Currently mixed feeding - how to proceed from here

[TheLastJammyDodger]

DS2 is now 3 weeks old. He was ebf for 9 days, but then lost too much weight so I was advised by my MW to top up with formula or expressed milk after each feed. He is now regaining weight, but has still not quite reached his birth weight. I have worked hard over the past 12 days to increase supply (improving latch, breast compressions, switch nursing, regular pumping in addition to feeding) and I do seem to have more milk (although still not sure it is enough).

At the moment, DS2 feeds every 2-3 hours during the day. Each feed is a bf (usually 4 sides) + a 60ml top up. At night he has a bf + 60 ml top up at around 2 or 3am, then is bf on and off from around 6am until about 9 am when he gets a top up. Some days I have skipped a few top ups, but this is hard work as he will then feed for hours and never seems satisfied.

Other complications are that I have 4 yo DS1 to look after 2 days per week so I just can't do hours of cluster feeding on those days. I have no family local to help and DH is now back at work. I am recovering from CS and cannot drive yet and all bf groups are a long way on foot.

At the moment I don't want to change this schedule until he is back to birth weight and we are discharged from the community midwives. However ultimately I would prefer to ebf or to move to just a single top up per day as I'm finding the current schedule a bit full on . I am going to a bf group tomorrow, so hopefully will get some advice there, but I would also like to hear from people who've been in a similar situation.

Is it too late to get back to ebf now? If I stick to giving top ups after every feed will my supply dwindle? Should I start reducing the number of top ups per day or is it better to reduce the volume given at each feed? Ideally I would prefer to make the gaps between feeds shorter during the day, but at the moment I'm struggling with that.

Thanks for sticking with this lengthy post and for any advice you can offer

Wow - what a struggle :(

It's good you are going to a bf support group. Do make sure you speak to a qualified person - more than a peer supporter. They are great, but this is way beyond their training.

On what you have said here, you will need to discuss a plan to reduce the formula your baby is getting. My sums have him taking 300 ml of formula over 24 hours - you don't say what he weighs but I'm assuming something around 3500 kg? That is a lot of formula - almost as much as he would have if fully ff. This does not leave much room for breastmilk and he may be coasting along mostly on formula - clearly to rescue your milk supply that has to change.

You can do it - it is definitely possible. Discuss at the group your options ie to reduce the formula volume each time or reduce the frequency of top ups. Either will work.

Thanks for replying. He was 3.4kg at birth and is now 3.2kg. He has anything from 60ml to 200ml formula per 24 hours (depending on how much I can express). I also probably didn't explain my schedule very well. I will usually feed him for at least 1 hour (sometimes 2 hours). He then has 60ml top up and sleeps for up to 3 hours, so that is 60ml every 4-5h during the day plus one top up at night. I usually pump around 3 x per day and can get anything from 40ml to 100ml. I am hoping that the bf group is helpful (it is a 4 mile round trip). They have a bf specialist there tomorrow. I think I really need the latch checking as I am just not confident that he is extracting much milk. I am very unsure at the moment whether to feed more or pump more.

The first thing is to know is you are doing an amazing job.

Breast feeding group will help massively.

Has anyone suggested anything about your diet? The amount of fluid you are drinking and your calorie intake etc.

I mixed fed for the first few weeks as my little one had a sore head from forceps and my milk took a week or two to get going. Hand pumping certainly helped me - first for the let down and managing the about of fore-milk. Then after the feed to help me gauge how much was left and having a reserve of hind-milk for bottle feeds. It is never too late. If you keep pumping then there should be no dwindling. Groups you can get to easily are best. Keep at it.

You and your body are having to cope with a new born, recovery from CS and looking after others. Give yourself a break - breath and relax. :O)

knowyourmind, OP's calorie intake and fluid intake irrelevant to bf.

OP, exhausting schedule....hope the group can help you get it sorted.