Getting back to just BF after formula top ups early on

[Carmalia]

My little boy is 3 weeks old and we had some feeding issues initially as my milk didn't come in quickly (somewhat non-ideal c-section situation). We were back in hospital on day 5 and did expressing and formula top ups to get his weight back from 12% loss. He got back to his birth weight earlier this week.

I'm now trying to figure out how to get back to just breastfeeding if possible. He is currently getting formula about 3 times per day, but I'm a bit ashamed that it tends to be when I need to just fill his belly to get him to sleep for more than 1 hour at a time. In the day I can mostly manage to breast feed on demand, but generally i run out of steam at about 4.30 in the afternoon and he usually has about 50-70ml. I also end up giving formula last thing before bed (11-midnight) and at about 4am. Between midnight and 4am I breastfeed him at least once on each breast - usually he falls asleep after one then wants the other 15 mins later.

So what I am wondering is what I should do to get away from this pattern? I feel like I'm not producing milk fast enough to ever really fill him up, so he generally needs to feed again quite quickly. It's not cluster feeding frequency (he did that on Monday evening this week) just quite frequent. But all the feeding issues have been so stressful and I just don't seem to be able to keep going without the few slightly longer sleep breaks I'm getting from the formula feeds. Even then he gets very windy and it takes a while to settle him, we are trying infacol but i think it needs longer to work, so he doesn't ever seem to go down for long, 2hrs max. Is there anything I can do to boost supply and generally make the situation better? He gets frustrated at the breast, pulling and tugging at my nipple which affects his latch (which feels good initially and I've had it checked a few times). It feels like he's not getting enough quickly enough and this is frustrating him. I keep second guessing myself and getting worried about what I'm doing which isn't helping my anxiety :-( any advice welcomed!

I've done this twice now, second time round with DS2 who is now 18 weeks. We came home from hospital basically bottle feeding as he really struggled to latch.

You really just have to slowly reduce the number of bottle feeds and accept that he will need to feed frequently to increase your supply. I also used Medela Calma teats to try and mimic the breastfeeding action, and avoid the easy fast flow of milk from a free-flow teat.

Thanks for your reply speak no words - great to hear of success! How long did it take you to get to breast only? I have the calma bottle teats so good to know that are effective!

Following, sorry no helpful advice to offer but I'm in a very similar situation with my two week old DS. So far have got the bottle feeds down to three in 24 hours around the same time as you. Trying to phase out the 4an bottle currently. Best of luck to you!

I barely remember how as daughter now 15! But I did this, I think it was just a case of gradually reducing the bottles and I think midwife advised offer breast first each time.

I feel for you. Had the same situation here. 13% below birth weight and almost a fortnight in hospital. We got there though! Apparently the reason that the formula puts them to sleep is that it lands in the tummy with a thump. So, as you feel sleepy after a heavy meal, so do they. For me, it was just easier and a huge relief when I felt that my baby was still hungry or unsettled. I was very keen to get back to full time bf though.

I slowly reduced bottles and increased boob. Your supply will increase to meet demand, don't worry. My way of dealing with the whole thing was to accept that this was my main function - housework and anything else was unimportant. We made a comfortable nest either in the sitting room or bedroom and just stayed there (or alternated between the two). Cold drinks, thermos of tea, phone, snacks, tissues, lip stuff and radio all within reach. Audiobooks were my salvation. We just curled up together and had a blissful babymoon.

Four months later and we're a lot more active but we still spend a good portion of our day in our nest. He sleeps through the night (tonight is an aberration!) and is plump + delicious.

Good luck.

Feeding at night stimulates your supply more so than during the day.

I'd drop one of the night bottles between midnight and 4 am in favour of a breastfeed, and take it from there, dropping a bottle every few days.

I found the La Leche League helpline useful in a somewhat similar situation with my first DD.

Don't be ashamed - you are feeding your baby and doing great! Our little girl was premature and in SCBU for 11 weeks and expressing with the hospital grade pump and then Medela hand pump kept up my supply until she could breastfeed exclusively. Lots of my peers also combi fed for over a year and various different combinations. Just try and relax and however it ends up happening will be right for you (easier said than done, I know). I used to set the alarm to express once overnight while she was in hospital and I think that made a big difference to supply. Good luck and congratulations.

I did this twice... slightly differently both times, but overall, I used to express for 15 min with a hospital grade double pump after each (or most) of the feeds, and started replacing formula top ups with expressed milk top ups. When I managed to do all top ups with expressed milk, I got confident that I produce enough milk and decreased a number of top ups.
Second time round, I also used a supplementary nursing system from medela for a few days for some feeds. This way my boy was getting full faster and did not get too frustrated and continued feeding calmly (as at one point he would get upset just after a few minutes on breast and wanted a bottle). It is a bit fiddly, but really was effective for us.
It's a very hard work though, and both times I was in tears a lot... hope you get real life support. You are doing great anyway, and please don't beat yourself up if you continue combination feeding. You already doing the best for your baby!

Thanks all for the helpful replies! It sounds like we're on the right track. I'm going to try to eliminate the 4 am bottle over the next few days (easier anyway to just breastfeed overnight!) and will then work on the rest as I feel able to. I think my supply is increasing, he's been a bit more satisfied today, though this evening it feels low again - he's currently suckling though so hopefully it'll get better! Thanks again and good luck to those in the same boat, we'll get there!