Trying to preserve breastfeeding while supplementing with formula

[splendide]

So, I've had a bit of a shit start to feeding. Fed constantly for hours a day for about 7 weeks then finally had a tongue tie diagnosed and cut. I thought things had improved but weight gain still terrible. Added 4 oz formula a day at 8 weeks and he put on 250g the first week of supplementing but only 100g this week. I've been advised to double the supplement to 8 oz a day.

I'm really hoping to maintain some sort of breastfeeding with him, is that realistic? Is there anything particular I should be doing other than feeding often?

You will find research about domperidone/motilium on the net. If I remember correctly, the original research was Canadian. If you go down that route you need a health care professional involved. Also the last time round someone recommended a book called mother food. It is about food for the mother what supports the production of milk. I actually remember when I was a child women in Germany nursing women were given a drink called malzbier, a nonalcoholic malted beer type drink. It is mentioned in the book and I have seen it recently in a Bangladeshi shop in Belfast. I will check the proper name when I am next near there. Comes in bottles that look like old fashioned bottles of stout.

Has anyone ever observed a full feed for you op? If you're feeding 17 times a day I would have thought that was often enough so it might be a milk transfer problem. I'd get the Tt re checked too. I'm no expert but from what I've seen the answers to bf problems are often, regularity of feeding, latch and Tongue tie!
I had to start topping DS up when he was very young (12 days) because he was still losing weight despite lots of feeding. After he had his Tt snipped we continued with the f top ups but I reduced them gradually. This was against advice at the time which was to go cold turkey but I couldn't face it. I eventually got the f down to 6-7oz a day (in maybe 2 or 3 feeds) most days and tbh it suited us to mix feed. I mix fed until he was 6 months and considered that "good enough" as after the terrible start we'd had I didn't think I would still be bf at 1 month (neither did the mw or hv). I suppose to many that wouldn't be considered a success.
I'm not convinced eating or drinking anything specific effects supply as I think milk production is prioritised but of course you need to look after yourself.

I'm really hoping to maintain some sort of breastfeeding with him, is that realistic? Is there anything particular I should be doing other than feeding often?
You don't say that you want to exclusively BF? Just that you would like to continue to BF?

You have my full admiration for keeping up that schedule - you must be totally knackered.

In your shoes [I mix fed two children] I would go ahead and either top up after every feed or substitute a couple of feeds a day with formula so you can take a break or express some milk.

One thing to try, is to express after every feed and see if there's anything left. He could just be a poor/inefficient feeder especially if he is underweight and probably knackered from feeding so often. With DD2, that was the clear sign which was that I could express a full 5oz when she was "done". I had to move to expressing all her feeds and giving them to her by bottle until her weight came back up. She became an enthusiastic bfer though when she hit about 9lbs and had a bit more energy. I put her to the breast about every second feed for no more than 10 mins to make sure she stayed in practice, but she usually fell asleep after 10 mins regardless of how much toe tickling and cold water sprinkling I could callously manage.

If you want to move to EBF, I can't help as I never achieved it - that's definitely TikTok's area of expertise.

:( :( Expressing after a feed to see what is left is not a good idea...it really tells you nothing.

Women whose breastfeeding is going well, with no transfer problem, may well produce loads for the pump afterwards, or hardly anything!

Women whose breastfeeding is not going well may do exactly the same - loads or hardly anything.

You cannot judge milk transfer/milk production by using a pump.

I only ever managed to get 5oz out of my boobs with a pump on two occasions(in the fairly early days when DS had missed a full feed)! I don't think it tells you anything abut your supply really.My friend who ebf could never get even one oz but her baby was fine. Sorry to give you more conflicting advice here op but I don't really see where in your schedule you'll have time to express, even if it did achieve something.

I don't think I can fit in expressing. I just can't see when. I don't replace a breast feed with a bottle it's as well as.

I would rather be ebf and had huge guilt about adding formula and resisted it longer than I should have probably (more guilt). I'm now pretty happy to mix feed but am worried it's a slippery slope. I'll keep feeding as much as he wants I guess and keep my fingers crossed that his weight starts going up without having to give much more formula.

The first 6 weeks I fed every hour to an hour and a half anyway with or without supplements but perhaps I had a bit of a hungry baby.

The first week I exclusively breastfed but she just wouldn't gain weight and not really sure to this day what the problem was.

I gave her every other feed a breast and the one between a formula from 2 weeks til around 4 months and then it was non scheduled from 4 months onwards.

I pumped to keep my supply up 3 to 4 times a day. Then 2 times a day from around 9 months onwards.

DD stopped breastfeeding completely at 14 months went to only night one at 10 months. It really can be done if you are passionate about it.

I pumped for about 20 minutes each time about 7 minutes on each breast then a little quick 2 minute pump on each breast again. You could also hand express if this is easier for you.

My earlier post was possibly misleading so sorry to drip feed.

I've had the two sides of the coin - couldn't express more than half an ounce with DD1. Her weight was plummeting [post EMCS], my confidence was shattered and I topped up on medical advice. Never got to the glorious EBF status but she stuck at one 8oz bottle a day which she guzzled usually after a 4 hour cluster feeding session which is somewhat soul destroying. From your schedule above [5 sides] I'm guessing you are spending most of your early evenings doing nothing but feeding. I could never express anything at all but DD went from 75% birth [20% drop] to 98% percentile so there was clearly plenty of milk in there.

With DD2, I had tons of milk from the off [vbac]. She just wasn't feeding well, no tongue tie but she was v small and couldn't suck for more than 5 mins without dozing off. Cue jaundice and UV treatment at which point I sought the reassurance of expressing all her feeds [had to while she was in the incubator anyway] so I could see what she was taking in. It was shattering and my days looked like yours except a little less snacky, as I was off expressing so she was every 3 hours during the day around 8 weeks with longer periods overnight.

Because she was in an incubator I had to feed her with a bottle as she had to stay in the UV light so I could baseline how much I could express before she did any BFing [about 5-6oz across 2 boobs so I was never going to be donating any]. Then once we were back at home, at every other feed I'd put her to the breast but for no more than 10 mins on each boob [always did both sides], then express and feed her that in a bottle. Generally I could see that I was expressing about 2 oz less overall so I kept up the post feed expressing until I could see that she was taking a lot more. No idea if what came out was "what was left" and entirely possible she'd had a full feed but my boobs could produce another couple of ounces anyway. By 16 weeks she was mostly BF and I stopped all the expressing completely. She hit a magic point when she got to 9lbs and was suddenly a much hungrier and aggressive feeder. Like DD1, I gave her a top up in the early evening by which time I was usually knackered and could routinely express very little.

In both situations it was hideously stressful. For allergy reasons [family history] it was important that I BF and I tore myself up about it. NCT "friends" put on even more pressure and I felt like a failure. By six months though most people were trying to wean onto formula to TTC or to return to work, or to just go out for an evening. Nobody cared by then and in hindsight I wished I hadn't put so much pressure on myself as it ruined the early months with both children with life revolving around BFing.

So best of luck with whatever you want to do. Try to be kind to yourself.

I think that sounds like a plan op. For what it's worth I found it easier to increase the amount I bf when I completely took the pressure off and accepted that I would mix feed. It didn't seem so critical, I relaxed and fed more comfortably therefore more often and so on.. Either way, don't feel guilty (says me!) your best is all you can do and you're doing it.

Thanks tiktok, well I've learnt something new today! Good article.

Just to say I had an almost identical experience to moonhare - at one point I was doing a formula top up after each feed and trying to express too. Hats off to anyone who manages to express after each feed (which is what I was advised) the most I was able to do was about 3x per day, and it felt like all I was doing was BFing, making up bottles, expressing and cleaning/sterilising.

Eventually we managed to start dropping bottles after DS's weight improved - now just give one bottle at bedtime by choice (DH and DS's little bonding time!).

I spent ages assuming it was ME that was the problem and so desperately trying domperidone, fenugreek, lots of porridge. I think in hindsight DS just had a rubbish technique - his latch was checked many times and it was fine, and we had TT snipped too, but I think despite that he didn't have a good enough 'suck' til he got bigger and stronger.

splendide there are lots of people who have to go back to work (the poor Americans have to go back at three months!) who continue to breastfeed for long periods of time just doing evening/night feeds. Feeding at night keeps your supply going.

My 8 week DS has bad CMPI and is doing best with hypoallergenic formula during the day. I felt rotten about it, tbh. Really worried it was the end. But I've kept BFing at night and hope to do it for a long time. So whatever way you have to mix feed, don't get too worried about it being a slippery slope - it doesn't have to be.

Actually, this is a bit of an unpopular opinion but I've found mix feeding has improved my mental health quite a bit. Its not all MY responsibility iykwim. Breastfeeding has become a lot nicer now too as each session isn't worryingly crucial.

Thanks Anna that's really giving me some hope. May I ask how many feeds you do at night? I'm worried my supply will dry up.

About 4/5 times. He's nowhere near sleeping through.

I haven't tested my supply during the day in about two weeks but I still seem to have loads, from the feel. Possibly its reduced, but its still definately there. My boobs are actually quite uncomfortable at night now as they "know" its feeding time. Last night I had to change my breast pad at 3am as it was soaked through! So supply is definately not in trouble. I expect I could keep going like this indefinately, really.

I feed loads till about 10 then normally feed at 2 and 5 and then 8 so that might not be quite enough. Not sure I have the strength to wake him at midnight!

Well I'm counting the 10.30 pm feed as well. So on average about 4. 5 on a fussy night, like last night, lol.

All the MWs told me that the nighttime feeds are crucial in maintaining supply i.e. You can drop daytime feeds, but dropping nighttime feeds is ill advised. So maybe this is why people manage to keep going just at night for 18 months and such.

Sorry "dropping" isn't what I meant. "Replacing with formula" is what I meant. Obvs babies will drop feeds naturally themselves. I don't suggest waking them! Not if they're feeding well during the day.

I see, yes.

OP, you've got loads of great advice here. But I'm just going to chip in with a word of encouragement...

I was where you are now with 2.5yo DD. She ended up mixed fed. At 12 months, we swapped cows milk for the formula, and then weaned at 18 months (my choice - she'd have kept going!). It got easier and easier as the number of bottles to be sterilised went down and as I got more confident.

I'm still pissed off that EBF didn't work out, mind! But more pissed off than distraught.

Oh cool, I'm glad it's possible at least! It's all a bit sad but I just want his weight up as a priority.

Quick reply, hope to cone back later with more advice. I have breast hypoplasia which was diagnosed by a laceration consultant after DD failed to gain weight. She also had a TT. We mixed fed successfully until my pregnancy with DS, and now she still likes a go although I wouldn't go so far as to call myself a tandem feeder! DD is 22m.

Trying to figure out what to do was a bit of a nightmare - we eventually wound up offering formula after every feed. It can feel like the worst of both worlds - hassle of bottles and breastfeeding!

Doing similar with DS who is 6 weeks. Biggest problem is my mental adjustment in coming to terms with not being able to ebf.

Sorry for typos - on phone and trying to do tea time...

We also had erratic weight gain - DS put on half a pound in four days, I thought things were fine and then only 4oz in a fortnight.

My wee one has been combination fed since about 5 weeks due to very poor weight gain. It took 8 weeks to regain birth weight. Tiktok gives great advice, I just wanted to reassure you that you can do both successfully. I give a breastfeed then offer a top-up with formula (which he sometimes refuses and sometimes takes the whole bottle). We've done that for a couple of months now. Overnight we set an alarm and wake him up if he's slept so that he goes no longer than 4 hours between feeds overnight, and 3 hours during the day. He cluster-fed in the evenings after we began topping-up but that has now settled.

Because my wee one's weight gain was so shocking (probably due to some impressive reflux and vomiting), paeds advised us to offer him the full volume of formula that he would need if exclusively FF. At the moment that is 4oz of formula.

There is light at the end of the tunnel and it does eventually get better.

Thanks Monster I'm going to start doing similar I think.

Bad news is my period has started despite me feeding him at least 10 -12 times a day. Something just isn't working I feel such a failure. I honestly just always assumed I would breastfeed. I guess I'll get over it.

splendide I remember a thread on here where everyone was moaning that their period came back soon even whilst EBF and they were appalled! Do a board search to find sinilar stories.

Sadly, I think the "no period" thing is something of a myth. In other words, its entirely normal.