Any alternative now to formula top ups?

[dotty2]

I posted a couple of weeks ago about my bf probs, so bear with me coming back for more advice...

DD2 is now 4.5 weeks old, still not back up to birth weight. Exclusively bf so far. I am anaemic after large blood loss and also have PCOS. I didn't manage to establish bf successfully with DD1 - apparent low supply then as well. I am feeding about 10-12 times a day and taking dom peridone to boost supply. Lots of wet nappies but infrequent poos.

We were referred to paed consultant at 3 weeks who was v. supportive, said dd appeared well and to give it another week. But she has only put on 40g in last week, so looks like no alternative to formula top ups now.

Also have a supportive HV who says she thinks I might be one of those rare people who really does have a supply issue.

Any thoughts? I mixed fed last time but it was hard as DD1 was never really settled after bfeeds, so suggestions for how to make that work better would also be great. Thanks...

dotty....there is definitely an alternative: top up with expressed breastmilk.

Anaemia, and PCOS, do seem to have a potential impact on supply and may make it harder for women to build up and maintain a supply that meets a baby's needs.

Expressing will boost your supply and help your baby gain weight.

You don't need to assume that expressing would be something you would need to do long term.

What do you think?

PCOS can cause low milk supply. I had to supplement at first - got quite upset about it but really it was a tiny proportion of DD's intake. I was able to stop supplementing at 5 weeks so fingers crossed you may nearly be there.

If you do decide to supplement, the way we did it was to always bf and then give a bit of formula to finish off with when DD stopped suckling but didn't seem satisfied - not a whole formula feed, just enough to settle her.

Good luck!

I have tried expressing but only get about 10mls. Also made me sore and logistically difficult with a frequent feeder who won't sleep unless cuddled, and a toddler to cope with. But maybe I should try again. How many times a day do you think?

Personally, I thought expressing would be the answer... but DDs feeds were so protracted there wasn't time and if I tried the yield was pathetic. The only way I could get anything was to express one side while DD used the other which is pretty fiddly and not nice and relaxed! It could be worth trying but I found it just added stress which is the last thing you need.

It got a lot better when I relaxed and stopped beating myself up about the odd half-ounce of formula ... then the problem resolved itself.

dotty - expressing is not always easy, you are right. The timing, the fiddly-ness, the pressure and stress are real problems

You can get more info at www.expressyourselfmums.co.uk - maybe a change of technique, a change of pump, or even hand expressing might help.

Some mums do feel on balance topping up with formula is the best answer, and overall, that is better than stressing and sweating about expressing...it's an indvidual thing, and it's certainly true that formula in some situations does help the bf to continue.
Hope this helps.

Thanks for those suggestions, both of you - yes, that's really helpful. Too tired to make a decision tonight. But I think what I really needed was some reassurance that if I do give formula it's not a total failure on my part...

Failure? No, you're doing brilliantly to get this far with low supply. And with a toddler too... I am truly impressed!

Just to clarify : when I said "Some mums do feel on balance topping up with formula is the best answer, and overall, that is better than stressing and sweating about expressing..." I meant that 'some mums feel overall it is better than stressing etc.....I wasn't giving my opinion on what was better!! I think mothers should be free to judge for themselves how much stressing and sweating they can bear to do

Would domeperidone be worth a try in this situation to try and increase milk supply?

Expressing seems to be one of those things that gets easier with practice - at least it was for me! On the other hand if you feel that formula top-ups are the right thing then there is no reason to feel bad, really

Am taking domperidone, but no noticeable effect so far.

Tiktok - don't worry, that's what I thought you meant. Obviously I know formula is not the best answer but of course it's a personal decision how long to struggle on without. It also feels very different this time round with a toddler to care for - have to think about what's best for her as well, and just how much TV I can let her watch on lovely sunny days while we're all camped permanently on the sofa.

consider some other things too, domperidone often works if there was a hiccough with the feeding earl on as it kickstarts the prolactin to start working again. A large haemorrage can shut or slow down the pit?uitory that makes the breastfeeding hormes, so hang in ther a bit whilst it recovers.

Don'y drink too much fluid i.s. drink to thirst and need et. but don't thinks that you should be drinking extra - it reduces milk supply. Don't drink peppermint or sage sage tea that cn reduce supply. You 'could' try fenugreek capsules, oats, nettle tea, blessed milk thistle etc.

Even if you can only manage 5 minutes expressing after most feeds that will help - so expressing little and often is more effective than one or two long expressing sessions (don't forget that there is no need to sterilise after every use if equipment only has breastmilk not formula in it.

If you do express s bit you can mix several sessions milk together, you might like to try using a supplmenter nursing system to add extra expressed milk or formula if you need to go that route whilst at the breast which in turn will help with supply.

A friend of mine successfully increased her milk supply and got her baby's weight up by feeding every two hours for a few weeks.

dotty2: Just thought I'd add that I was in the same situation as you with DD1 and went for FF top ups at about this time, and DD1 quite quickly preferred the 4oz bottle to me and she was all FF a few weeks later. DD2 and DD3 I went straight to FF after a few days.

It wasn't worth the misery to us. I felt like a big failure. Then I got over it. DD1 (now 6) and DD2 (3) are strong and thriving with no health problems. It's no failure

Maybe I was lucky with my use of 'top-ups' but perhaps it was that the way we did it (not through any planning or knowledge, just how it worked out) was to top-up with a little formula at the end of a BF which didn't seem to have settled DD (ie she'd been feeding for ages, seemed to want more but couldn't get it outta me), never actually a whole bottle. The BFing was still very frequent and protracted.

Does that make sense?

I did try fennel tea, it might have helped or it might have just coincided with the supply becoming sufficient anyway.