Advised to stop BF but very sad - what would you do?

[Grayfig]

Hello all. We’ve been advised by our paed to consider stopping BF my wee 18 week old girl due to possible protein intolerance. Eliminating dairy and soy hasn’t really helped. She has mucousy stools with occasional blood and is quite often unsettled at night with poor day sleeps. He is not keen on elimination diets and suggested amino acid formula.

We worked very hard to establish EBF after topping up with formula from 2-11 weeks when she was slow to regain birth weight. It has been a tough time but now BF is finally easy and enjoyable for us both.

On the one hand, I obviously don’t want to harm her and know we both need more sleep. On the other, she is putting on 150g/week, happy in the daytime and developing well, loves BF and it’s the only way to reliably settle her. Also - she may still sleep poorly on formula anyway. I really feel so sad thinking about her searching for the boob and having to refuse her, and don’t want to forgo the other benefits of BF for her.

What would you do in this situation?

I don't mean to seem rude but you appear to have massively overestimated the benefits of breastfeeding and the risks of not doing so. Just so you know, the solid evidence for breastfeeding does not show improved emotional development (what even is that and how on earth would it be measured ?), effects on cognition and obesity are hugely cofounded and highly likely to be correlation, some studies show EBF babies at an increased risk of allergies and there is stronger evidence of a moderate protective effect at a population level against colds and gastric bugs. For me, none of these are anywhere strong enough to outweigh the evidence in your particular case that BF is not suited to your baby. Can you have another discussion with your doctor to explore what you see as the risks of FF?

That's a tough one then. Personally I would weigh up all my pros and cons and do what feels right at the end of the day. I'm not going to enter into a ff/bf debate. You sound like you have researched well enough yourself.

In a few years time if you start to second guess your decision (whatever it was) you need to tell yourself everything you did was with the information you had at the time. It's so easy to let yourself feel guilty with the benefit of hindsight.

I still think a second opinion (if you can get one) would be helpful for you to make the decision that is right for you. Good luck. I'm sorry you're in this situation.

Tbh I am really astonished that you have a child who has bloody stools and you're even hesitating.

My child had an unspecified protein allergy. I tried eliminating stuff, but their night time gastric distress continued and my GP said "I would never recommend an elimination diet to someone recovering from pregnancy and childbirth".

I put him on Neocate. It's rank but a tip on here was to add a few drops of vanilla extract to make it palatable and he drained it. He literally improved in a week. Slept better, no more writhing, no more horrible stools.

I am quite shocked you're trying to find reasons not to do something so immediately beneficial.

Stig I have heard of some babies with mucus/blood as an indirect result of t/t because of large supply/fast flow if they can't regulate the flow of milk and they get too much too quickly, there is still so much we don't know about the mechanics of breastfeeding.

Sycamore, as well as the benefits seen on a population level, there are very real benefits to the mother child bond that I can tell you from experience will be a huge loss - she will be very sad to stop BF, as will I.

Elspeth, obviously elimination diets are a reasonable option for some, otherwise you yourself wouldn't have tried. I think it's a big decision to forgo what I had hoped may be a year of BF in order to put a baby on a "rank" food indefinitely to address a possible protein allergy (there is no test for this and so it may not be beneficial as you say; we could be making the wrong call).

Ok I'm just gonna say it. Your 18 week old baby is not going to be "sad" to stop breastfeeding. She doesn't have the brain development to grieve.

The only wrong call would be to explore options for several weeks whilst your child is having bloody stools and gastric distress. I spent 4 weeks on a dairy and soy free diet before it was clear that he wasn't improving and I'd have to eliminate more and more from my diet and all the while be crossing my fingers.

No way.

ALL special formula is horrid. So what? It doesn't mean babies don't need it. And it certainly doesn't mean it's less deserving of a trial.

The difference in my son made me quite emotional and my regret is making him suffer for those 4 weeks unnecessarily. He absolutely thrived in Neocate and thrived on it till he was 18 months old. By which time he had zero intolerances as we'd re-introduced everything carefully.

I can't understand people demonising it. It's amazing stuff.

Hi

I was faced with the same decision. DD was covered in weepy smelly eczema. I sobbed in the pharmacy waiting on my prescription for her formula when she was 13 weeks old.

Honestly she was a new baby after a few days. Yes the formula is smelly and I did feel sad (still do) that we couldn't continue to BF but There was no alternative.

She has dairy and egg allergy confirmed via blood test. She still suffers with eczema but night and day in comparison.

If I was faced with the decision again I'd do the same, 100%.

Hope this helps.

Nope. Sorry, I agree with others. If your baby is bleeding then it's time to stop.

It may or may not be a protein allergy and moving onto formula might not of been your plan. But sure as shit, I bet you never thought bf would bring you to this.

You are confusing two issues.

1. Your child is bleeding from their gut. You have tried elimination. It didn't work. You have been advised by what sounds like fairly supportive/sensible doctor what the best next step is. Listen to him. Yes you could eliminate further food groups. But where does it stop? The picture I see is a stressed out mum, trying to eat enough of the right food to make enough milk for her baby, who might still have gut problems. For what?

1. You hoped that you would bf for a year. I hoped I would be able to bf for 3months. In reality, DD wouldn't even latch. FF from almost the get go. Did I feel guilty? Bloody hell, I did indeed. Then I copped on to myself and realised that I was making myself miserable over how my baby was fed whist she was thriving.

I am also a HCP btw. But I took the advice of my specialist on what was best for me and my child re the 3months bf plan that never turned out.

We set our own hopes and dreams about this, whilst sometimes forgetting that just because we can does not always mean we should.

My non-bf child would take exactly how ever much she wanted of her formula. Very often never finishing her bottles. She is EXACTLY on the 50th percentile for height and weight. Very rarely ill. Had a egg intolerance that was grown out of. Our bond is also very strong, given that her favourite thing is to make me sit down so she can sit on my lap always when I'm trying to clean, oh dear what a shame ha ha ha

Her cousins, 1 ff and 1 bf (same family) are constantly ill, seem to pick up every bug and have many allergies between them to boot.

Now I've said my tuppence worth, I will merely say this: this is not about whether bf is better than ff. It is about doing what's best for your baby by considering all the options and advice.

Oh and remember FED is best

Good luck in whatever you decide, tis hard this parenting lark

We had similar advice and I decided to give it 2 more weeks. I eliminated eggs and wheat on top of dairy and soya. It was the trick and we continued to 2.5 yrs old - DS was thriving and although didn't take to solids til he was about 1, I am so glad I followed my instincts. He is now 3 and can tolerate eggs, wheat and soya and we are half way up the milk ladder. Paeds were still trying To convince me to stop bf when he was a year old and clearly thriving. By this stage he hadn't had mucous poo for 6months! I am not anti neocste, we picked up the prescription and had it ready for whenever I decided to call it a day, but the elimination diet really worked and although I lost a ton of weight initially (was great actually!) within a couple of months I had altered all my standard recipes to be clear of allergens and we managed just fine. Other people could t comprehend how we got through the weaning process but honestly now he has he most healthy, varied diet and just knows to say he isn't allowed dairy if I'm not around to check. It's just one anecdotal success story but positive outcomes are always nice to hear when you're faced with these decisions.

Formula fed babies are more likely to suffer allergies.

Not true at all. In fact children who are formula fed are slightly less likely to develop CMPA. Misinformation like this is one of the reasons you should listen to your paediatrician instead of strangers on Mumsnet. These people are advising you to disregard medical advice: under no other circumstances would they do so. People really are blinkered when it comes to bf.

I agree with previous posters. The health benefits of bf are ridiculously overstated to the point where it makes me angry that vulnerable women are being lied to. Your baby has blood in her faeces. How can bf possibly be enjoyable to her when it's causing her pain?

It's a shame that you can't carry on bf when you want to and have worked so hard at it but it sounds like you would be benefitting more than your daughter.

My son is EFF and I can assure you we've bonded very well. I don't see that my bond with my son is in any way inferior to your bond with you child and the implication is a bit insulting TBH.

I absolutely hate people who say you bond better with your baby by breast feeding, totally untrue, my bond could not be stronger with my father babies. I am amazed you hesitate to try and reduce discomfort to your baby for your own satisfaction in breastfeeding

Formula fed babies

There are clearly 2 issues here. 1 is your baby being poorly and the other is the guilt and grief you will feel upon giving up bf, especially as you have worked so hard to regain that experience. I am not going to beat you for it, I tried and was not successful for many reasons with my first 2. The twins were never going to be formula fed and mentally I was better for making the decision rather than hoping and feeling a failure. That decision is for you and your conscience to make.

My experience comes from a son who briefly developed a cmp intolerance around 7-8 months of age following a tummy bug. My niece developed the same thing a short while later, however her illness never really cleared and she got worse - exploding nappies, vomiting, eczema. The works! It took a long time and trial and error to find the one brand of formula milk which did not make her ill, and it all boiled down to the specific amount of one ingredient when compared to another, but I cannot recall which. A few years later and she has been happy and thriving on a wheat, gluten, dairy, egg, nut and soya free diet for quite some time. Every now and then they have to test to see if she can tolerate any of allergens and she can tolerate wheat/gluten in very small doses occasionally. But actually she eats really well. Imagine fresh cooked veg and roast meat for pretty much every meal! She sees a dietician regularly to keep an eye on things but she is a child who is thriving. So with regards to eliminating foods, I don't see how you can not if you wish to keep bf. it isn't as hard as you think, but you need to make sure baby is getting all the nutrients she needs. If you can see a dietician who can help you work this out, I would.

Could you try an elimination diet for 2 more weeks and if it doesn't work, move on to the formula? There is a Facebook group called 'Breastfeeding with CMPA and other allergies' I've found very helpful. They are also great at suggesting food alternatives for you.

What's not clear to me from your doctors advice is how you are going to identify what your baby is reacting to. If you don't do it through you and your breast milk, are you supposed to just give them a range of food directly when you start weaning them? If your baby is reacting this badly to tiny traces of a food in your milk, their reaction is probably going to be much worse directly? So swapping to formula immediately might make them better now, but at the cost of making your baby ill at weaning time.

To Fartness, CMPA is much more common in formula fed babies. 'Cow’s milk protein allergy (CMPA) appears to be the most common MPA, with controlled challenge trials demonstrating an incidence of 2% to 5% among formulafed infants (level I evidence).1 The incidence in breastfed infants is 0.4% to 0.5% according to 2 trials (level I evidence)' from this article www.ncbi.nlm.nih.gov/pmc/articles/PMC2553152/ .

Follow your instincts. I breastfed DS on gluten, dairy, soy, sesame, sugar and nut free diet. It was hell but he was so miserable and only as we chipped away at the things that were causing problems did he get better. The only thing I felt strongest about was that breastfeeding was better for him. Actually it gave me clues to some of his more serious allergies as he reacted mildly to me eating them and more serious to him eating them.

I have no way of telling if it was the right thing apart from instinct and the fact that he has come through most of his allergies now despite years of serious reactions, he no longer has gut issues, eczema or asthma.

A small amount of eczema round his neck disappeared when I stopped at 14 months so he was still reacting to something in my milk but given that he reacts to every additive under the sun, plastics, foam, petroleum and all its derivatives, I think it was still the right decision though it hurt at the time.

No need for formula feeders to get defensive. I have used formula before so know what I would be moving from/to. Again, it is not clear cut whether formula would be a fix as it's very hard to get a definitive diagnosis in this area. So, a potentially removable component passed through BM may be the cause of this, but in response to your query, it appears to be enjoyable to her as she takes to the boob with gusto and settles immediately,

Fartniss: incorrect. CMPI is certainly more common in FF babies. Some forms are almost exclusively seen in FF babies, such as FPIES. www.ncbi.nlm.nih.gov/pmc/articles/PMC2553152/

Bonding IS different in breastfeeding compared to FF due to the extra prolactin and oxytocin release I'm afraid. It is the biological norm of mammalian feeding and is one of (not the only) way mammals ensure good mother-baby dyad bonding. I am not suggesting you are not bonded to your child, of course you are. But my personal experience of BF vs FF is that for us, they are very different beasts.

Oops MrsPanda - I wrote my last post before yours had appeared. Snap!

How you doing OP hope you are both getting along ok

Thanks Stig for asking. She hasn't had any blood for 2 weeks. She's been unsettled at night but so have all the other bubs in my mums group, this 4 month sleep regression is a killer! She's mostly been pretty good in the day and had 2 great days with long sleeps this week. So we are eliminating dairy, soy, and now wheat and eggs to see what happens. Seeing paed on Tues and IBCLC also. I will make a final decision in 2 weeks as long as she is ok in the interim. People have been very helpful on here, although some a bit judgy as it's a complex and difficult decision in my opinion. As for me...knackered but surviving and will do whatever it takes to get this little girl well.

Sounds really positive:) I think that you did get some off key responses but unless in the thick of being a BF mum of a newborn it can be hard to see the gains of the parts of bf that are different to bottlefeeding. It's not so clear that switching to ff is going to be better/easier or more satisfying for either of you. Great that you have a bit of time to decide

And I meant to say yeah that 4/5 month bit is knackering - really hard work!

That sounds very positive. Do you think it's the wheat and eggs that did it, how are you coping with the diet restriction?

Hi guys, my daughter is now 13 weeks and was born prem at 36+5 and I'm struggling to fill her, she didn't eat at first and I was in hospital for a while but now I can't seem to fill her AT ALL, it's just started about a week ago but seems to be getting worse and worse each day, she has 5oz every 2 hours but then struggling cos it's too much for her little belly, do I give her rusk or babyrice? Or is it too early??? Please help!!!

What do you mean fill her? Are you sure she hasn't reflux and is wanting to drink to quench the burning pain?

13 weeks is too early for food, but I'm not an expert, you should see a paediatrician for advice.

But she's bring anything back up, it's just once she has a bottle she seems to want something else, I give her 'infant hipp milk'and there is an alternative 'hungry hipp milk' I really don't want to put her into rusk because I've heard it can be bad so I'm thinking the hungry one might be the only option