Starting/finishing a breastfeed with a formula top up?

[mommalow]

Hi all,

New to mumsnet and new to mummyhood and looking for some advice (not judgement!) please! My DS is 4 weeks old and is exclusively BF. He started out great, breastfeeding every 3-4 hours and having lovely long feeds, but for the past two weeks this has changed drastically. In most cases I'm lucky to get 1.5 hours between feeds and at night getting sleep is simply out of the question as he has micro-feeds constantly, never actually filling him self up so never actually falling into a deep sleep.

Im wondering if starting or finishing a feed with a bit of formula from a bottle may help to fill him up a bit more, and space some time out between feeds so he can actually settle and so we can both get some sleep. As he is taking such short feeds he is also often only getting the fore milk, so his poos have been green a lot and probably explains why he can't settle. My HV said "oh simply breastfeed him longer", like it was me deciding to only give him 5 minutes on the breast and then stop! No matter how many times I try to get him to re-latch he just isn't interested. He does have a bottle of expressed milk from DH every night and is very good on the bottle - normally drinking the whole 130-150mls that is offered to him (this seems to offer at least 2 hours of sleep as he actually takes a lot of milk). This seems to be the only feed where he takes a proper amount in one go.

So - has anyone done this and if so can you share your thoughts or experiences - whether positive or negative! I know often people discourage introducing formula as it may decrease milk supply, but this isn't to replace a feeding - simply to add to it a bit. All advice welcome!

Very simply mommalow if you supplement with a bottle your milk supply will diminish. Your wonderful son has been given the best possible start in life by you and if you persevere you will look back and be glad you did. The National Childbirth Trust gives advice on breastfeeding questions - contact them with your questions.
Having said that I would suggest you try to space out the feeds in the hope of making him hungrier either by stimulation (playing with him)to keep him awake and distracted or keeping him asleep longer (try a baby sling during the day or walks in the pram, rocking, background music, white noise or a drive in the car). I remember playing with the soles of my son's feet roused him when he fell asleep mid feed but best to go to the experts for advice. He is very young to have an established feeding schedule and his requirements will change from time to time naturally.(eg. During growth spurts). Feeding on demand means fulfilling his needs and although you will miss sleep this stage will eventually pass. My first boy fed every two hours for a long time. I coped by sleeping when he did. I know it can be very hard to be sleep deprived. Just remember you are doing a wonderful job and relax. Best wishes.

Mommalow, it makes no sense to add formula to your baby's feeding,sorry :) To go longer between feeds is to reduce your milk supply. His feeding at four weeks is well within normal, and if he is healthy and gaining weight it's what suits his needs at the moment.

He will change and the gaps between feeds will get longer by themselves.

Don't get hung up on foremilk/hindmilk. I think you might have misunderstood it. It's fine for him to feed frequently and for short bursts and he is not missing out on anything.

Try and get some sleep when he sleeps, but if you find this too hard, then you're not alone. Call any of the BF helplines, and talk it through. Nothing you have said in your post indicates anything than a perfectly normal baby with perfectly normal feeding....and things will get better :)

It is the quantity of milk consumed which dictates how much milk mum produces not the length of time between feeds Ticktok. The more taken at each feed the longer the gap between feeds. That is why as baby's stomach grows the time between feeds naturally lengthens. It is normal during growth spurts for the time between feeds to shorten again. Left to feed on demand babies will get the quantity of milk they need over time.
I only suggested trying to lengthen the gap between feeds as the OP is lucky to get 1.5 hrs between feeds and she finds this unacceptable. In my day 2 hours was considered normal so working towards that would be a reasonable goal.
I agree with you that everything Mommalow says in her post indicates a perfectly normal feeding scenario. She is doing a great job.

I don't know as much as Tiktok, but I thought that leaving longer between feeds would reduce supply. There's no way to make a baby take lots more milk than they want in a feed, so how do you stretch out the time between feeds without it impacting supply?

I was only suggesting trying to space feeds a little as the OP has issues with the present pattern. To answer your question:- When baby is hungrier than normal he takes more milk. This is what stimulates the breasts to produce more. Left to himself baby will get his needs from on demand feeding which I would normally recommend. If this does not suit the mother then little changes lead to a happier outcome. Keeping baby alert by playing with him during waking periods or encouraging him to sleep longer (see earlier post) will ensure that he is hungrier when eventually feeding and will take more. I would never allow a baby to cry.

Frequency is very important fir supply building in the early days. Spacing out feeds isn't helpful to increase supply

This
www.emmapickettbreastfeedingsupport.com/twitter-and-blog/the-dangerous-game-of-the-feeding-interval-obsession

I did this once a day last thing at night......for over 2 years.

Mix feeding worked well for me but I haven't heard of others who mixed fed for so long. I started on one bottle of formula per day at 2 weeks old.
I also pumped once per day to keep supply up.
I recommend the NUK tears as they have low flow so your child doesn't get used to the fast flow avent bottles.

Esspee, increasing the interval between feeds reduces supply. To deliberately make baby wait longer to make the baby take more reduces supply. It may not matter with a baby who's thriving and gaining weight ok. But as a matter of principle this is not how it works.

Clearly my NCT counsellor training is out of date. Good news is the OP hasn't got back to us so she must be doing OK.

I'm currently training as a counsellor Esspee and haven't seen any info to support what your saying.

As I said, clearly my training is out of date. I accept that. I am a grandmother and in my day it was a case of supporting the mother's wishes and trying to find ways to make it work for her. The demand and supply was, we were told, to do with the total amount of milk consumed not the time between feeds. This is assuming that the spacing was within the normal range. I accept that since those days recommendations may have changed.

I'm a peer supporter so know next to nothing

OP, have you looked at adapting what you are doing? Sometimes it's quite freeing to accept your baby's sleep and feeding patterns as normal and look at it from another angle. So can you feed lying down so you're both resting? Have you tried a sling? Do you have help and support close by? Somebody to take him for a walk or watch him while you rest? Are you getting enough food and drink of good quality (for your needs, nothing to do with your milk)? Enough of a break or enough help to make feeding your priority?

I know it's so very exhausting but it will get better. It's early days.

Wardrobe those are great suggestions

Espee, you are right that knowledge has moved on. Increasing gaps between feeds to more than the baby indicates allows milk stasis which puts a block on production. It's still the case that milk removal drives production, so in that sense demand matches supply.

I am an Nct breastfeeding counsellor and we still do work by following mothers' wishes and making things work for them :)