone I know who has stopped bf before they wanted to has cited it as their reason. Why is this? It's not addressed enough imo and I think it would really help a lot of people!

Caz I agree.

I think a big part of me being able to bf DS successfully is down to all the brilliant advice I've read from tiktok and others over the past year, and it has really upset me to see contemporaries of mine struggling to continue with bf because of misconceptions like this.

It has made me want to train as a breastfeeding supporter in some capacity, so I can help others be better informed.

Tiktok, do you know if the Infant Feeding Survey found a causal relationship between mixed feeding causing supply reductions causing the switch to full formula feeding? Clearly one tends to lead to the other statistically speaking but I'm trying to find research on the causation. I'm mix feeding my 7 week old since day 2. It's going fine and I'd like to keep it up, but I can't find concrete research about the risk I'm taking. What I mean is, I understand that giving formula at a certain time of day instead of bfing will mean that in time my supply will be reduced at that time of day. However, for me that's not a problem as my partner will always be giving a bottle of formula at that time of day. What I'm concerned about is whether that will affect my supply during the rest of the day and I can't find proper research on that - just people repeating that mixed feeding reduces your supply. It's very frustrating!

I had a quick look at the Infant Feeding Survey and have read similar surveys before. They seem to admit that it's not possible to work out from such surveys where cause and effect lies with mixed feeding leading to full ffing. For example many women who are mixed feeding may be doing so because they were already experiencing supply problems. Or the decision to mixed feed in itself may indicate less motivation to maintain bfing (or less reluctance to ff) than a decision to ebf. Is there other research out there that addresses the risk that I'm talking about?

Hope this isn't hijacking your thread OP!

Nice analogy I saw on MN for breasts running out of milk...

Baby drinking from your breasts is like drinking from a river, not a pond :)

monkey, it sounds like you are doing absolutely fantastically! I didn't properly master feeding lying down for ages and it's such a great thing to be able to do as you can rest/sleep while you feed and that makes so much difference to night feeds. (or any feed if you're tired).

I remember the early days where DD would cluster feed and I just kept telling myself that I needed to trust my body to feed her and that if she was happy to keep latching on/feeding then I would just keep swapping sides until she did fall asleep. Don't get me wrong, we did have the odd fractious/fussy period, but in general she was happy to keep feeding/comfort sucking/whatever she was doing, so I just kept at it.

You're doing great!

How fantastic monkeypuzzeltree - feeding lying down is sooooo nice and easy, and you are doing so well!

As other posters have said, evening super long feeds are your baby stocking up for the night and increasing your supply. I have massive amounts of milk and my baby DD will still cluster feed in the evening (as I have an oversupply she really really is not hungry but it is just what they instinctively do). It makes her contented to be close to mummy and suckling, so I just go with it.

I knew this would happen from DS so have just stocked up on good tv box sets and snacks and enjoy the sofa time! In a few weeks they will grow out of it (and I will have no excuse to hog the tv, curses!)

Sioda, the survey cannot ever show direct cause and effect, because as you say the mothers who mix feed from the early days may be less motivated to breastfeed than others, and the reason for mix feeding might well be difficulties with breastfeeding. There's also the 'behaviour' effect on mothers - formula may lead a baby to sleep/settle quickly/for longer and the mother's confidence in bf is reduced.

The stats show an association, rather than pure cause and effect.

However, we know how breastfeeding works, how production is driven, and what reduces supply - less frequent stimulation, with gaps between breastfeeds (cause and effect). We know frequent feeding in the early days leads to less milk (cause and effect). Introducing formula feeds as a top up means less frequent feeding which means less milk.

So it would not be surprising at all that early top ups mean mothers are likely to stop breastfeeding sooner - even if that is not the whole story.

Giving formula a certain time of the day does not 'instruct' your body to make less milk at that same time of the day - that's not how it works. It reduces your supply overall...not crucial for everyone, but crucial for some.

HTH :)

Thanks tiktok, that's what I was wondering. It baffles me that there doesn't seem to be any proper research done based on actually asking women who mixed fed and ended up fully ffing what their reasons actually were, how many top-ups they were giving, how much and how regularly etc. It's so unhelpful to women that we know some people can 'get away with' mixed feeding without difficulty and some don't, yet there's no way to know which one you're going to be in advance or how best to manage mixed feeding for those who want to keep it up. Thanks for the clarification about supply too - I had misunderstood that. I'll just have to keep taking my chances because there's no way I'd cope with the lack of sleep of ebfing.

Just so you know research has shown that there is no link to lack of sleep and breastfeeding. Yes small babies go longer between bottles then a breastfed baby because formula is harder to digest, although that doesn't always correlate either as some formula feed babies also like feeding little and often. But it doesn't see to mean more overall sleep, some breastfed babies sleep through early on to. It doesn't correlate with how they are fed.