Breastfed baby given formula and being sick

[LDoug1991]

My baby is almost 6 months old and is breastfed. She has the very occasional bottle if I’ve had to go out somewhere for a few hours. The last 2 times I’ve asked my mum to give her formula in her bottle as I didn’t have much breast milk in the freezer so wanted to see how she gets on with the formula. Both times she has vomited a few hours after (she is otherwise not a sicky baby). Both times she was given pre-made Aptamil. She was pace fed and didn’t drink more than 60ml. Has this happened to anybody else? Are there any formulas you recommend which may be easier to digest?

Did she throw up or spit up? Huge difference. Also worth having a good understanding of how much mess spit up makes - it’s a lot.

Try a different formula like the Kendamil ready to feed one. She may just not be used to it

The first thing I would try is pumping breastmilk and offering that in the same bottle under the same conditions. It may simply be that more air is getting into her stomach with the bottle and this would test that issue.

Almost all formulas get recalled at some point. Breastmilk is made for your baby so just continue to pump.

Another point is how it's being given. Too much, not sitting up when being bottle fed and not being burped all contribute.

It might be a mild milk sensitivity. DS was breastfed and when he was old enough to have milk with food (eg weetabix) he projectile vomited and went grey. We then tried formula (I think we were trying to rule stuff out, it's 2 years ago now), and it happened again. I never gave up diary in my own diet and he grew out of it by the time he was 12 months.

This happened to my daughter when little and it was milk protein allergy. She couldn't ingest any milk (in any food or formula) without being violently sick until she was about 3. She was breast fed as well. Strangelyit just went away around 3ish. After I stopped breast feeding we used prescribed infant milk (I think soya based) and I cooked using soya milk. If your baby is being violently sick after milk based formula it might be this. It was very different to usual baby sick for her.

It was definitely a throw up, and a few hours after. The same as what happened the last time we gave her some formula. I’d just like to find one she can tolerate for emergencies when we need it, so will give Kendamil a try, I’ve heard that is good for more sensitive babies

Thanks! We’ve tried this, I do usually give her expressed milk but wanted to find a formula she can tolerate for emergencies as I don’t have a freezer stash of my milk. She was fine with the expressed milk

Yes, with one of mine. Turned out he had a sensitivity/allergy to something in cows milk. He was prescribed a soya formula, and when he started solids, we made sure to avoid milk in anything. He was fine, and grew rapidly and strong.

Thanks! I know breast milk is best, we will be continuing to breastfeed and give expressed milk most of the time, I just wanted to find a formula she will tolerate for emergencies as I don’t have a freezer stash (yesterday I had to leave her unexpectedly at the last minute and was unable to pump before). She only actually had about 40ml of it yesterday and was sat upright, pace fed and she burped well

This is interesting thank you. I did wonder if it was possible it could be a slight allergy to milk. I eat dairy so I thought she would be getting that through my breast milk and is fine, so I didn’t think the formula would cause any problems like that! So this is useful to know 😊 did he get sick immediately after both times?

Thanks! Was he breastfed and you ate dairy? Or did you have to cut this out of your diet? My little one is fine with my breast milk and I have dairy and cows milk so I wasn’t sure if it could be this

The first step for cmpa in formula fed babies is extensively hydrolysed dairy based milks. They partially break down the milk proteins and that's enough for a lot of babies to not recognise what is left as milk. Imagine cutting up the front page of the newspaper. Picking up random chunks it would be hard to figure out the main story but some people would still be able too. When you breastfeed your body has already partially broken down the proteins as part of your digestion so it's the equivalent of the extensively hydrolysed formulas. Sensitive babies will react through breastmilk but it's common for cmpa to not be diagnosed until weaning with breastfeed babies.

Also maybe is the bottle flow too fast for the baby ? Could cause to swallow too much air and then be sick?

I’d guess at cows milk protein allergy too. Both of mine had it, and with both it wasn’t apparent until weaning. Both have grown out of it entirely though. Some babies have more of an ‘intolerance’ than an ‘allergy’ which leads to a slower reaction (in reality both reactions are allergies, just different kinds)

I would go much slower and offer more breaks. You say paced feeding (which is what I did too) but in your mum's generation (I remember from babysitting/family babies when I was a teenager) they were very much more encouraged to ensure that the teat was full of milk to prevent wind, and it was considered important to try and ensure the baby drank as much of the bottle as possible. Nothing extreme like force feeding, just lots of gentle cajoling, but the idea of letting the baby totally take the pace, and have the teat full of air will feel absolutely wrong if she bottle fed her own babies and was always careful to ensure those two things. Not saying nobody can ever take on new information, just that it can be a particularly tricky thing to adjust to.

If the formula was first stage then there isn't technically any such "easier to digest" although the partially hydrolysed ones may be something. (IIRC it's said to be a bit of a myth that it's gentler.)

You could try a non dairy one though if it's only to be given occasionally but it will cost you a bomb because you're meant to throw a tin out if it's not used within 4 weeks, they don't make the premade stuff for those specialist formulas.

A few friends have found that ready made caused vomiting or constipation whilst their usual powder didn't, even the same brand.
When I transitioned my son from breast milk bottles to formula bottles (I exclusively pumped), I did it by swapping only 30ml at a time, then after a couple of days 60ml and so on. I would suggest trying a bottle like that, mixing the two then gradually increasing. But you'd probably have to give fairly regular bottles to get baby's gut to maintain a tolerance to the new addition. Depends whether you want that hassle.
Agree with @BertieBotts too, my dad in particular found the concept of paced feeding tricky to follow and was desperate to keep the teat full of milk. Mum was fine. I suspect he secretly thought I was wrong and if I hadn't been around he might well have done it the old fashioned way.

Hello,
This exact thing has been happening to us with our 4 month old (and pre-made aptimel). Did anything come of it, did your baby have a milk allergy in the end?

It's likely a milk allergy. The dairy protein in breastmilk is broken down so baby can likely cope with it but then can't cope with how much there is in formula. I am.still breastfeeding my 13 month old because of it. The dairy allergy formula tastes terrible so he never took it.