Formula top ups

[winohhh]

Just been to get 10 week old DS weighed and he's dropped below the 1st centile. We breast feed at the mo, but been told to top up with formula. I'm feeling pretty shit and feel like I've been starving him. They recommended formula weeks ago and I persisted with just breastfeeding, and now feel awful.

He had a tongue tie diagnosed and clipped at 5 weeks, and has been struggling with oral thrush for the last few weeks. We've seen 2 private lactation consultants, the breastfeeding midwife, the nct breastfeeding support person. I've really tried to ebf, and feel shit that I can't, and shit that I delayed formula so he's now so little.

Any positive stories about combi feeding? Will I be able to carry on breastfeeding or will my milk dry up eventually?

I am in no way a regular on here or an expect but firstly, stop blaming yourself. Tongue tie can make BF incredibly difficult especially if mothers aren't given adequate support. There is no reason why you cannot give him some formula whilst continuing to BF. And with support and if it's what you want, as he gets stronger you can return to EBF. You're probably in a catch 22 of him being starving hungry and not strong enough to improve his suck and latch. Give him a bottle for now and just see how mixed feeding goes for both of you. (I'm sure I'll get flamed for that though!)

Meant to add , it's not that you've been starving him it's that he's had tongue tie and oral thrush which is nasty so he has struggled to feed.
Have you been treated for the thrush? You are probably just re infecting one another if you're not completely clear.

It's TOTALLY possible to top up with formula and keep bf, if that's what you want to do. Please don't blame yourself for wanting to do the best for your baby.

Have a look on kellymom.com for lots of useful info, and maybe try contacting your local La Leche League group for support, or calling their helpline?

The important throng to remember is that you'll have to do plenty of pumping to maintain your supply whilst topping up, but the great thing about that is that you'll have lots of milk in the freezer for the future!

My son's TT was clipped at 8 weeks, and it took a while before we saw an improvement with his feeding. I honestly believe that some babies just need to practice bf before they get effective at it.

What centile was he born on?

I'm not advocating that you do nothing, but some babies are just small. Being small isn't in itself a worry, but quick drops down the centiles might be.

Has the HV only suggested formula top ups? Extra breastfeeds are an equally good suggestion of you think milk is now being transferred effectively (ie since TTC fix). Could you express and bottle feed ebm to be sure it was going in? Might be ibexes scary if you can hear lots of swallowing through normal additional bfs.

All that said, I'm not an expert, just a bf mum who frequents these boards and reads lots of the same advice over and over.

I would have suggested expressing as much as possible to keep supply up But the op has said that she can't express so either she really can't physically express or she's not getting enough support to do it effectively.
Winohhh, please don't beat yourself up. We are bombarded with how breast is best, which it is, but sometimes help is needed to get a little one on the right track and in your case that help may well come in the form if mixed feeding which is absolutely fine especially if it helps him put on weight and you to relax and regain your strength. I BF all of mine and I'm a great believer in BFeefing but maybe mixed feeding now will allow you to continue to BF for longer and as I said, it is possible to return to EBF if you can bolster your supply.

Sorry - didn't see any reference to not being able to express (and still can't, but it's been a bloody long day here).

Thanks everyone.

I'm not sure I did mention it, but can't express. Only get 0.5 oz per pump. Any tips for increasing that welcome.

He was born on 30 centile. So dropped quite a bit. A bit worrying.

I'm trying to treat both of us for thrush. We are a week in to our third treatment, so far no change! Quite frustrating!

No time for long reply- but I am still bf my 18mo old who had top ups. Will try and post longer later. You will be fine- you are doing great.

Are you using an electric pump? Some people can express more of they look at photos of their baby, as it helps generate the right hormones. Apparently milk supply is better overnight too, but it's not an option for everyone to pump several times a night. Oats are good for supply, and a friend of mine swore by fenugreek tablets.

Ds dropped percentiles very dramatically, stopped pooing altogether and I ended up weighing him before and after feeding to see how much he got, and then topped up with formula.
I was unable to up my supply, and ended up ff.

I topped up after every feed and expressed after each top up. 0.5 ounces is loads you are expressing. I was measuring in ml but struggled at the stage you are at to get 10ml each expressing which is a bit less I think. Often it was just a dribble in the bottom of the bottle. Remember, the point of expressing in this context is not to get loads of milk- if you had that you wouldn't be expressing- it is about telling your body you need to increase your supply. If you are using an electric pump you could also try a basic manual pump. It found that it really helped me using a manual pump to work out how to improve my pumping technique.

The advic I got too was that there are golden hours between about midnight and 5 am when your body produces the hormones to do with supply. I was advised to try if possible to feed twice during that period (it is a killer- but I had a higher space between the 5am feed and the next to get some sleep) to improve supply. I have more tips by my toddler is demanding. Sorry I will come back again. You are doing great.

Also as long as your child is gaining weight- not losing it- things are going I the right direction. It took my (originally 8 pound baby) months and month to hit ten pounds. But we laugh now- she is HUGE! You will get through this. I'll be back later.

Thanks everyone! I'm going to try getting a manual pump this weekend, see if that helps. I don't think it's my supply that's the issue, I just don't think DS is feeding very effectively. He's better, but still not great, and lost a bit of weight last week. I guess my supply will go down when I top up more regularly so will try to pump more then.

Thanks for the encouragement!

Hi, win, hard to tell what's going on. You say your baby lost weight last week. Can you give more details? There are no first centile lines or 30th centile lines. Are your baby's centile lines being estimated? What measures have you taken so far to increase his intake? Sounds as if you have had probs since the start. Do you feel they are all linked?

That was me estimating centiles based on the dots on the graph tiktok! Last week we stopped topping up with formula and just breast fed, on the advice of a lactation consultant. But at the weigh in after a week of breast only, he'd lost a few grams from the week before... Not much, but still, certainly hadn't put any weight on. So far we've tried demand feeding, we've had the latch checked by several lactation consultants/ midwives/ health visitors, tried different holds, I've tried expressing after every feed, taken fenugreek. I think his feeding is a bit more effective after the tongue tie procedure, but obviously things still aren't quite right. He still seems to have thrush. I do wonder if he learnt bad habits with the tongue tie, and is struggling to correct them.

I am absolutely not an expert when it comes to bf'ing but I mix fed DD1 by offering breast at each feed and then following it up with formula, so the introduction of formula doesn't have to mean the end of breastfeeding.

I can't give expert advice but I topped both of mine up with formula while continuing to breastfeed as well. Mine DD dropped from the 25th centile to the 0.4th. I tried so so hard to breastfeed exclusively but in the end it just wasn't working for either of us. Giving a few oz of formula if she still seemed hungry after a breastfeed worked for us. I stopped panicking and stressing out as I knew she wasn't going hungry and she was happy to go between breast and bottle. I was still breastfeeding morning and evening when she was 18 months.

Still not clear what's going on. It's not clear if you have tried the easiest ways to increase intake which would be more frequent feeding and using at least two breasts each time with 'switch nursing' when you can. If you have been in touch with lactation consultant you have probably tried this.

Ive tried more frequent feeding and switching breasts. The trouble is each feed can last an hour. A lot of that isn't effective sucking. So I'm constantly trying to keep him awake or use breast compressions. I wonder if sometimes he's just not hungry, but I'm trying to fatten him up!

You say he has thrush - can you talk about what symptoms you are seeing?

Do the feeds hurt?

He has a white tongue. It's not painful to feed. But my nipples can feel a bit sensitive if he's on for a long time. I did have a little rash on my nipple which seems to have cleared up now with treatment, but nothing is helping his white tongue.