Weaning off Formula Top Ups, Back to Breast

[expatmom24]

I had to start giving my baby formula around 3.5 weeks as she dropped weight again (post hospital) and was very unsettled after feeds and not sleeping. I had her on the breast constantly around this time (literally had to master the lying down feeding position to get even a wink of sleep), but she was never satisfied and cried constantly for days. Due to this and her drop in weight, her pediatrician mentioned that she was probably not allowing me (my breasts) to fill up in between feeds (preventing her from getting any hind-milk), and asked that I offer her one breast every 3 hours and top her up with formula, until her weight stabilised. This truly made sense to me at the time, as I don't have a lot of breast tissue and because my milk took longer than average to come in (likely due to her assisted delivery). Plus I was at wit's end and couldn't enjoy most of the early days with my baby! :( She is almost 8 weeks old now, is definitely healthy/more settled, and I am doing my best not to over-feed her (she has about 6-7 feeds a day, and I think she's getting about 30-40ml from me, along with 90ml of formula on average per feed). However ideally I would like to get her back to solely breastfeeding (if possible), or at the very least, I would like to be able to begin producing more milk for her naturally. Does anyone have any advice on how to safely wean her off of formula (at least for the majority of feedings)? I've tried pumping here and there after feeds to help stimulate more milk production, but between prepping/sanitizing her bottles, nursing, and then bottle feeding and winding her every 3 hours, it gives me little time to interact and play with her as it is, and I really want to enjoy these early moments. Any advice would be appreciated!

What a difficult experience, expat :( :(

It's a real shame....the paed is not helping you, and really needs some updating :(

It's absolutely the opposite of what he/she should have told you. If you can, seek out a second opinion from someone who knows about bf - you can call any of the bf helplines and speak to someone.

Babies where there is a difficulty with getting enough milk MUST have at least both breasts every time, and as frequently as possible. One side only every three hours reduces intake and reduces supply. This is what mothers do when they have a problem with over-supply and when the baby is spluttering and not enjoying bf because of being overwhelmed.

It is volume of milk that drives the intake of the baby. Yes, hindmilk (the creamier part of the milk) exists, but deliberately extending feeding gaps for the baby to get hindmilk is the opposite of what mothers need to do.

It's important you understand this, to enable you to go back to full breastfeeding.

thefunnyshapedwoman.blogspot.co.uk/2011/05/foremilk-and-hindmilk-in-quest-of.html

www.analyticalarmadillo.co.uk/2010/07/foremilkhindmilk-and-lot-of-confusion.html

explain it quite well.

So....first step is to feed your baby more frequently, using at least both breasts, and even 'switch nursing' (you can google it). 6-7 feeds in 24 hours is probably half the number you need to be aiming at. You will need to maintain formula for the moment, but you may find you can reduce it by 10 mls or so at a time....though do seek help from someone in real life who can help you with this.

What do you think?

Is this paed in the UK? It's actually a disgrace you were so badly informed :( :(

I've mix fed DS after starting f top up on the advice of mw after weight loss at 10 days. DS was tt and although feeding got better after it was snipped the top ups remained. We've gradually reduced the top ups to a bottle or so over a day. The paed did you a great disservice telling you to leave 3 hours and only use 1 boob. If you do that you're telling your boob that you only need to feed that much and your supply will reduce. Feeding is cyclical so the more you do it the more you can do it. I mistakenly believed thatif I left my boobs to "fill up" I'd be able to feed DS better but it really doesn't work that way!!
I fed DS on demand and always both boobs (and sometime back on the first!!). I offered a top up of formula if he was still hungry. Boob really was my first port of call!! By around 10-12 weeks he stopped taking f after a few of his feeds.
I've never managed to ebf but to be honest I'm ok with it- I'd hate for you to have the decision made for you through bad advice. It's really hard when hcp are telling you something but I really think you'd be better off with LLL or another bf helpline- not all paeds are bf experts!- oh and tiktok is!- always great advice!!

Thank you tiktok and NickyEds for your helpful responses. I really appreciate it!

I should have also added that I had her in a topnotch London hospital where I met with several lactation consultants the first few days, and also had weekly midwife support, so I truly felt certain that I was feeding her correctly during those first few weeks - was feeding on demand and using both breasts every 1-2 hours on average. She also had an amazing latch from birth and was soiling her nappies often as expected. However, because she lost weight and was horrifically unsettled/not sleeping for several days, I was keen to take advice from any medical professional at that point. Now I definitely wish I had a second opinion at the time (and a bit more education on the matter), especially as I told the paed I was still keen on breastfeeding longterm (And yes, the paed is in the UK). :(

The good news is that I still have milk coming in and I have a happy baby on my hands. I just have to think forward and work a bit harder to get breastfeeding back on track. Yikes! I do agree with your plan tiktok (about reducing mls at a time) and my OB recently mentioned something similar. I will definitely reach out to another bf professional for help on that. Glad I posted on here to start however, as hearing from other mums is a bit more comforting!

Again, thank you both VERY MUCH!!!

No probs-it's hard when bf doesn't work out how you planned. I've also found that as my supply gradually increased I would feed off both boobs then give DS say 30mls of formula then offer the breast again- doesn't always work but I found it did sometimes. If you can talk to someone in rl about bf- doesn't have to be a hcp-I spent a looooonng night talking to my sister (who ebf her 3 children) about how it felt and postioning and things and it was really helpful. She said that I was really tense and sort of hunched over my baby and helped me get into more comfortable positions. It helped make feeding more of a pleasure than a chore !!
Happy baby sounds like you're doing a great job!! Good luck