Mixed/breastfeeding problems

[Liliputian]

Hi everyone
my baby is 6.5 weeks old (my first) and I’ve been mix feeding her since her second day — a midwife gave her formula in the hospital after she initially struggled to latch (despite latching right after delivery) and couldn’t get much colostrum from my breast. She was also on antibiotics (as was I, during labour because of an infection and fever) and there were concerns about her getting adequate fluids. Tbh those few hours and days after her birth are such a blur that I can barely remember any of it or how I ended up being ok with her taking formula so soon.

But We kept her on formula since, no more than 2-3 feeds of around 70 ml a day — the rest is BF but she cries and fusses a lot during feeds, especially when boobs soften and are drained. Generally she’s been latching ok but she never seems to be satisfied even after really really long feeds and then she cries and gets really upset and latches/unlatches. At times I find that all I’m doing is feeding constantly, non-stop and she’s still hungry and cries/fussed and then guzzles down formula. I feel like a complete failure — her fussing and crying on the boob makes me fearful that she’ll build a negative association with BF and even with me and do the opposite with formula/bottle (which my husband tends to prepare and give her).

I’m sure the formula has a lot to do with all of this and I’m desperate to phase it out but my other half thinks this is a really bad idea. He thinks the formula is a vital supplement and weaning her off it now will just cause both me and baby stress and confusion. But I hate giving it to her and I hate the idea of her developing some sort of aversion to breast milk and breastfeeding.

i have a pump but am struggling to make time to use it since I tend to feed her as soon as she needs it which is pretty much whenever she’s not sleeping. When I have used it, I’ve not managed to pump very much, max. 20-30 ml each time. Very grateful if anyone has any advice about what I can do or thoughts on why she’s fussing so much and how/whether to phase out the formula. Thank you!

[NonJeNeRegretteRien]

So firstly I would say your husband is wrong, formula is not an essential supplement. It’s really important he understands that it doesn’t have to be part of baby’s daily intake.

you might benefit from a chat with a lactation consultant, your HV may be able to point you in the right direction.

i combifed from very early, baby takes both bottle and breast. I did this with both children.

the challenge with combi feeding can be that the baby does have to work a bit harder to get the breast milk, which tires them out, makes them cranky etc. Formula flows nicely from a bottle and is much less effort for them. Take a look at paced feeding which is designed to support combination feeding.

When BFing she is likely fussing because that’s the way that babies try and stimulate milk, hang in there, let her do it. Swap her onto the other breast if there’s no milk coming from the one she is on, sometimes the let down happens in both and you could have a fast flow breast and a slower flow breast - I do. Sometimes babies struggle with fast let down as it can be overwhelming at first. When she is fussy She’s just trying to get your milk supply up. You could for now give breast first, and top up the rest of the feed with formula.

when she has a bottle try and pump, although I didn’t do this; instead I varied when she had the formula so I didn’t lose the feed. That is to say one day she might have a bottle at 9pm, but the next day she would have it at 10am and so forth. Then as I became more confident my milk was enough to sustain her I dropped the formula feeds. Now she will just have a bottle of formula if my husband is looking after her and I’m not around (rare).

Don’t beat yourself up about the amount you’re getting out in a pump session, many women simply don’t get on with pumping.

I also used some supplements known for helping with milk supply, they are Brewer’s Yeast and Fenugreek capsules. You can buy them from Amazon.

[DustyLee123]

When she’s finished one breast do you offer the other ?
Are you eating well and drinking a glass of water at every breast feed ?

[Liliputian]

@NonJeNeRegretteRien this is v helpful, thank you. I’m not sure it’s a letdown issue as she latches and takes bf very contented when I feed her first thing or in the early hours when I’m fuller. it’s when I sense boobs are drained and v soft that she seems to get frustrated.

this morning she was doing the same thing — boobs far less full but she was still hungry and crying. Crying got worse and worse and she kept crying on the breast eventually did a big poo and then settled, so that seemed to be the issue … just seems different everyday but the common denominator is that she seems hungry all the time and constantly wants feeding (even when she’s tired and frustrated?) and gets upset/cries when my boobs aren’t v full … will also make sure we do strict paced feeding for her next formula as I really feel atm that I’m competing with her bottle …

@DustyLee123 eating well as much as I can although not as well as during pregnancy as I’m a lot more tied up now ;) but water is a good point — initial weeks wasn’t drinking anywhere near as my body needed mostly because of how weak my pelvic floor was after delivery — was afraid of drinking too much. But that’s improved a lot now and I’m drinking much more and as much as I can …

[BuffaloCauliflower]

Your baby is cluster feeding, which is really normal and not at all an indication that they’re not getting enough. They do just need to feed all the time at that age! I’d do some reading up on cluster feeding, and also the top up trap.

[BuffaloCauliflower]

Sorry hit send too soon! It’s really common for women to worry about supply, especially when your supply starts to regulate and boobs go soft. But your boobs are never empty, milk will keep coming as long as baby feeds and it’s a supply and demand product - the more you feed, the more you make. Babies want to feed more in the run up to growth spurts to tell your body to make more milk. The fussing and on and off feeding also send signals to your body to make more. It’s easy to misunderstand these normal behaviours as baby not getting enough, so formula top ups are given, but these can work against you because baby is having feeds not from you so your body isn’t getting the signals to make that feed. Does that make sense? Throw out any ideas of baby feeding on a schedule and just feed them as much as they want to be fed, they know what they need.

[BuffaloCauliflower]

Some helpful graphics

[Liliputian]

Thanks @BuffaloCauliflower, this is really reassuring … all I’ve been doing lately is reading around this issue including the top up cycle, I think that in those moments when she’s crying and seems really upset and frustrated and angry with my nipple I start to despair and it’s hard to give things perspective … she is at the age of peak crying and fussiness too and it did occur to me that she may be cluster feeding and having growth spurt, I guess I just expect my supply to be stronger relative to how much I’m feeding her on the boob (which is a lot or at least seems that way) and I have this idea that my supply should be really abundant but maybe that comes later or is a myth? (I’m also a bit older than most mums so might also influence things). What you’ve said definitely makes sense and thank you for the graphic 🙏🏽

[Liliputian]

These are brilliant … keeping and printing and possibly laminating 😆

[BuffaloCauliflower]

@Liliputian the source is Lucy Webber Feeding Support on Facebook, highly recommend.
What do you mean by ‘I just expect my supply to be stronger relative to how much I’m feeding her’? It sounds like you think if you had a better supply she’d be feeding less, is that right? Because that’s not how it works, clusterfeeding they feed loads regardless! Nothing you’ve said suggests you have low supply, though if you keep giving formula too it is possible your supply will go down as it’s a supply and demand product. Though plenty of women do combo feed effectively, you have to be conscious in keeping your breastmilk supply up in a way you don’t so much with exclusive breastfeeding.

A couple of things on supply. Firstly, if baby is having plenty of wet and dirty nappies and is growing, your supply is fine. That’s really all you need to look at. Also at 6 weeks your supply will be regulating to how much your baby needs based on how much they’re feeding. Boobs go soft around now, this is normal and expected. Continuing to have super pumped up boobs after now would actually indicate an issue.

But also how we try to measure supply is really unhelpful. What you can pump doesn’t tell you anything about your supply, we respond much better to real babies than machines. Leaking or not also tells you nothing, we’re just all different. I’m currently EBF my second child (fed first for 20 months) and in 2 breastfeeding ‘journeys’ I’ve leaked one drop, once, this time round. I’ve never got more than a teaspoon pumping so I don’t bother. But I’ve successfully grown 2 babies on just direct from the boob milk with no issues. Other women leak constantly for months and months, or can pump loads and loads. Doesn’t make much difference to the baby as long as they’re growing.

Another thing is storage capacity, which we also can’t really tell by doing anything, and isn’t related to breast size. Some boobs store more milk that others, if yours store less your baby may feed more often than someone who stores up more. Either way milk will keep coming as long as you feed. Different babies feed differently too, my second is much more efficient than my first was.

In short, the abundance you’re looking for is probably there just fine, you just can’t see it. Some women do make loads of milk and have big oversupplied and donate loads (I’m sure you’ve seen the pictures of full freezers) others make just enough for their baby and feed just fine. Oversupply is actually not so great, there’s a higher risk of mastitis and babies don’t need more than they need just because more in produced. Look at nappies, are there enough wet and dirty, look at your baby, are they growing. That’s all you need to know.