BF baby swapped to formula/expressed milk and very constipated

[Felix90]

My dd is 5 weeks old and over the past week or so, I've swapped from bf to feeding her formula through the day then expressed milk at night. I'm in a good routine of expressing each time I feed her so I have enough expressed milk to feed her at night and it's going well so far.

At first we fed her a couple of feeds of the pre-made SMA cartons just while we got used to the whole formula thing, and she started to get a bit constipated. We then bought some of the powder Hipp organic stuff, then swapped to Cow & Gate and shes still struggling with constipation. She's managing to poo but in between each one she's really struggling to push and keeps crying and won't settle easily. She usually settles really well and hardly cries at all, and I feel so helpless as there's not much I can do

I've done lots of research and tried giving her cooled boiled water with a tiny bit of pure orange juice in, and another time gave her the same but sugar water rather than orange juice to try and get things going, as recommended by a midwife and HV. I've also tried warm baths and massaging her tummy regularly. Neither have really worked and they are short term solutions really and I don't know what to do.

Has anyone else had this problem? Is it just a case of her system getting used to formula rather than breast milk? Is there anything I can do to make it better? I feel so bad for her I know it may be a case of finding a formula that is right for her but I've tried three so far and it's becoming expensive and wasteful swapping formulas all the time.

Bump!

sometimes swapping formula can cause constipation. (bitter experience) I was told to drink orange juice myself (was still bf as well as ff)
That should work with expressed milk too, shouldn't it? use that at times to induce conveniently timed pooing?

I was advised to add an extra ounce of water to every bottle of formula. Worked for us.

Thanks for the replies. I drink orange juice regularly anyway and also have upped my fibre intake just in case it makes a difference.

Is adding an extra ounce of water recommended? I'll try it but just worried as it says on the pack not to dilute or make more concentrated than it says on the instructions. Would it be ok?

Felix don't over dilute the ff, adding fibre and orange juice to your diet will make no difference and the formulas are all essentially the same so you aren't likely to see big differences though your baby may well suffer less as she gets older. Giving sugar water and oj is old fashioned and not recommended. Can you just up the bm? That is the safest and simplest way to reduce constipation in small babies?

Sorry realised I sound grumpy reafing that back, am not at all...just one handed:)

are you saying you have changed formulas 3 times within one week? Thats a lot for her digestion to deal with. I would stick with one and let her system get used to it. Formula can make their poos firmer and they do put a lot of effort into getting them out. If required a small amount of cool boiled water (with nothing added) could help. What is the poo like when it comes? If it hard and dry then she is constipated and if it is soft then she isnt.

and yes, dont dilute the formula and orange juice isnt recommended either

I decided against diluting the formula after doing some research. We started off giving her the SMA pre-mixed just because it's what they had at our local shop, just for when we were out and about and I was still bf. Then when we decided to feed her more formula, DP went out and ended up buying Hipp hungry baby formula which I wasn't happy giving her as it was a hungry baby one rather than just normal stage 1 stuff (thought it might be a bit heavy for her). He went out again and they didn't have the normal Hipp stage 1 left so came back with Cow & Gate so that's what we've been using for now.

Her poos have softened a bit now but she's still grunting and struggling to push through the night and also in the day she seems slightly more settled once she's actually filled her nappy but then starts crying and pushing again after a while until she does another poo. Im guessing if her poo is getting softer she must be getting more used to it so fingers crossed it gets better soon!

Unfortunately I can only express 4oz a day but sometimes up to 6-8oz so she gets 2 feeds of breastmilk a day but that's it. I wish I could just feed her expressed milk full stop but I can't get enough out for her

Just to be clear about 'diluting' the formula - it was recommended to me by a GP and yes they say not to dilute formula but the warnings are for people who would dilute formula a lot to make a tin of formula last longer. They also say not to make bottles up with extra formula and less water in an attempt to make babies sleep longer. However adding an extra ounce of water is fine. Obv if you don't feel comfortable doing that I quite understand. Will she drink water at all? Just keep trying her with a little water every so often.

I would agree that changing her formula so often may not have helped but that can't be helped now. Keep her on the cow and gate and see how she goes.

It will take her tummy a while to adjust to formula from breast milk I think.

Cider thank you I appreciate any advice! If it continues I'll go to the GP so they will probably recommend the same as you were recommended anyway just not 100% on doing it off my own back if you see what I mean. She will take water so I've been giving her an extra bit of water along side her feed a couple of times. She does seem to be getting slightly better now so I'm hoping she's getting used to the cow & gate, fingers crossed!

if she is taking water then no need to dilute the formula. I wouldnt do it without medical advice

If she is taking water (which is a great habit to get her into) I would just keep giving that. Little and often.

It was an older GP who recommended it to me when my DS was tiny. It is probably not recommended now but it worked for us. No more constipation. He is now 12 and taller than me so seems to have survived! . But I understand why people would be wary of doing it.

they dont routinely need the extra water so little and often would be a bad idea. It is ok to give some if they are constipated or the weather is very hot but not all the time (until they start solids)