Anyone tried scheduled as opposed to demand breastfeeding?

[jasper]

It seems most current experts on breastfeeding support demand feeding.
I consider myself to have been something of a failure on the breastfeeding front with my first two. The details are unimportant, but briefly, they would both suck for hours on end, I never once had the sensation of fullness in the breasts, never felt my milk " come in", never leaked...And this was with the most wonderful support from midwives and breastfeeding counsellors...Anyway I lasted about six weeks with number one, less with number two.This has made me wonder if perhaps demand feeding might work out where demand feeding had failed for certain mothers, eg. me.
I recently read Gina Ford's book with interest. She suggests scheduled feeding ( I think three hourly at first). I really do not want to open up the whole breastfeeding debate as I am sure demand feeding is best in some way, but having failed twice I really would like to hear from anyone who has succeded with scheduled breastfeeds where demand feeding failed.
Please don't suggest ways of making demand feeding work!

I was interested to see that the La Leche FAQ states that one of the signs that your baby is getting enough milk is:
"The baby is allowed to determine the length of the feeding, which may be 10 to 20 minutes per breast or longer. "

and yet they also say that if baby nurses for only 5 mins at a time that it is NOT a sign of decreased milk supply.

Now I am confused!

Im off to take a chill pill - what an emotive subject

Wrt whether GF has any understanding of physiology, I have a friend who works with postnatal woman and she is seeing more and more women who are struggling to bf their babies because of GF's routines.

My friend also has to deal with the fallout from parents who have tried GF and been disappointed. Mothers are coming to her, with badly dented confidence because their baby won't behave like a CLB and bf has been a disaster too.

The issue isn't whether GF's routines work for some people, it's whether her routines are causing harm to others.

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robin w - You could try Dr Dettwyler at www.prairienet.org/laleche/dettwyler.html I don't think she has any published research as such on these pages but the articles listed are taken from her general research. As an academic her comments will be more 'serious' than a general website. There is also a piece titled "Non-nutritive Sucking" which may be of interest.

As far as I can tell water/dummies aren't advised in very young babies because it may spoil their appetities. ie the water would replace valuable breastmilk. Also dummies may cause nipple confusion. But for older babies this shouldn't be a problem. The thing is that babies do like the comfort aspect and it can be useful to do both at the same time - ie provide food and comfort. I don't know how old your baby is so difficult for me to comment. My baby never took a dummy anyway - only wanted the real thing - but like I said before his demands for the breast did decrease in time. However if he was ill or just wanting to go off for a nap then I would let him have the breast even if he wasn't hungry. I think many of us have a preconceived notion of how long our baby should be on the breast and this can affect our feelings towards b/feeding. It isn't always easy and you can get 'touched out' by the constant demands. But who said any aspect of childcare is easy!

Enid - I think it means that if your baby feeds for a short time that it doesn't mean you don't have enough milk - probably just that the baby is more efficient at taking the milk (sucking harder)

Oh and I forgot to say - your comment "or trying water to see if she was really hungry" is problematic. How can you see if she is really hungry by giving her water? She may well drink it down and be filled up and appear to be sated but is getting no nutrition whatsoever. Also it would be difficult to measure this on the basis of when she next asks for food because breastmilk is digested very quickly, perhaps as quickly as water. As Tiktok says b/milk contains water anyway so it is designed to both satisfy thirst and provide nutrition.

Whew, this is exhausting keeping up with this.
Thanks again for all your comments.
RobinW, your idea about giving an occasional bottle of water makes perfect sense to me.It clearly helped you achieve your goal of establishing bf so that can only be a good thing. It's not like you were advocating gin and tonic.
At the risk of repeating myself( but here goes) much of this general bf stuff has been thoroughly discussed on other threads and I was hoping we would not get an outbreak of general bf debate.I realise some of you were just trying to be helpful in repeating the same general stuff about establishing bf but believe me, I have been there, done that.
I specifically wanted to hear from those of you who had success with scheduled feeding where demand failed.I am most encouraged to see that a more scheduled approach did indeed work well for some of you.
Believe me I have tried every trick in the book regards breastfeeding.I have read every book too! As for La Leche League, well I am sure they do a great job educating and informing but my experience is that they just banged the same old drum about "the more he sucks the more you will produce...breastfeeding should not hurt...make sure he is correctly positioned" . Actually I personally found them to be astonishingly unhelpful as it seems they just can't see past exclusive bf and I think this does not help mothers like me, who would possibly have benefited ( reading other threads) from giving the odd bottle of formula.
I also see absolutely nothing wrong with breastfeeding experts saying to mothers at a certain point it time and in certian individual cases "look, sometimes it is just not worth the effort"!! I certainly believe this to be the case.
As for the blessed Gina's writing style - I like it! Must be my strict upbringing, makes me feel reassured or something.
Anyway,
All babies are different.
All mothers are different.
Right, can I have this weeks prize for stating the obvious?

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jasper, just to let you know that I had excellent results and a lovely fat, happy baby with scheduled bfeeding. I demand fed for about 3 weeks and we both seemed to hate it. Just the kind of mum and baby we are I guess!

Robin w - not my 'advice' as such. I don't have much of an opinion on dummies although I know that they can lead to problems in themselves. And yes (this may horrify you) I have slept with my baby latched on. If you can find a comfortable position then it works very well.

I didn't say that giving water stopped b/feeding merely that it may affect it and that problems may arise in the early weeks. I'd have to see that article but it depends what they mean by 'giving water'. There is a difference between a spoonful (as I admimistered when I gave mine some gripe water) and whole bottles of it. It is all down to common sense of course and the point about advice from Health Visitors is that they tend to err on the side of caution hence some remarks can be irritating.

I understand your views on research but ancedotal evidence can be useful too and shouldn't be dismissed. After all there is an awful lot of information on this website which you obviously take on board as you read and contribute regularly. Unfortunately there isn't a lot of research done on b/feeding - I know I have tried to look for it. Most websites such as La Leche League for example I feel are authoratitive as they are supported by trained breastfeeding counsellors.

The Internet itself is patchy for research. I know as my last job was a research post and I spent nearly all my time surfing and often came to dead ends. As you'll probably know many journals you have to subscribe to. However you can use a local university library and take photocopies (not always very handy though). If you find anything of interest please do post the reference here.

Jasper - the advice on the LLLI site is for those who really do want to b/feed. If you don't feel it is worth it then I guess that it is taken as read and you would make your own decision about whether to carry on or not. The point is that all problems do have a solution and they are just giving postive advice about how to do this. It would be pretty useless if they just said "give a bottle instead" as this may not solve the problem or indeed perhaps contribute to it. I know this from experience. But I won't bore you further...!

There are a number of studies that look at the effects of supplementing of otherwise breastfed babies, with water or formula. To pick one, in 1991, when 407 babies were assigned to either supplementation with water, or not. This was in Norway, where there is a lot of bf anyway, and it was in the maternity ward. The supplemented babies were less likely to breastfeed exclusively after this, and they were breastfed at all for a shorter time (you can read the details in Acta Obstet Gynecol Scand 70: 205-209).

There are plenty of studies looking at routines and schedules and timed feeds, as well as supplements (not always water, sometimes glucose water, and often formula). There are no studies (that I know of) that show breastfeeding is prolonged in these sitiuations, though there are some that show it makes no difference, and some that show supplementing shortens overall bf duration.

You can find some of these studies in Enabling Women to Breastfeed (Stationery Offiuce, 2000). You can also find studies listed at UNICEF's Baby Friendly site, www.babyfriendly.org.uk, which has refs for the Baby friendly '10 Steps', which say 'no supplementing' with anything unless medically indicated.

I think all that can be said is what the evidence tells us is more likely to happen, and we couple that with what we know is the basic physiology. Of course GF's routines work with some babies and mothers - just like the studies that show supplementing makes no overall difference, some women will succeed, though I think there is a lot of anecdotal evidence (even here on this thread) that GF babies do not breastfeed for very long -no longer than a few months, though sometimes (not always) that is fine by the mothers and fits in with what they wanted, and I have no problem with that.. There are mothers who find the routines impossible to follow, and they and their babies suffer (at least the ones who phone me, do - yes, I am a bfc).

Of course some women will decide that bf is not for them, and things have gone so wrong, that they feel there is more to life than a struggle to bf - that's their choice!! I would support anyone in their choice, but I would never say to someone who had asked me for bf help and support, 'look, are you really sure it's worth it?' That's as bad as saying 'look, aren't you sure you should carry on, no matter what?' Good bf help and support takes its lead from the mother's own agenda.

Sorry this is so long, but I was asked!!

Of course, GF doesn't suggest supplementng (apart from with expressed breastmilk), but the research shows her emphasis on schedules is less likely to lead to successful bf, as well!

GF actually does do a very good schedule for 'mixed' feeding which worked very well for a friend of mine. She breastfed and gave formula for 13 months.

Can someone answer this question for me, Why giving a BF baby a dummy will cause nipple confusion? We are all told if you are BF not to give a dummy for at least 6 weeks, not to introduce a bottle (even of expressed milk) because of this nipple confusion. I am puzzled, because in my experience (and this is personal with two babies) the opposite was true. With my first she was 3 months premature so as much as I tried to get her brest feeding, she was fed by tube for a long time, I never ever managed it. I would weigh her before a fed (in hospital) feed her for 20 mins or so, and then weigh again and she didn't put on a gramme in weight! Therefore I gave up and expressed for 4 1/2 months. So second time around I was deternmined to 'Do it properly'. Therefore I demand fed for about a week, until I spent most of the time in tears with engorged breasts, cracked nipples and a baby who was gaining weight (she never dropped a gramme). Then I just had to express (something we are told not to do) to actually empty my boobs and for the first time in a week they didn't feel on fire. So instead of wasting that milk, I gave her a bottle, this didn't lead instantly to her not wanting a feed at the next time, but it did really fill her up, make her wait for 4 hrs before needing another feed and from then on we both coped better. My nipples had a chance to recover and not bleed after each feed (yes she was correctly positioned), my milk supply was fine all day long as I had time between each feed to stock-up as it were, and occassionaly all Daisy wanted was a 2 minute comfort suck to send her to sleep (so I gave her a dummy). I still fed until 7 months, mixed feeding between bottles and BF as I worked full time (leaving by 7.15 am and returning about 7.15pm - but thats another argument waiting to happen).
All I know is that there seems to be no 'facts' just lots of different ideas that work for one person or another. I am sick of being told by anyone 'this is the right way' 'there is no other way'. GF does this, burt so do other advocates of demand feeding, exclusive BF, and anyone else you care to mention. WHy can't people say that this is our opinion, or that this is one way that may work, but there are many other ways that work too.

Eulalia and Robinw - to use your quote Eu,'And yes (this may horrify you) I have slept with my baby latched on' - I can't think of any people I know personally who b/fed and didn't do this. Me absolutely included, I think mainly every night for a good 10 months, if the truth be told! And why would there be a problem with it? I looked as b/feeding much more in the light of dd getting comfort and closeness from me and me being solely able to provide this (is this maybe the difference in some people viewing b/feeding soley as food - and therefore, understandibly, a bit of a chore? ). Oh there's no doubt in having bad points to it (no jetting off overnight for me). But now dd's all of 2 - I realise how fast the 1st yr went and actually (though this is not my broodiness, may it never rear its head for yrs!) miss that level of closeness like crazy! Especially just now when I asked dd for a cuddle and she wandered off saying 'no fank-oo mummy, gonna go play wiv toys!'

Crinchie asks "Can someone answer this question for me, Why giving a BF baby a dummy will cause nipple confusion? We are all told if you are BF not to give a dummy for at least 6 weeks, not to introduce a bottle (even of expressed milk) because of this nipple confusion. "

I have never told anyone that - and people who say things as dogmatically as that deserve a kick up the bum, because life is not as predictable or as clear-cut as that. We know - from research - that bottles and dummies in the early days can reduce the liklihood of successful bf. This does not mean that every baby who has a bottle and a dummy in week 1 cannot bf....I mean, I can run across the road without looking and I probably won't get knocked over. But my chances of getting knocked over are considerably reduced if I do look first! The UK stats show that a baby who has a bottle or bottles in the first week is three times more likely to be fully bottle fed than the baby who has no bottles in the first week. But that doesn't mean every baby.

There is nothing to indicate 6 weeks as a cut off point beyond which dummies and teats are fine....or 2 weeks, or 8 weeks...nothing. I think common sense would suggest strongly that waiting until bf is well-established, esp with formula, is sensible, so you don't let the baby go too long between bfs. A baby who's thriving and whose mum's bf supply is well-established is prob. ok with a dummy, if that's what keeps everyone happy.

Quite agree about people who lay down the law about feeding. But Crunchie, there are 'facts' about it, not just 'ideas'. The facts are evidence-based, but that still doesn't mean the evidence applies to every individual circumstance....go back to my running across the road analogy!

My feeling is that the reason babies who are given a bottle in the first three weeks are more likely to end up being fully bottle fed is that the mum sees how straightforward it is! No cracked nipples, no worries about not getting enough, no endless arguments about bfeeding...not to mention lots of other people being able to help feed the baby! Bliss! (and I speak as someone who's daughter would not take any kind of bottle until she was 7 months old)

Spot on Jasper! Infact, Eulalia, why do you assume that Jasper has already made up her mind to give up BF if she doesn't find the LaLeche info helpful. Neither did I. This philosophy of "the more they feed from you, the more you will produce" does not work for everyone as this thread has shown. It is the most frustrating situation to be in, desperately trying to increase milk production, to meet demand when this is the only advise you are being given, and its not working. What are the alternatives? Or are LaLeche so stuck in their ways that they can't answer this?
Scheduling for me and ds worked just fine. Yes I had to supplement one bottle feed a day in the evening to make up for a non-existent supply by 5-8pm (expressed milk from the morning when I had more than enough) and ds was a very contented little chap on the GF suggested scheduling. He was never a big feeder, and is still on the light side, but demand feeding was causing him to lose weight.
And Suedonim (no, I'm not having a "go at you" day, but just had to say that), as with any suggested courses of action, ie GF vs A.N.Other, there will be happy parents and child like us and sadly not so happy ones. Nothing works for everyone, but it doesnt mean that GF has "harmed them". I don't feel that LaLeche "harmed" me, even though the advise they gave me made me feel a complete failure on the bf front. I just found a better alternative, that worked for me.
Jasper, good luck with baby No3 and I hope that bf works out for you this time. I'll be interested to hear how you get on, maybe you can pass on some tips for me when my next one arrives in April!

Thank you TikTok, you have answered my question, I didn't know there was any factual basis on which these statements were made. All I had heard was don't give a bottle/dummy as they will get nipple confusion. You have explained things, thank you. I didn't stick to this and got away with it, but I am a huge fan of mixed feeding which I did second time around. I loved breast feeding, but I needed the balance having a bust toddler who was very demanding of my time, I couldn't spend hours feeding for comfort no matter how much I would have liked to. I did continue breast feeding at night until my baby slept through at 4 months! and then continued feeding before bedtime until 7 or 8 months. So I kind of sit on the fence with everything, and ensure that I do things that make everyones life easier (sorry if that makes me a bad mother)

If only research was as easy and as definitive as is being suggested. It is very hard to design a way of testing if mothers who have difficulty with breastfeeding give water/dummies because they have difficulty or if the water/dummies makes them give up. One interesting study, published in the Journal of the American Medical Association on July 18th last year, suggests it isn't clear cut. This is the conclusion " We found a strong observational association between pacifier use and early weaning. No such association was observed, however, when our data were analyzed by randomized allocation, strongly suggesting that pacifier use is a marker of breastfeeding difficulties or reduced motivation to breastfeed, rather than a true cause of early weaning."

As good research design is difficult quite a lot of what is published is not well designed and can be misleading.

Quite right, Wendy....it's never going to be possible to design a study that controls for everything, as you would have to randomise mothers into a breastfeeding only, breastfeeding and supplementing, and formula only groups, without giving mothers choice which would be rather unethical! Randomised controlled trials are just not possible with bf, except in situations where mothers are in maternity wards with different policies and the will to make people follow them! So we are left with observational studies, which do not necessarily tell us about cause and effect. Mothers who give bottles and then end up bottle feeding may have given bottles because they had problems with bf...though I think it is unlikely to be as clear cut as that.

The idea that constant feeding is bound to resolve problems is clearly false - as this thread shows. Constant feeding, with the baby hardly ever coming off spontaneously, and being miserable, is a sign of 'ineffective feeding . Lots of babies may prefer to be on or near the breast for a lot of the time, but there is a difference between these 'happy sucklers' who just love bf, and the baby who is never happy, who feeds without a break for hours on end, and may be colicky, fretfull and distressed. Anyone who tells the mother of a baby like this that all she has to do is feed, feed, feed and then leaves her to it, is another one who deserves a kick up the bum!

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SOOOOOOO true Bloss !

Had everyone in the world heard of Gina Ford when they were pregnant? I had never heard of this woman until I read about her on this site!