Formula top-ups - too late to phase out? (long)

[Mavornia]

I gave birth to my little boy on 27 March and wanted to exclusively breast feed. However, he has been getting a bottle after every feed.

I have type 1 diabetes and it's important that babies born to diabetic mums feed well asap post birth as they can have too much insulin in their systems just after birth and a good feed can avoid the need for them to go on a glucose drip.

My son was delivered by emergency c-section. I tried breast feeding as much as I could (but didn't have any immediate support with latching him on etc and I was very woozy from medication and exhausted). I told midwife I was worried that he wasn't getting enough milk and she said I better top him up with formula after feeds until my milk came in properly.

I was very anxious about his blood sugar levels and wanted to avoid him going on a drip so I agreed.

The problem is that I have never been able to drop the formula feeds. I put him on one breast for 20 minutes, then the other, then give him any expressed breast milk I have, then give him formula.

I can never express more than 20 ml or so at a time and I use the pump regularly throughout the day to try and stimulate milk production.

I'm feeling awful about giving him bottles but what can I do when he's crying with hunger after feeding at the breast.

I just don't seem to have enough milk and I think it's too late to do anything about it now that he's nearly 5 weeks.

Any ideas greatly appreciated.

Most people can exclusively bf, so I'm sure it is not too late, you probably just need to keep bfeeding instead of giving that top up which may well mean going back on to the first side again. My ds is 7 weeks old and has been feeding for the last 1.5 hours as he does most evenings, although sometimes it is for longer. He has both breasts 2 or 3 times during his evening feeding frenzy and it does stimulate the milk well. He is growing well yet when I express I don't manage to get much out as he is just better at emptying the breast than a pump. If you don't manage to drop the top up try not to feel guilty, he is getting the good stuff from you and just a bit of extra bulk from the formula for a few extra calories.

why are you doing 20 minutes each side then ebm then formula? has someone told you to do it this way?

how often are you giving formula and how often?

the only way you will make more milk is to feed more. the amount you express is no indication of how much you have. your baby is far better at getting milk out than a pump.

I would leave your LO on the breast for longer - all of mine have fed for longer than that, even when I was convinced that there was nothing left - it stimulates more milk. Good Luck

Does he fuss at your breast and that's why you take him off after 20 minutes? If not, leaving him for longer would be a good first step.

I found that my ds just really wanted to suck for a long time. He wasn't crying with hunger when he came off the breast, just frustration because he wanted to suck. I should have just let him but my nipples were very damaged so I couldn't bear it and let hum suck my finger instead (bad mummy ).

I've read on here that babies will take a bottle after bf whether they're hungry or not but obviously to cut out the top ups too quickly would not be a good idea. Might be worth just leaving him at the breast though and see if he's happy. That will stimulate your supply much better than the breast pump anyway.

Should have mentioned that although I took him off and didn't top up, he was gaining weight well and thriving otherwise obviously I would have had to do something else.

While I was in hospital I was letting ds stay on the breast for up to hour or more - however long he wanted really.

But the when the midwife came to see me at home she told me not to keep him on longer than 20 minutes each breast under any circumstances! She said he wouldn't be getting any more milk out and would just be using my breast like a comforter/pacifier. Was this wrong advice then?

ds feeds every 3-4 hours and generally gets a top up after most feeds. He takes between 2-4oz (an odd time he has taken 5oz - which made me think he must be getting next to nothing from me).

So tired and exhausted from bf, expressing and making up bottles.

Thanks for taking the time to give me you rinput.

xox

Sorry, I'm not expert but that was rubbish advice Mavornia!!! He will use you as a comforter if he wants because babies love comfort!

Hopefully Tiktok or someone will be around to tell you how to cut down the topups safely or you could try the breastfeeding helplines such as NCT, etc. Will google them for you and post.

ok. your midwife was giving your very old fashioned advice. your best bet is just feed feed feed. it'll take a while to get things back on track if he's having a lot of formula. no need to express, just keep him on the breast for longer. forget the 20 minute thing. let him feed as long as he likes. have you looked at kellymom.com?

Mavornia, you're right to be concerned....this is the trouble with top ups, and you were just not given the right help and support at the start

You have the worst of all worlds - bf, followed by ebm, followed by formula, with expressing in between times ....all that hassle. On top of needing care for your dibetes.

Talk to someone who knows about bf and who will support you - any of the helplines will be fine. They will discuss with you ways of gradually moving over to full bf, and no, it is not too late.

But you need to start changing things sooner rather than later.

And when you feel better and things are sorted, write to the maternity unit with a copy of the letter to your PCT, and say what hard work and hassle that midwife's poor advice led you to - with you needing to recover from a section and cope with diabetes, too.

Good luck

Association of Breastfeeding Mothers
www.abm.me.uk
Helpline: 0870 401 7711
Offers voluntary mother-to-mother support, counselling and information for breastfeeding women. Helpline open from 9.30am to 10.30pm

NCT Breastfeeding helpline
Breastfeeding Line: 0870 444 8708
The National Childbirth Trust has trained breastfeeding counsellors who can offer individual advice and support

La Leche League
www.laleche.org.uk
24hr Helpline: 020 7242 1278
Helpline offering advice and information on breastfeeding, plus local group meetings.

Breastfeeding Network
www.breastfeedingnetwork.org.uk
Helpline: 0870 9008787
Offers free, confidential telephone information on breastfeeding and one-to-one local support.

Oh, and you keep on producing milk so swapping back to the first breast as suggested below will also give him more.

i should add.. if he's having a lot of formula it will take your body a while to catch up. not a good idea to just cut the top ups out straight away, it's more a case of cutting them down. the first step is to keep him on the breast for longer. and of course... take tiktok's advice.

That's great, everyone - at least I have a plan of action now!

I've heard of kellymom but just haven't had a chance to look at the site yet - will try to do that now and talking to a helpline sounds liek a good idea too.

You're right tiktok- it does seem like the worst of all worlds at the moment - but I'm so encouraged thatyou think I still might be able to move to exclusive bf eventually. I'll certainly give it my best shot.

I'm going to latch the little munchkin on now and let him stay there a slong as he wants!

Will check back again later.

Thanks everyone.

There was a thread a little while ago - the OP's name began with a 'K' I think, anyway, she went from topping up a lot to full bf...can anyone remember it?

I remember it and have been trying to search for it (on and off with DD being a PITA). WIll look again.

Mavornia - I agree with Tiktok that it does sound like you have the worst of all worlds with doing all that and expressing as well (I thought that many times when I was mixed feeding, though it was that or no breastmilk at all for my DS so it was definitely worth it). Good luck - I hope you get the outcome you want.

Can't find the other thread

is it this thread?

mavornia - with ds I had dreadful advice in hospital right at the beginning (pressure to top up, test weighing, you name it), he ended up refusing to bf, I was trying him at the breast, then expressing (hours on an electric medela for 50ml at very very best), then giving formula top-ups and hating it... I really recognise the 'worst of all worlds' feeling! BUT we persevered, ds eventually stopped refusing, and when he was 4 weeks he had his last ever bottle - of either EBM or formula. He'll be 2 next month and is still bf. So yes, it can be done.

You have to go with the frequent and loooooooong feeding. I was fortunate in that I never experienced nipple pain (beyond a mild soreness), but ds, once he'd got past the refusal phase, was really a pretty much constant feeder for at least 2 months (sorry). (But it is so worth hanging in there!) As others have said, your MW's advice was very wrong.

Good luck! I'll be around as much as I can if you have any questions

I've got a 5 wk old and bf
he feeds every 2 hrs
Maybe the ff you give is filling him up so he is not going back to the breast as often as a bf baby wold , therefore production is not as great?
I'd say stick him on every 2 hrs during the day if poss to maximise milk production?

my ds feeds 2 hrly during the day
Not at night he goes 4-5 hrs

I was in similar situation to you regarding expressing then topping up, Mavornia. Is absolutely the worst of all worlds. Had same advice as you from hospital, isn't it rubbish?. Came on here, rang NCT helpline and we turned it around. It can be done - the best advice I had was to go to bed for a couple of days with DD both of us with no clothes on and to put her on the bosom the moment she even meeped. She fed ALL the time for weeks after that but now 5 months down the line I am just SO glad I persevered. NCT Helpline were just fab so give 'em a call.

Hi Mavornia,
I was in a similar position to you (apart from the diabetes complication) in that breastfeeding didnt seem to satisfy him, relatives told me constantly that he was hungry, my nipples were so sore that when I used a pump blood came out, and i became convinced i was starving him and started topping up, and feeling completely useless. After reading kellymom.com and mumsnet, i decided to persevere and started feeding him very frequently - basically any time he was awake (all the time!) and doing the left breast, right breast, back to left, back to right thing. Also I bought some fenugreek capsules and some capsules called 'mothers milk plus'. I am convinced this helped stimulate my milk supply. I dropped the formula at 10 weeks and he is now 13weeks old and looking healthy and i am 100% happier. Is there any way you can get someone else to do all the housework and cooking for a few days so you can concentrate on bf? From what i have read it is never too late to bf - it is even possible to bf an adopted child with a lot of pumping and determination (Martha Sears did it - nurse, and wife of Dr Sears and co-writer of lots of baby books) I hope you get lots of support, Good luck xxxx

just noticed this thread. absolutely agree with the going to bed thing. your milk supply will increase, ring nct, and see if you can see someone to check positioning correct, so baby is getting full feeds,i'm sure it wil reslove- if you can let someone else take care of day to day things for a few days, so you can concentrate on baby and increasing milk supply- seems to take forever, but in the grand scheme of things, its only a few days! good luck

Just want to say you've had some great advice from others on here so far and stick with it! Wanted to add though that I've also got type 1 diabetes and my 1st 2 babies (I've had 3!) needed topping up with formula - please don't think this was a mistake or feel guilty about it because it just has to be done for their health. I had to top my 3rd one up with ebm which was absolutely exhausting as she wouldn't latch on very well but she's now 15 weeks and exclusively breastfed. Although I topped her up with either a cup or a syringe so she wasn't getting used to a bottle (don't know if anyone else has suggested that). So good luck!