how much longer?

[Tissy]

I'm afraid this is probably a variation on an old theme, but I'm feeling a bit down at present, and would appreciate some advice. Dd is 9 months old, and has never had any milk but mine. I express milk for her to take to nursery. She gets 2 x 6oz bottles in addition to her solids and a beaker of water. Once again I'm facing a reduction in the amount of milk I can express during the day, and the only way I can get anything approaching 12 oz is to try and express late at night after she is asleep. For the past few nights she has been more voracious at bedtime, requiring both sides before she'll even think about going to sleep, and consequently there's very little left to express, even if I leave it 3 or 4 hours before trying. Today I only managed 5oz, and I can only expect another 2 oz later. At this rate we will have got through the stockpile in a couple of weeks, and then what? I desperately wanted to get to 1 year, so that she can go straight onto cows milk, and avoid formula, but it looks as if that won't be possible now. Should I try some domperidone, to get the volumes back? Should I give her less to drink during the day, and replace it with water? Should I supplement with formula to get her back to near a pint a day?(I don't really know how much she actually gets at the moment, but estimate that its around that amount). She's not great about eating solid food, preferring sweet things to savoury, so I'm worried that she's not getting enough protein at the moment. Any ideas?

Tissy my DS (11mths) has never taken to the bottle particularly well, and never has more than 4oz during the day when I am not there - and usually a lot less, about 1-2oz. However I can express off more than this, so I know he must be drinking more when I am around. But he is quite stubborn - I've been back at work now since July! Anyway, he seems to cope, although he is quite a little baby and also a rather terrible eater, he does eat more when I am not there - probably making up for the milk.

Anyway, I think if she is having a good feed morning and night, you might be able to think about going down to one bottle during the day? My bottle feeding friends had all gone down to 3 feeds by 9mths - actually recommended by HV here to make sure they were taking enough solids. Don't forget bread is a good source of protein, as well as yoghurts, fromage frais etc. And if she is taking 300ml or more of milk from you, probably getting enough protein anyway - she just needs calories to fill her up. Congrats on making it this far - have to admit I have never expressed off more than 7oz at work so I think 12oz is fantastic!

Tissy, I'm absolutely NO expert on breastfeeding at all, and am willing to be corrected, but I know that I went on to cow's milk (with A & D drops) at 6 months - wouldn't take formula at all. So, you probably can avoid formula anyway if your daughter is 9 months now. I know that's not the 'recommended' advice but..

Tissy, your experience is normal. The way to maintain levels of expressed breastmilk is to express more often, and/or to feed the baby more often, maybe when you are with her or at weekends.

The official advice is cows milk as a drink only after a year. That's unnecessary, as you will see if you do your own research in the med journals. Look up iron formula and infant feeding in the BMJ (www.bmj.com) for a paper that showed cows milk is fine WRT iron status after 8 months.

Tissy again I am no expert but I do have a baby about the same age, and like you I am keen to avoid formula.
Why not just stop expressing and feed straight from the breast if you are there - before she goes to nursery in the morning, then again at night when you are reunited, and then perhaps again before bedtime. During the day she could have water or a little fruit juice along with her meals if she is thirsty.
I am sure that would be plenty milk for her but if I am wrong hopefully one of the real experts on this site will correct me

Hi Tissy - congratulations for keeping the breastfeeding going and working for so long.
I agree with Jasper about breastfeeding in the morning prior to nursery and when you are together again. I would try and increase the solids and juice/water she gets at nursery during the day and cut back the EBM. I remember you saying that your dd did not like water so I would give her juice or watered down EBM as a drink at the nursery because she is not relying on milk as her main food there. The milk she gets when actually breastfeeding will be plenty for her at this age, even if it is only twice a day you manage to feed her. As Florenceuk says she can get plenty of protein etc. from other sources.
You will not need domperidone - more frequent expressing will do the trick eventually if you want to increase your supply. What about a couple of annual leave days and then you can have a few consecutive days of unrestricted breastfeeding to boost your supply. As I said earlier I am sure she is getting more than enough from you without needing as much as 12oz EBM at nursery. You definately do not need to start formula at this stage.HTH.

Have you tried making sweet/savoury dishes for her? I used to make ds a mild curry with coconut, also beef with apricots, chicken with apple etc.

That's a good idea Eulalia.

How's things going Tissy?

Sorry, incorrect grammar. How are things going?

Thanks for asking, mears . Things are OK. I spent Saturday feeding dd at every available opportunity, as well as expressing at every available opportunity, but we had to go out on Sunday, so only managed to express 2 oz in the evening. I diluted the bottles of EBM a little this morning, and have a relatively quiet day at work, so maybe I'll be able to express a bit more often. I think my difficulty is not knowing how much milk dd should be getting- I don't want her to be deprived, but I don't want her to get formula, either. I'm afraid the first few chapters of "Breast is Best" completely put me off the idea of formula altogether. I expect that was the intention though! Dd looks quite healthy, but isn't gaining weight particularly fast, so I don't know if I'm getting the balance between solids and milk right.

Eulalia's idea for "sweet savouries" is certainly a good one, dd has had pork and apple, which she loved. I just hope she doesn't end up with a horribly sweet tooth- she managed to steal a chocolate biscuit at the weekend, when dh wasn't watching, and the look on her face was a picture- as if she'd discovered our most closely held secret!

It is normal for babies weight gain to slow down at this stage as they are much more active. My unprofessional advice at this stage is to stop getting her weighed! If she looks healthy and happy then she is fine. I agree with you about the no formula thing. There is no doubt that it is totally unnecessary, so you are not depriving your dd in any way. As I said before it sounds as though you are providing more than enough.

Tissy: I am a gatecrasher from another chat-page, but as a friend of Mears and an ardent breastfeeder, thought you would like some reassurance. You are doing everything you should be and I applaud your steadfast efforts regarding expressing. I too would feed prior to a shift, then express halfway through and get about 100ml a go. I then breastfed as soon as I got home again. My ds would often, not take any EBM, while I was away, but soon caught up, when I got home! Did you know that the levels of prolactin are higher at night, so letting your dd feed for as long as she wants would be better than expressing and you will soon see a rise in the milk supply after a few days doing this. I wholehearedly agree with Mears, there is no better alternative to real suckling and if dd only gets water or juice, while you are away, then she will come to no harm. At these times she can have fruit, veg and other solids, bulked out with baby rice. She will not need to have formula now, so you should give yourself a huge pat on the back and just enjoy the pleasures of breastfeeding.My ds has just stopped B/F and is 2yrs 9mths. I loved almost every moment!!