Those of you who have been told to top up with formula when you wanted to keep breastfeeding

[hunkermunker]

What did you say?

Who told you to do it? Did they suggest any other ways to fix whatever issue they thought the formula would solve?

Did you?

How did it make you feel?

Did you continue to breastfeed after you'd topped up?

I'm sure you're all sick of my story re DS2's low blood sugars, so I won't bore you again with it - suffice to say it made me feel upset, undermined, angry and like I'd been punched in the stomach - here was somebody who was meant to be trained to support me to breastfeed and failing to do so.

You know my story, hunker (hello ), but for the benefit of the thread:

ds slightly jaundiced, day 3, still in hospital, mainly because of me at this stage (had lost a lot of blood, felt fine though). They had me test weighing before and after every bf. ds sleepy and in hindsight probably not feeding often enough, but no indication of this, no advice to express colostrum, nothing. My milk was literally coming in on that afternoon. Doctor told me to top up. I protested as I knew that would interfere with the bf. The response was direct emotional blackmail: 'Do you want your ds to be well?'

Topped up. Felt shite, particularly as after a few days and once we were home he started refusing my breast. (Oh, and the topping up didn't prevent the jaundice worsening and him having to have a couple of bouts of phototherapy).

Tried and tried and tried him at my breast, putting up with refusal, scratching and crying Topped up with EBM and formula until he was 3 1/2 weeks and stopped refusing, with EBM only until 4 weeks, exclusive bf thereafter and still bf today, with him at 2.3 years old and me at 36 weeks pg.

Had very, very dark moments during those 3 1/2 weeks. Hated giving the formula, hated ds 'rejecting' me. Occasionally felt quite desperate.

Oh, and I edspised myself slightly for having 'fallen over' and topped up so quickly. I am actually not the type to be so railroaded. But it was a long and exhausting birth and the people there were really not used to having patients disagree with them. The MWs were dreadful in that respect - they just did not to explanation or discussion of any kind with patients.

Hunker, I was told to top up with formula by my GP at my 6 week check after DS1. The only reason was that I was tired (who isnt with a 6 week old baby?) and she told me I needed to get more sleep. DS1 was a big and bonny (if screachy) baby, gaining weight and generally thriving.
I was very surprised, decided I didn't much like her idea (giving formula for no real reason) and looked up info on line about topping up, found kellymom and mumsnet and never gave him formula. He was breastfed until he was 2.

Berolina what a story! Well done you. That was really tough.

Health visitor (and MIL) with all 3 DCs. Suggested top-ups because the girls cried a lot and DS1 because he was quite low on centile chart. Neither suggested anything else. All had varying degrees of reflux. DD1 had severe milk allergy, I did try her once on WySoy and she hated it. DS1 is still low on centile chart, just like his Grandfather.

Mind you, this is the same HV that suggested my DD1 (with the allergy) had yoghurt as she wasn't getting enough calcium

MIL was convinced that DD1s reflux was because she was allergic to b/milk. Draw your own conclusions...!

Sorry, forgot the important bit. I disagreed with HV, I never gave top-ups to the girls but DS1 was on expressed b/milk and I couldn't keep the supply up so he was ff from about 5/6 mths.

I generally felt pissed off when I was told to give formula for no good reason. The DCs were all healthy and thriving.

Thanks, ladies

Berolina, you're a star.

Pannacotta, that's just the sort of thing I mean - no reason to top up, just given as "get this woman out of my clinic" advice.

Duchess, agree, it's the "no reason" that angers me.

At 6 weeks I was told to formula feed as dd1 has lost weight. Completely panicked and just did as I was told. Still bf'd for 6 mths.
Dd2 I topped up with formula from 3mths and bf'd for a year.
Dd3 was taking a bottle after I came round from a caesarian (I won't even describe my anger at this) but I bf'd for about 9mths.

By taking maybe 2 lots of formula during the day I felt the pressure taken off (e.g. stress about not producing enough etc) and felt it was the right thing to do - I had pnd with all of them. Perhaps not what everyone would consider ideal but worked for me.

topping up worked fine for me. Had real probs bfing at the beginning (prem and jaundiced baby...) and it took me to six weeks (plus private lactation consultant) to get it sorted. Topping up in the mean time took the pressure off and allowed us both to focus on learning to bf.

If it hadn't been for a bit of formula, I would have given up altogether. Instead, I carried on to eight months.

Also, because she got used to bottles early, she didn't have any problems switching onto bottles permanently later. For me, the topping up advice was good. Ok so I didn't get to exclusively bf but I really didn't care about that. BFing to eight months felt like a massive achievement to me.

I find the emphasis on exclusive bfing a bit offputting tbh. I think it makes the best the enemy of the good, to use an annoying work phrase.

Use of formula in individual, supported situations can indeed prolong breastfeeding - I have seen this happen many times.

But far, far more often, I have seen formula top-ups usher in the end of breastfeeding.

Formula is an intervention - needs careful handling for a positive effect rather than a negative one.

margo and hamster - great that it worked for you.

DD born at term weighing 2.4kg and had to have blood sugars done as it was the protocol although all agreed she looked perfectly healthy.
BF after birth and sugar OK but then they forgot to test it in the night and next am was 2.6. I asked for help to BF her but instead was told in v patronising tone that she needed to have formula. Was cup fed, threw up, then tube fed and threw up finally wound up in SCBU on a drip where she stayed for a week having tube feeds of EBM. I was not allowed to BF her for most of that time was told it would exhaust her.
At the time I just did as I was told convinced she would die otherwise but now I wonder if the whole problem was of their making. Maybe she was sick because 40ml formula was too much. She never threw up the EBM. I had quite a struggle to get them to take the tube out even when she was BF really well and throwing up the formula top ups.
Now exl BF at 4 months and never wavers from 0.4th centile. I felt guilty for ages that she had such a bad start though.

I topped up for two days. Milk took 6 (I think) days to come in. I was anaemic, exhausted and fed up. DS jaundiced. Doctor in hospital suggested it at 4 days. Bit sniffy. Midwife fantastic though. Said it was entirely up to me. But she would make sure that ds was a breast fed baby. I trusted her. We decided that a few top ups would help me relax and stop fretting about starving ds (she assured me I was not starving ds ). I fed ds, and then she gave him a bottle of formula. He had about half an ounce. Did it twice more. Milk came in. Relaxed. No more top ups.

I'm pretty sure we could have missed out the top ups. In fact, the midwife made it clear that there was no pressure. And it was about me, not ds . But I can't think it was the wrong thing to do. She was so supportive of me during the 6 days after ds was born. She taught me how to position him, and encourage a good latch. When she said it would only be for a couple of days I believed her. And she was right.

mamadoc, better to be angry than guilty!! Not your fault at all - you were listening to people you trusted. I agree with your assessment of the situation, though.

Feel proud and magnificent you overcame that difficult start

Thanks Tiktok. My HV is excellent not a thing you hear too often on here. She never suggested top ups and just reassured me that DD is a small person. That and coming on here are the secrets to our success!

DS would not feed after a loooong labour and both of us were shattered. I was put in a private room and told to ring for help when I wanted to BF. No one told me when this should be and DS just wanted to sleep. After a couple of hours of waiting for him to cry (as I thought this was the sign he wanted feeding) I rang and various people came to 'help' us but couldn't get D latched on. They would always say for me to ring again when I wanted to try but the 'helping' was getting progressively rougher and DS and I were both getting very distressed.

Eventually he had one feed and everyone acted like the problem was solved, but no one showed me how to do it for myself they just shoved DS poor head at my breasts. I was reluctant to get the staff to do that again but couldn't persuade DS to feed by myself.

The hours ticked by and after 8 hours since birth I was told he needed a blood test. Result was low blood sugar (I have no idea what the score was) so he had to have formula top up, but I was advised that this would not scupper BF.

Unfortunately they handed me a bottle and no one told me about syringes, cups and other methods of getting milk into DS, or expressing. So, for us BF was scuppered as DS had been traumatised, so had I, and DS thought that milk came out of teats, not breasts. Thos 'top ups' would have led to him having no breast milk if I hadn't had been told at antenatal classes that if you don't feed/express then the milk dries up, so I insisted (practiacally had to force the MW to fetch) on an expressing kit. I did contact the LLL and had wonderful help but sadly BF direct never worked for us as it took 8 weeks to stop screaming at the sight of my breast and I kept having to go back to hospital with infections (not the hospital's fault), so I gave up trying after 4 months and just carried on expressing.

Sorry Hunker, I meant to answer your question and seem to have held a self couselling session instead I got talking about DS birth yesterday and it brought up how sad I was about the BF again.

Nine.....this rough handling is something breastfeeding counsellors feel very strongly about. It really does put babies (and mothers) off. Some babies go stiff and unable to latch after this sort of 'treatment' (which can happen not necessarily straight away but a day or more later); some babies switch off and go to sleep; some babies go ballistic.

Margo, I agree that sometimes a bit of formula can prolog bfing and I've seen it happen.

But what I find offputting is how quickly HCPs will say "give him a bottle" without any kind of discussion with the woman, no acknowledgment that it might mean the end of bf if she does, just no bloody thought for her feelings on the subject whatsoever.

well that's true. It wasn't said in the overall context of helping me get there in the long run. They just advised topping up without discussing with me how to make sure bfing continued in the meanwhile. HVs and midwives all utterly crap on the subject. It just so happened that it helped me (that, and the more than £300 I spent on the lactation consultant!)

On the positive side TikTok, I know enough about it that next time no one will even so much as touch my baby. I have made lots of friends at the LLL and a leader would come out to me in the hospital if necessary, so there is no reason everything should not work out next time.

Hmm, it's interesting this because on this bf peer support course I've done we looked a bit at low bloods sugars and the complete lack of decent research about it. There is apparently no medical consensus about how low a blood sugar = significant hypoglycaemia (mostly because it's a continuum). A study into it that is often relied on was in fact based on a group of formula fed underweight pre-term babies, yet is extrapolated to all babies (it's the one that says sugars should be more than 2.6mol). But bfed babies tend to have lower blood sugars than ffed babies as normal, plus feeding larger volumes of formula (rather than the drips nd drops of colostrum) fills the baby's tiny stomach up and makes it less likely to feed, and so can compound the problem. (Not that I am saying that there aren't times when a baby is hypoglycaemic and does need intervention, I'm just suggesting it's under-researched and over-relied on sometimes.)

I have a friend who is a paediatrician and he told me the same thing: There is no real evidence for testing or what levels are normal. Apparently hospitals differ a lot in their policies on it. He thought it better to go on how the baby looks alert/sleepy, muscle tone etc.
I do find it hard that things are so protocol driven eg my hospital insisting on 4hrly tests for all babies under 2.5kg. It is hard as a 1st timer to go against them but maybe next time I'll just politely decline

Where I am they don't do the blood sugar testing. I'd never heard of it in fact before reading it on other threads. Asked my DD's paed about it once and she said it was a load of bolleaux, a totally outdated method and proven to be unreliable. She was also astonished that it was still being carried out in what is considered to be a "progressive" country.

dd - born weighing 2.5kg (because she is naturally petite but they wanted to say "small for dates"), jaundiced, very sleepy. She fed at birth and again a couple of hours later. Woke a couple of times in the night, had 2 sucks, went back to sleep. They made me express at 1am and she had 15mls off a spoon. At 5am they tested her blood sugar and said it was ok. At 11am she still didn't want to feed and we gave in to them and gave her formula from a cup. That night I agreed to them putting a tube in her nose. After that I attempted to bf every 3 hours and topped up with formula via the tube. Took about a week to move to fully bf. I wish I'd known what levels of blood sugar were ok, and how long it was ok not to feed for.

ds - born by emcs at 34 weeks. In SCBU they started him on tiny amounts of glucose water, wanted to move him onto formula (through feeding tube, no sucking reflex) and we kicked up a fuss and refused. So they got breastmilk from the milk bank at the hospital (the Rosie in Cambridge). And moved on to my milk as I managed to express. Bf'd for 8 weeks, constant pressure from hv, gp and hospital doctor to top-up as he wasn't gaining weight and was sleeping all the time. Eventually gave in. Felt like my milk disappeared overnight after that first bottle - ds kept hunting and sucking and crying. Gave more bottles. Ds put on masses of weight and woke up and started crying and smiling and acting like a baby ... Hated giving him formula, don't know what else I could have done though. Would have liked to try the babymoon thing but non-suportive dh and no childcare for dd.

I'm pg again, and its likely to be born early. I need to hunt out the threads on expressing colustrum before the birth I think. And have the blood sugar info written down to take in with me.

Hi Hunker, the HV said I should give my 10 day old porker (on 91st percentile for weight) a formula feed as his last feed of the night. Her rationale for this was "he's so big, he'll never go more than a few hours on just breast milk and you need to sleep, he'll sleep longer on formula" she also said that it would be nice for DP to do the feed and give me a rest. I thought her advice was odd as I was not actually that tired cos he was sleeping OK! I just said "oh how interesting" and ignored her cos I'd read in my baby book that giving formula could interfere with the production of breast milk in the early days. I think if I'd been feeling tired or DS had not been feeding so well I might have taken her advice cos she's the HV and is supposed to know what's best

Ds2 was delivered by c section at 38+5 due to IUGR - he was 4lb 15oz. He fed immediately after birth, then slept, but I had trouble feeding him when he woke - managed to get a little bit into him, but not much. Whilst I was in the recovery ward, MW encouraged me to express into a cup (don't remember actually giving this to him, so he possibly bf once again).
By later that night though, he had slept for quite a long time (3-4 hrs?) and not fed, so MW (different one) tried to get him to latched on, but he wasn't interested. She was quite insistent that he should feed and said she was going to take him away to do a heel prick and would bring back some formula, which one did I want? I told her I really didn't want him to have formula. Anyway, she went away and I felt really uneasy, thinking she might give him some formula herself. How wrong I was!
She came back and said he had been sucking her finger and he had a very strong suck and if we could just get him latched on, she thought he would feed really well. So she stayed with me until he did! Once he got the hang of it (after a day or so) he was fine. Top ups were never mentioned again!
It took him about 6 weeks to reach the lowest centile; I had him weighed every week in the first couple of months and the HV's never suggested topping him up.
I think if he had been my first baby I would have given in on the first night and been persuaded to give him formula and probably wouldn't even have tried to continue bf.