Reducing formula top ups & increasing breastfeeding for prem baby

[Mrshallsy]

Looking for advice....I have a 22 month old girl and a 10 week old girl who was born prematurely at 35+3 due to static growth. We were 8 days on NNU and were discharged breastfeeding with top ups when required following the removal of an NG tube advised to used bottles (which I never wanted to use 😫). She never lost any weight initially but her weight gain was very slow so was advised to add two 60ml tops ups a day which increased to 60mls after every feed of a prem formula to give her the extra calories to gain weight (also had a week of high energy SMA formula to encourage weight) we were then signed off by the NNU community team as she was gaining excellent weight, however I am now stuck with not enough breast milk to satisfy a full feed and am continuing with large top ups. I am desperate to decrease the the top ups entirely and breast feed exclusively. I'm looking for advice on how to do this I have tried giving less formula after each breastfeed but she is then unable to settle without extra formula. I am not sure if expressing after a breast feed will increase my milk supply? But I know this will be difficult breastfeeding, bottle top ups and expressing altogether while chasing my toddler around 😫😫 PLEASE LADIES HELP ME!! I don't want to give up breastfeeding but am struggling with doing both types of feeds😘 xx

Do you put her to both breasts for each feed?

The only way to really increase supply is to get your baby to demand it by feeding as much as she needs.

If she only feeds from one side in a feed, put her to the other instead of topping up. If she does both sides, put her back on side 1 instead of topping up.

You might have to deal with a lot of swapping about whilst your supply builds up

Congratulations on your baby!

Fellow prem mum here.

Breastfeeding is much more effective at increasing your supply than expressing would be. So just have baby at the breast as much as possible; let her have both sides then put her back on the first side again, and repeat. Let her 'play' on the breast even if she's not feeding purposefully; all the nipple stimulation encourages your supply.

Make sure you're feeding tonnes through the night; night feeds trigger the right hormones.

Remember it's normal for babies to cluster feed. Brand new babies will often go hours feeding constantly without 'settling' - that's a normal, healthy behaviour and not a sign there's insufficient milk.

I've had success with lactation cookies - I think there's only anecdotal evidence really but I find a significant increase in my supply when I eat them, so maybe worth a try...?

Good luck. You're doing an awesome awesome thing for your teeny tiny treasure.

Didn't want to read and run but keep up the bf. My ds was born 33 + 2 with iugr couldn't be bf due to various reasons and it devastated me. I wish I had advice for you but all I could suggest is talking to your hv. Also expressing after a feed will increase your milk as you are tricking your body into making more in demand
for you

P.S. I'm also a fellow preemie mum to twins! My girls were born at 26+1, and I'm still breastfeeding at 10 months

I fed only from one breast in hospital and then expressed from the other side then when I got home I was told to breastfeed from both which was brilliant to start with as she was very satisfied then started spending 45 mins on each side so I was told to limit feeds to 20 mins and then top up 60mls. I haven't seen her content from a breast feed (both sides) from that moment which I think was when she was about 6 or 7 weeks old?? Also in this time when she was 37 weeks she was in intensive care on a ventilator from bronchilitis for just under 2 weeks so I feel like I've been constantly playing catch up with breastfeeding. Dare I say it but she is annoyingly going too long at night between feeds 4-6hrs and even if I set alarms for 3hrs I just sleep through them and the only thing to wake me up is her which is generally a lot longer than 3hrs. I know night time feeding is the best to help milk supply but I just can't seem to wake up to an alarm :-( I will look into cookies, I've just bought some tea with fenugreek in hopefully that might help too? X

Don't limit your feeds - if she needs 45 mins, or 2 swaps onto different sides, that's fine. That's how supply increases. I suspect your issue is that because you top her up, your supply hasn't increased in line with her demand, so you sort of have to go back to the beginning and start again

Yeh that makes sense, when we dropped her top ups in NNU they basically shoved me in a side room and just said FEED HER breast only! Haha and this worked within 48hrs she wasn't having any top ups through NG it's only when we got home that the community team introduced top ups again. I know you're right shes growing and instead of getting more breast milk she's getting more formula :-(

I know nothing about BF prem babies but I wouldn't have thought limiting feeds to 20 mins was good advice. You need to get her feeding as much as possible and yy to feeding overnight as much as you can! Good luck!