Why do midwives seem so keen to get new mums to top up with formula?

[Monkeybar]

A friend of mine has a 10 day old ds, who has been losing weight (or maybe not putting any on, can't quite remember what her dh told me). Had a traumatic birth, baby in scbu for a few days etc. I visited last week and they said that he wasn't thriving and that the midwife told them they would have to top up with formula. I don't understand why all the midwives seem so quick to advocate this. I'm not a bf millitant (although exclusively bf my ds until circumstances meant he had to have a bottle mid afternoon ) and if a baby was really poorly through lack of food then of course they should have formula if that helps. But as my dh (used to be a dairy farmer) was quick to point out, mammalian milk production needs cranking up through lots of stimulation ie multiple feeds until it plateaus, so if you stop the feeds in the rising phase, you'll never catch up.
Any midwives/HVs out there who can enlighten me? (I want to support my friend, but as a bit of a NCT devotee (her, not me) I'm sure she'll feel like a failure if she doesn't manage the feeding, having already not had the birth she wanted)

maybe it has been sugested so mum gets a break and does worry so much then not becoming a vicious circle.

For a quick fix, in a lot of cases - and because they have seen paediatricians recommend formula so often. My midwives when dd was born believed what paediatricians had told them - but paediatricians aren't experts on feeding babies and it seemed to me that they really weren't bothered how a baby was fed, as long as it was fed. My experience was that where someone was struggling to feed, or the baby didn't seem to be thriving, or the blood sugars weren't high enough, a quick-fix for the paed was to give formula - for them, that's the problem solved. Dd's paed was staggered that I refused because no-one had ever done so before - he didn't "get" why I was so keen on not giving formula because "one milk is pretty much like any other".

They are also not allowed to let a baby go home until it is feeding well - and maybe theygiving formula is an easy way to achieve that and free up hospital beds. Plus there's lack of resources - sometimes there just isn't time to help a woman breast-feed and it's quicker to suggest a top-up.

Lack of information and access to breast-feeding experts doesn't help either. Because they don't always have decent training in helping a new mum to breast-feed, it's easier for some midwives to suggest a bottle of formula than to help the new mum with her latch. Plus some of them seem to believe the hype on the Aptimil bottles - wnen dd was born three of them told me that "It's as good as breastmilk" when they were trying to get me to agree to have dd force-fed formula.

Oh Monkeybar - I don't know why some midwives do this. Really what your friend needed was a review of her breastfeeding technique. Your dairy farmer friend is completely right!!!

I think sometimes some midwives/hv are not that updated on breastfeeding. Also - it takes a enormous amount of time and skill to support a woman going through breastfeeding difficulties. When you look at your diary and you have to fit in 10 calls before a really busy clinic at 12.30 - you just haven't got the time to spend 2 hours with one woman. I'm not justifying her advice - she shouldn't have suggested ff top ups without investigating other avenues first (maybe she did???). I suggest you should get your friend referred to a breastfeeding specialist midwife - there should be one at all hospitals. Just ring up the maternity department and ask to be put through.

I've had the same advice given to me in two different ways, with two different outcomes.

With ds1, the midwife insisted I must top him up after every feed. Result - he throve, but I didn't succeed in establishing a good supply, ended up mix-feeding and with PND.

With ds2, the paed suggested (strongly, but suggested) that I give ds2 one formula feed and go to bed. Result - ds2 was full enough to sleep for 3h, I had 3h sleep and was full enough to satisfy him at the next feed and so on. That bottle of formula managed to jump-start a stumbling breastfeeding relationship and ds2 throve on bm and is still doing so at 9m.

So IME it's not the formula that's the issue, so much as the way it is used.

The best thing of course is to get face-to-face advice from a training breastfeeding counsellor/supporter.

Are friend and baby at home or in hospital? Is it post-natal midwives or community midwives team?

We were readmitted at 7 days and didn't get out for another 8 days - and it only clicked last night after weeks of feeling miserable about it that of course, I didn't get the support I needed because we were readmitted to Paediatrics not to the post-natal ward, therefore no midwives and although they give breastfeeding mums accommodation and food, they don't have even the overstretched staff trained in helping women to bf they do in post-natal.

At 10 days my understanding is that it's normal for a baby to be less than birthweight, it's by 2 weeks they're meant to have put that weight back on. I wish I'd known when I was in hospital panicking that ds would never put enough weight on to be allowed home. I'd echo PrettyCandles' advice - contact a breastfeeding counsellor/group.

Same thing happenned to me - it meant they could tick the feeding box and get me discharged. Tell your frined not to be pressurised into doing anything she is not happy with - it's hard. If it is any consolation the community mw's and hv's are much better about this nonsense now I think.

Thnaks all. My friend is now at home, and looking at PrettyCandles post, maybe (hopefully) this is what is being suggested - one bottle to give everyone a break.
It is the community midwives that are advising the ff. I realise that they have to follow rules where weight is concerned, but even so, it does seem a bit mad that breastmilk isn't considered 'good' enough!

i just wanted to add that i had a tough time with first dd and she had some formula in hospital and on and off for two weeks. BUT when I was recovered i was able to pick up more and more breastfeeding and then exclusively fed her for months.

Sometimes a little break can help - dont let your friend beat herself about it - she should use the time to have a great meal and build herself up

My 3 and a half week old was not putting on any weight (was still at birth weight). Luckily I have a great HV who referred me to a BFC. She spent an hour with me going over posotioning, attachment and everything else that you could think of related to BF. Baby put on almost a pound the following week, and another the next. Now 6 weeks old and at 10lb 11. Midwives should not be pushing formula until sure that BF going well. Seems to be true that they just don't have the right training to do this.