Forced into formula feeds

[alc123]

My little one was born at 35+4 and was 4lb11oz and dropped to 4lb6. I really wanted to EBF but got forced into formula top ups. Roll on 10 weeks later and she’s gaining but slowly - just shy of 7lbs now. Got referred to paediatrician who wants me to up her formula and still have weekly weigh ins even though my health visitor was happy with her and had gone to fortnightly. Feel like we’re going backwards and that my milk is getting low :( she’s following the 2nd centile in the red book. Anyone else had similar experience and got back to fully breastfeeding or at least lowering the formula?

Could you try expressing and give that as a top up rather than more formula. Or breastfeed more often. Have you spoken to a lactation consultant to work out a plan to get back to more bf and less formula?

I think it's normal for them to put a feeding plan in place when baby drops a certain amount of weight after being born. The same thing happened to me and I was determined to BF. So in hospital I was told each feed must be 60ml, my son struggled to latch as he was so tired and had a bad case of jaundice. So I expressed managed about 10-15ml pumping solidly for 1-2hours at a time so I never got a break because once the first session was done I had to start over again. So I had to top up 45-50mls of formula. After two days they were happy with weight gain and we were allowed home. I continued with this plan for a week or so but as time went on I could express more milk and reduce the formula.
Finally my son got the hang of BF and we ditched formula altogether and he's still BF now at 20months.
I think it's fair enough what has happened at the start but I'm not convinced about continuing on. Keep trying with the BFing because once you have that cracked there's no need to worry about how much your baby feeds.
It is so hard OP and I'm sorry you're going through this.

Oh and just thinking of tips. I have large breasts and my boobs were so full of milk and son could barely take my nipple in his mouth. I used the reverse pressure technique and also a circular massage all around the aerola of my breast which really softened them up making it easier for baby to latch. (Please Google reverse pressure technique)
Another thing I did was express a bit of milk and then latch baby so my boobs weren't to full.

Hope this helps

You don’t just have to blindly follow what the pediatrician says, did you say you want to reduce formula and aim to EBF? You have to be quite forceful sometimes as doctors often like what they can measure because it’s easier for them.
I’d BF on demand and reduce the formula if feeding well and gaining unless they can give you an actual reason for the benefit of formula in your circumstances (they probably can’t).

Could you try pumping more to replace some of the formula feeds with expressed milk. That way, you somewhat protect your supply, you increase the amount of breast milk your little one has, but you are still topping up.

It sounds like she's very tiny, and giving her help putting on weight through top ups is probably more beneficial to her than removing the top ups. I understand your wish to just breastfeed, but do you think it's in her best interests right now, compared with being mix fed?

@dementedpixie I try and pump but
I don’t get anywhere near enough for her. I do put a Hakka on the other breast when feeding and add this milk to the formula. The consultant is coming on Tuesday. So hopefully she can help.

@Horehound thanks, she has no issues latching but does push herself into a shallow latch. I just don’t think I have a good supply to keep up with her. She cries at the breast quite a bit now

@Megan2018 I’ve been a bit stressed with the amount of health visitor checks we’ve had who have expected me to up the formula then now the paediatrician too. Breast feeding is ok but the more formula she has the more she seems fussy at the breast.

@Babyboomtastic expressing isn’t going well I don’t get much at all but I try. I don’t mind mixed feeding it’s helpful that my husband can feed her I just don’t want it to carry on going more towards that than breastfeeding that’s all

Instead of using a pump what about hand expressing? How does that go? I think if you think your supply is low you need to BF as much as possible and also express using whichever method.
It will take a day or two to increase

Can you look at setting up a feeding schedule?

Try putting baby onto breast every 2hrs daytime. Feeding first for 15 mins. Then topping up with small amount just 2-3 times a day if needed. The more the feed the more milk produced
So your always feeding from breast first. Then top up only 30-50ml maybe 3 times a day for a few days, then 30ml three times for a few days, then 30ml twice a day etc..

Oh just see she’s still very young. I can’t remember at 10 weeks, but I’m sure around then ds would still be feeding more like anywhere from 10-30mins at a time as a slow feeder. So she might just need longer at each feed.

Has anyone mentioned an SNS to you?

Also you will get less out of a pump if you have very small or large nipples and are currently using the standard flanges that come with it.

@addler no what’s an SNS? I do get milk out on the pump (I’ve tried three different pumps and flanges) just not much to keep up with little ones demands!

@Caspianberg I offer breast all day pretty much but it gets to a point where she’s so stressed out on the boob I can tell she’s hungry, then she will guzzle down 120ml no bother!

@Horehound I put her on the boob at every chance during the day and then whenever she wakes at night. I just don’t think I have enough to meet her needs. I always give her breast before bottle but she is now having 460ml a day on top of boob. And i think she would have more if she was given it, she’s ravenous :(

Aw @alc123 you're doing so well. How long were you planning to BF for?
Hopefully the consultant on Tuesday can help you.
I don't have any more suggestions unfortunately.
What happens when you just don't give her formula and put her on breast? Because you say you don't have enough to meet her needs but even as she is feeding your body is producing more. Just make sure you are drinking lots and lots of water and milk yourself.

You dont need to drink milk to make milk

www.medela.com/breastfeeding-professionals/products/feeding/supplemental-nursing-system This is the SNS feeder system

@dementedpixie the angle is as coming from about drinking milk was for OPs own bones not for milk production.
Of course calcium is found in leafy greens etc too

OP to get your supply up you need to pump and pump. Get lots of help at home serialise your pump and then keep in the fridge for fivdd we hours taking it out whenever there is a spare five mins for another pump. It’s the number of times not the length that makes a difference. See if your GP will prescribe domperidone for a fortnight - increasing supply by about 25% is a side effect not what it’s licensed for but unless you have some particular health issues it’s very safe as is your subsequent milk.

Lots of cluster pumping and as many little feeds as possible should make a difference. There is nothing that will improve your supply more than removing milk - the more this happens the more you make. Good luck

You can use the SNS to give the top up at the same time as breastfeeding. It'll help with the extra stimulation and oxytocin for you, no bottle preference for baby and decreases the time of feeding-pumping-top ups.

Sounds like baby is just not feeding effectively at the breast, chances are your supply is absolutely no issue x

I really hope the consultant on Tuesday has great advice for you 🤗

breastfeedingtwinsandtriplets.co.uk/2017/06/07/dropping-top-ups-gradually/

Hi OP, no idea if this will be helpful but just wanted to say huge WELL DONE! My bub is 4 months now and we are majority BFing, I give him 3-4 oz of formula top up before bed but mostly out of habit.
He was full-term, 7th %ile at birth, lost a lot in week 1 (I think 12%) and a couple of midwives went into meltdown on me and insisted we gave formula top ups. This is my 2nd and 1st had double tongue tie which sadly ended our BFing journey early on (he's now a thriving 4 y.o.!) So I started top ups and was worried it was the beginning of the end...
But luckily I got referred to the infant feeding team and had a great hour being observed in a relaxing room by a lovely expert MW who had not much advice but just gave huge encouragement. She could see that bub was trying, that feeding made him calm and relaxed even though he wasn't transferring loads. She said some babies take a while to learn it, encouraged me to feel confident that he'd get it eventually, and be grateful that formula is such an easy safe back up to have in the meantime... It was a very subtle mindset shift but she made me feel there was no rush to be perfect, and as long as I kept offering the breast we would get there.
She was right - bub is tracking the 9th %ile now, very strong, chatty and engaged, and is a champion feeder who LOVES mummy's boobs! We got here by just not giving up :) See if you can get any additional support if it's available - that one session was a game-changer for us - and try to be kind on yourself. However it works out your LO will be fine and is lucky to have a mum who cares as much as you do

FWIW I fed mine both breast and formula on demand - if he seemed guzzly I gave him as much formula as he'd guzzle :) We both were happier without any constraints or stress! Once he was stuffed full of formula he got all smiley and content and it was much easier for us to have a good enjoyable breastfeed next time. You could maybe try the same? Wish you all the best X

And also (sorry keep forgetting bits!) we give formula via syringe feeding not bottle. This may end up biting me in the bum! as he still can't take a bottle... but I think it definitely helped avoid him giving up on boob, because the formula delivery method is the slower, more annoying one! Your MW/HV should give you 5ml syringes if you want to try them, and will show you how; they sterilise like any bit of kit but don't last long, we've been buying replacements off Amazon.

No idea if this is still relevant, but I absolutely went from ebf, to formula top ups, to exclusively bottle feeding alternating expressed milk and formula, back to ebf. Fed her for 2.5 years!