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Infant feeding

Get advice and support with infant feeding from other users here.

Original poster

mixed feeding advice and the gut

29 replies

PaolaM · 06/08/2015 10:36

Hi Ladies, I'm new here.

My baby is almost 5 months old and has been roughly 50/50 combination fed from the start due to weight loss and dehydration. I had a c section.

He never learnt to breastfeed properly, refused even slow flow bottles and on top of that for some reason didn't gain well on breast milk alone. He comfort nurses but it tends to send him straight to sleep. I've been expressing so I have lots of milk but perhaps it's not creamy enough or I cant express the hind milk, who knows... He gets hungry roughly 2 hours after breast milk and 3 hours after formula. He seems to have some reflux too. I give him goats milk formula and some probiotics because DH is allergic to cows milk and it's supposed to be closer to human milk anyway. Because of our family history of allergies I'd like to do my best to heal and support his gut but I'm at a bit of a loss here. Any ideas what to do?

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Peppasmate · 06/08/2015 10:45

I rarely ever tell people to do this but i really think you need to speak to your HV.

Formula is digested slower then breastmilk so that's why he gets hungry more quickly after being breastfed.

If your baby has reflux, there are medications available but if you've got to 5 months, I would perceiver as often it improved once solids are introduced.

I don't really get about healing his gut, why would it need to be 'healed'. I think if he had a cows milk allergy it would be quite obvious by now.

Good luck. Hooe things improve.

2-3 hours is a normal amount to feed a baby of 5 months.

Original poster
PaolaM · 06/08/2015 11:22

Thanks, Peppasmate. I have spoken to a few HVs... They said we could try gaviscon but it's likely to cause constipation and generally wouldn't treat him unless the spitting up continues once he's on solids. He never has cows milk and I avoid it at the moment too because of the breastfeeding so I'm not sure we'd know if he can tolerate it yet. I'm hoping that introducing it later will help avoid the problem altogether. Healing the gut, I guess what I meant is that he's not exclusively breastfed and wasn't delivered natirally so that's not supposed to be optimal for gut health and avoiding allergies...

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Bellossom · 06/08/2015 11:28

Have you read the latest allergy advice? It doesn't recommend exclusion like you've done. I'd speak to a HV and try and get a dietician referral so you can work out what you can feed. I wouldn't worry about gut now as evidence for that is shady anyway and you'll be starting solids

Bellossom · 06/08/2015 11:29

I also wouldn't worry about creamy milk / hind milk. Feeding every 2-3 hours isn't unheard of and if you exclusively fed you're production would increase

carriebrody · 06/08/2015 11:31

Feeding 2 hourly is 100% normal for breastfed babies btw.

Original poster
PaolaM · 06/08/2015 11:48

Thanks for your replies.. Ah I don't mind feeding him every 2 hours but every time I tried to cut out the formula his weight gain stalled and he was unhappy... It took us a full month to get him back to his birth weight initially and only after putting him mostly on formula so there is something going on with my breast milk. I have lots, a full freezer and have now started throwing away some of the first milk I expressed to make space... Sad moment :(

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Original poster
PaolaM · 06/08/2015 11:50

The goats milk formula was recommended by a lactation consultant I saw... Seems like a good product and he's happy on it

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crazytyke · 06/08/2015 12:55

Why are you throwing away ex pressed bm and giving formula?!

I'm a mix feeder and FF, but even I think that's a bit crazy!

Original poster
PaolaM · 06/08/2015 13:01

Because he stops gaining weight when I give him more breast milk. I've tried a few times. I'm trying to give him more again now, let's see... I know it's a bit crazy and it's not what I wanted or intended to do. That's why I'm trying to find out more about what could be causing this situation and see if I can change things...

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Laquila · 06/08/2015 13:08

Hi OP, does he feed from both sides when he bfs? It can be very hard to know how much a baby's getting when you're breastfeeding - how much you're able to express is not necessarily indicative of how much he's taking in.

Do you know what centile he's on?

Was he ever checked for tongue tie?

Mum2babelle · 06/08/2015 13:17

My little girl had cmpa. We didn't realise until we tried formula at 4 months. We then switched to a prescription formula. I tried to change diet and it made no difference. I still don't know why that didn't work to this day (she's 22 months now and only allergic to egg now).

Reflux for us only got the better when she was on more solids less milk so 10-11 month point and disappeared when the bottles went at 12 months.
Gaviscon and ranitidine helped but not much. We didn't get constipation - the Breast milk prevents this so as long as you keep a bit of boob milk should be ok.
Try gaviscon and when ready wean.

Mum2babelle · 06/08/2015 13:20

Oh and gut wise try a probiotic (c section baby here too) but in droplet form not powder. As the powder caused constipation.

Original poster
PaolaM · 06/08/2015 13:23

He's on the 25th and yes, the lactation consultant checked him so he shouldn't have tongue tie. He rarely takes the second breast, either falls asleep or refuses it and just won't latch on (but might take a bottle anyway). I also tend to give him most of his feeds (BM or Formula) in a bottle now as he won't always accept the breast (teething so that's not making it easier and might refuse a bottle too but less often).

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Original poster
PaolaM · 06/08/2015 13:27

Mum2babelle, I've been giving him the biogaia drops for a few months already and have been trying optibac for children in the last week. Do you have any suggestions of what's worked for you?

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StoryOfMyLife · 06/08/2015 13:34

My daughter (who is 3 now) has cmpi and had similar symptoms, not great weight gain and reflux.

You said you've excluded dairy from your diet, have you cut out all dairy? There is dairy in so many products, crisps, bakery etc. you need to read labels religiously.

Saying that you really need advice before excluding from your diet, I was referred by my GP to the kids hospital dietician.

I ended up expressing exclusively with my daughter because she didn't regain weight on breastfeeding alone. I didn't top up with formula (I got some prescribed incase though). Have you tried topping up with breast milk in a bottle instead of formula?

Coincidentally my daughter tolerates goats milk products now but still not cows dairy.

Original poster
PaolaM · 06/08/2015 13:45

No, I haven't excluded all dairy but I'm avoiding it. I eat goats and ewes cheese (since he's having goats milk formula I didn't see the point of giving that up). And he does gain weight with the formula so I don't think he's intolerant to it. I might have the occasional ice cream or piece of milk chocolate or a slice of pizza but it's like once a month, if that. And I avoided all dairy religiously during my pregnancy. But yeah, I discovered there were milk proteins in a type of salami I was having a few months ago so yes, you never know! It's beyond me why they's add it but there you go... the processed food we're sold these days! I meant to express exclusively, hence the freezer full of milk. I give him his BM feeds mostly from a bottle.

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Mum2babelle · 06/08/2015 13:46

Hello. I would have said those! You are doing all you can gut / immunity so don't stress about that.
Have you been referred to a dietician?

marmaladegranny · 06/08/2015 13:55

Would it be worth going back to, or to a different, lactation specialist? Your situation sounds very much like the problems my DD had with her DS - on third visit to lactation clinic one of the advisors realised that her DS had a non-standard (?sideways) tongue tie and once that was dealt with it was a whole new world!

minipie · 06/08/2015 14:06

Yes this sounds like DD too, whose tongue tie was missed by several hcps and only picked up at 4 months. Might be worth a re check?

However that wouldn't explain why he gains weight on formula but not on EBM. That is weird! Could it be coincidence ie the weeks when you were giving EBM were slow growth weeks anyway (as they don't grow in a linear way)? If you express and leave the milk in the fridge for a few hours, it should separate and have a thin layer of fat on the top - does yours have that layer?

please don't throw away your EBM!

Original poster
PaolaM · 07/08/2015 10:11

Yeah, I might have to have him re-checked then! The thing is, if he starts feeding at the breast, then I can BF him for a lot longer...

My milk does form a thin layer of fat on top. Used to be thinner though and the milk looks less watery now, also after it has separated (I can't tell it apart from formula anymore excepts sometimes it's more yellowish) so maybe while I was expressing often enough to establish supply perhaps I was not expressing for long enough at each session in the early months. But it all sounds within the ranges of normal, so who knows?.. 2 more of my girlfriends have told me their milk had been way too watery and both gave up pretty soon. Actually one of them is a nurse and ended up expressing for 6 months for her first child but said her milk wasn't creamy enough for her second one. She blamed it on having a c section and right after appendicitis so 2 surgeries at the same time after a very difficult pregnancy. I know she saw the difference in the milk between the 2 kids. Maybe it can be stress, too.

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Original poster
PaolaM · 07/08/2015 10:14

And if I just tried the BM in the slow growth weeks, that would have just been bad luck :( Just trying again to see how he does on it. So far he had mostly BM yesterday and 2 bottles of formula and looks happy for the moment.

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Original poster
PaolaM · 30/08/2015 13:14

I've decided to have Alex re-checked for tongue tie, I've noticed now that he has an upper lip tether, which apparently might also cause problems with breastfeeding as well as a gap between the front teeth! Surely enough, I have that too and I have a gap between my teeth and my husband doesn't have it and no gap, so I definitely need to look into this. Who managed to finally diagnose tongue tie in your babies? Any recommendations for doctors/clinics in London?

On a positive note, whether it's because I've been taking lecithin which might help expressing or just bed luck before, I've fed Alex breastmilk only in the last few weeks and even though he's teether and fussy, he's been gaining weight normally. And when he wasn't teether he actually got really chubby. I can't believe I've had so much bed advice about how to feed my baby and regarding the quality of my milk, as there's clearly no problem there, at least not at the moment! Pity, as he could have had beast milk only all these months...

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Lilipot15 · 30/08/2015 15:47

Can I ask how you give the probiotics and when you started?
I didn't know there was an infant formula with goats milk.
I would second advice that you consult with a dietician to check your baby's intake of vitamins (although I see lately he's been on breast milk - well done) and just as importantly your own calcium and vitamin D if you are minimising your own milk intake, as you need to make sure neither of you are deficient in them.
My first DD had CMPA, sorted by me cutting out dairy whilst BFing but I needed dietician advice to ensure my own calcium intake (increased demands whilst BFing and not enough in the breastfeeding vitamins alone).

Lilipot15 · 30/08/2015 15:48

Ps I ask about the probiotics as both my DDs were born by c section and I'm interested.

Original poster
PaolaM · 30/08/2015 17:15

You just mix the probiotics with the feeds (if the baby is bottle fed) or the drops can be given with a spoon or directly in the mouth... I've been giving them since he was 2 months though not so religiously now he's on breast milk only but will probably continue.

I'm eating dairy, just avoiding cows milk products. But I have goat and sheep cheeses. Quite a bit these days, too after restricting my diet for so long, tbh :)

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