Wanting to increase milk supply & cut out top-ups

[latestaddition]

Hi, I'm new to Mumsnet. I've heard from a friend that there's lots of wonderful breastfeeding advice to be found here. I wonder if I can ask some advice?

So, I have a 7 month old daughter (she's my first child). I've breastfed her from the start. After a few months though- when she was about 5 months-, gradually, I started giving her some top-up bottles of formula as well. This was because I was worried about my milk not being enough for her; and also to give us the chance to get some sleep and also to get her on a bit of a routine. These aims have been achieved (our routine is far more steady now, which I think she loves, & we're all sleeping better).

About the formula: I started by giving her a bottle of formula at 11 pm. At the beginning this was the only formula I gave, and I'm happy to continue giving that for as long as she needs that milk. Gradually though- particularly once she started solids (at 6 months)- she started needing top-ups after the 2.30 / 3.00 pm feed, and also after the bedtime feed. These are not huge top-ups. Usually 70-80 ml. However, they make me worry about my milk supply since I think she really needs them. I've also noticed than when I express (e.g. in the morning and at 11 pm at night) I've been getting smaller & smaller amounts.

Just to note, in case this helps, she also breastfeeds briefly before her 2 naps. She's cut out night feeds (e.g. at 4 am) a while ago, once she was on solids.

I'd love to cut out (or at least decrease) the top-ups, because I want to continue breastfeeding for a while longer, at least one year. And I'm worried that with the top-ups this may not be possible. Any advice? Please give me ideas on how to express (if that is needed) or how / if to cut out the top-ups.

Many thanks in advance!
Latestaddition

latestaddition - welcome to mumsnet

The only sure way to increase breastmilk supply is to remove more milk - you have proved the 'opposite' ie to reduce milk supply, you remove less milk.

Introducing solids and sleeping through can mean the baby takes less milk less often - result is less milk made. This may not be a big deal, but if you add to that, more formula top ups (which you did, sorry!), rather than breastfeeding more, then the net result is a lower milk supply.

Your baby is, I'm assuming, healthy and thriving, and eating solids well. This means she will not hit a crisis if you simply cut out the top ups - just stop them. If she seems to need more breastmilk after a breastfeed, put her back on, swapping sides back and forth - and you could also offer breastfeeds at other times from your usual but I would dount this would be necessary, to be honest.

Another way or an additional way would be to express, but I would not think this would be necessary if you increase the direct bf.

I am an NCT breastfeeding counsellor by the way.

Hope this helps.

Thank you tiktok for giving me advice so quickly.

Yes, to answer your questions, my daughter is very healthy & thriving. She's on the 60th-70th percentile for weight & on the 90th for height, so I think she's doing very well. She loves her solids, has 3 small meals a day (puree & finger foods).

I'll try what you suggest. My instinct is to do exactly what you say! But, first question / issue, my daughter has come to 'expect' the little bottle after her breastfeed (seems to love both). She even opens her mouth in a kind of 'different' way after breastfeeding for some time. I think she likes (after the milk is not so quick) that the bottle gives her milk quickly, although she really loves breastfeeding too, and lately she's very keen to breastfeed actually. What my second issue is (and this is an obvious one, I suppose). Will she feel hungry & cry a lot if she's not getting enough? I particularly worry about the bedtime feed, because she settles so well after her breastfeed & bottle. Should I first cut out the afternoon feed & then the bedtime? Or both together? Should I just stop the bottles cold turkey as you suggest? Or bit by bit? (e.g. give less formula each day)? And how many days should it take, do you think, for my milk to increase?

Would love to cut out the top-ups altogether (except the 11 pm bottle) since I love the breastfeeding, and my daughter loves it too, I think, and it would be so sad for my supply to dwindle because of this...

If I were to also express- just to accelerate the speed of the increase- what times would you suggest? But then of course direct breastfeeding would be much easier...

Anyone? I would just love some more advice...

I'm planning to cut out the 2.30 pm top-up today, to start from that & see how it goes. I'm anxious about it! One other concern I have is that I don't want to create problems with my daughter's sleep. She sleeps relatively ok, and we really struggled to get to where we are (we never let her cry, so it took ages for her to sleep from 11-7, but now that she does- even though she often wakes briefly for other reasons- I don't want to jeopardize that).

Please. Would love some advice about increasing the milk supply...

I'm not an expert, but if it was me I would cut out the 2:30 top up by feeding as usual then immediately getting up and going somewhere - like for a walk or something. Then I would offer a boob again when we got back.
Good luck.

Ditsy's idea is a good one - at 7 months, your daughter is disractable and this might well work

Your daughter's expectations of a bottle may well exist, but she can learn not to expect it without being distressed in any way.

I can't suggest anything else for increasing the milk supply - there isn't anything else except removing the milk more often. Herbs and foods have some anecdotal evidence, but they won't work on their own.

I can't see any of this as likely to distrupt her sleep, though.

Hello again DitsyMe & Tiktok.

I hope it's ok that I update you? Today I fed my girl at 2.30 (or so). We were out, at a friend's house (with other babies). After the feed- which wasn't a particularly long one-, I didn't offer a bottle, & she just played happily with the other babies. Then about 1- or 1 1/2 hour later- I breastfed her again- again, a brief feed. She had a nice nap on her way back home (in the buggy) & then at 5.20 had her supper normally, & ate it all (seemed hungry). The thing is, even if she got a bit hungrier at supper time, I think if things go as they did today, I'm happy to not be giving the top-up, at least at 2.30 as a first step.

At 7.30, before her bedtime, I breastfed her, but she did seem agitated, & I offered her the top-up, just because I wanted her to settle to sleep easily. She drank about 100 ml. I think I'll continue with the top-up (for now) at 7.30, and maybe reduce it bit by bit? I'm also thinking whether it might be a good idea to briefly breastfeed at 11 pm too, before my husband gives her the formula bottle? I know there's hardly any milk in my breasts at 11, since my husband has been giving her the bottle for 3 months now (and when I express there's hardly any). But maybe if I actually breastfed briefly (when I'm up to it, and not knackered) at that time too, it would help?

Anyway. Thanks again for your help girls. Will keep updating this if that's ok?

Thanks for update

You will have milk in your breasts at 11 pm - the breasts do not work on a timetable like this, emptying and filling conveniently...so yes, bf at 11.

Carry on doing what you are doing as it seems sensible to go with what you and your baby are happy doing, and you can gradually build up the bf.

Hello again tiktok, thanks for your message.

I have to say, I'm getting a bit anxious again

Here's what's happening: yesterday & on monday, I cut out the afternoon top-up. My daughter was ok. She played, then a while later (about 1 hour) she wanted more breastfeeding, so I was happy to do that. Then I also breastfed her (yesterday) before her lunch & after her lunch- but these were extremely short breastfeeding sessions. I think more comfort & thirst than actual milk.

I still gave her the formula top-up at bedtime; she drank 100 ml (after a short breastfeed).

In the end, I counted how much milk she got yesterday from formula and / or full fat milk:
--100 ml full fat milk with her morning porridge
--100 ml formula top-up at bedtime
--180 ml formula bottle at 11.00 pm

That's 380 ml. Which means she's getting probably quite a small amount from me (taking into account that she's having big solid meals). I'm sad to say that last night she also woke up at 3-4 am, & when my partner offered her a small bottle, she drank 120 ml. So basically: is she getting any milk from me at all if she's drinking all that formula?

I'm particularly concerned because all the feelings I had that signified I had milk are not there anymore. For example- kind of full breasts. A feeling of let-down. A particular way of her feeding (not frustrated, although even now she seems to enjoy it). I tried expressing last night at 10 pm and got nothing, less than 5 ml. So either my pump is not doing that well (and it seems to be making strange noises it's true) or otherwise there's no milk. This morning my daughter breastfed on one breast only. Then I expressed the other & got only 40 ml. That's much much less than I used to get when I expressed.

So please tiktok, can you tell me, is it possible that my milk is basically drying up?! I'm so so sad & anxious. I really would like to work on this, but is it possible? (The one thing I'm really reluctant to do is to go back to night feeds...as I said we had months & months of sleep deprivation- she used to wake up every 1-2 hours at night- so I'm so relieved that my partner has taken over the nights. If possible, I'd love to work on the problem DURING the day if that makes sense)...

I'm happy to pump more, but I think I need a new pump. Do you recommend any one in particular? Or maybe I should rent? As you can perhaps sense, I'm very anxious about all this, as I feel I've failed my daughter by not doing things right...

(By the way, I just want to add... when we started with the formula- 1 bottle at 11- I never intended, after 5 months of exclusive breastfeeding, for this to be complete mixed-feeding. We decided to give that one bottle (initially it was EBM) just for me to get some sleep. I have no idea how I managed to get from 1 bottle at 11, to my milk basically drying up now.... and so many top-ups needed. I really can't say how this happened).

latest - you need to talk this through with someone in real life, I think.

Yes - you are giving a lot of formula and milk...quite a lot more than what you gave the impression of in your first post

Yesterday she had 500 mls - the 380 ml and the 120 overnight bottle.

It's hard to work out how much she is getting from you as this will be very individual, but you can increase it following the suggestions discussed - I'd add she doesn;t need 100 mls on her porridge, as she can have water, and the other top ups can be reduced, perhaps...maybe gradually?

This is the trouble with top ups - they creep up

Tiktok, thank you so much for your help & advice.

Actually, today I did call the NCT helpline (I've called them in the past too) & talked to a really nice breastfeeding counsellor there. She gave me some ideas, pretty much closer to what you have been saying, i.e. to put the baby on the breast more, and to gradually cut out the top-ups, & maybe to express a bit, particularly at night (e.g. around 10 or so). She also said that- because I was expressing quite a lot of milk, & have stopped in the last month- maybe I'm not getting that feeling of 'fullness' & 'let-down' just because the expressing was causing oversupply (that was probably true for a while). However, I'm not that convinced, because it simply feels- on so many levels at the moment- that my supply is really really suffering & I'm more & more depressed & disappointed by this (maybe irrationally, but I am... )

Here's how today went:

6.30 breastfeed (one breast only)
then I expressed the other breast to see what I got, I got only 40 ml
Breakfast- 100 ml milk (40 of which EBM) with porridge
Before lunchtime- a good long-ish breastfeed (long-ish for my daughter is a few minutes at most, always has been)
Around 2.00 pm or so breastfeed (no top-up)
After the afternoon nap- more breastfeed, baby seemed extremely frustrated & hungry during this one, unsatisfied clearly. So I offered supper early & she was ravenous. Gobbled up a huge amount.
Before bedtime- very brief, frustrating breastfeed, then a formula top-up (she drank almost 130-140 ml)

Am very sad... Not sure what more to do really. I'm so tired of months & months of lack of sleep... I'm also so tired of expressing for months on end (I did this because I was anxious about my supply). The idea of expressing loads again makes me feel a bit desperate... (especially at night).

Am so sad about all this.

No need to express a lot - even the bfc said 'a bit' and 'maybe'....

Judging supply on what you can express is so misleading anyway.

The 5 feeds you gave between 6.30 am and bedtime is a good number - you could have also offered breast at the supper, too.

You're doing ok - really. You don't need 'to express loads', honestly If at all....

I just wanted to offer some support and say that you mustn't feel like you've failed your daughter.

It sounds like your anxiety is preventing you from following the advice that you've had from tiktok and the BFC you spoke to in RL. How does your husband feel about it all, is he supportive of you increasing your BF?

Sorry I don't mean that to be harsh - sorry if it comes across that way?

Thank you Ali & tiktok. (Ali, of course you don't sound harsh!!) My partner is supportive, yes, but I feel he would also be ok if I told him I'm wanting to quit breastfeeding completely.

Tiktok, it's really encouraging to know you think we're on the right track.

It's quite difficult with a 7 month old to put them on the breast that much during the day- at least it is a bit hard with my daughter- because they're so distracted. And also our days are planned around activities, seeing friends with other babies etc. However, I'll do my best. Will breastfeed her before her morning nap too, today, & also after supper (if she wants it). I gave her half milk / half water for her porridge for breakfast, so she should be hungrier soon.

My main problem is that yesterday, for the second night in a row, she woke & clearly wanted a feed at 4.00 am (she had 120 ml formula). So that's the thing, that milk is clearly missing from somewhere else, can't believe it's simply a coincidence...

Also, last night I got a rather better amount at 10 pm with hand expressing (rather than with the pump).

To be honest, I would love some real life, detailed advice...I found the NCT bfc really good & sympathetic, but it's very different talking to someone in person & talking to them on the phone. Writing here really helps, but I'm not sure if I'm writing too many details?

latestaddition - do you not have any bf cafes or drop ins at childrens centres near you? I find them very helpful.

The other thing I was going to say in addition to all the great advice here is that we experienced a drop in bf at that age and we were exclusively bf - my dd just became very interested in her solids and was only taking the letdown (which is very small now and I cant express at all even though I know my dd is getting plenty of milk so I wouldnt worry about that) and then stopping.

We just carried on and tried not to worry about it and now at 10 months it had swung the other way - she is more interested in bf again and less in the solids.

We also nightweaned ours at the same age even though she wasnt having that much milk - she still occasionally wakes up really early though - usually when teething or when shes about to have a devlopmental leap - sitting up/crawling etc.

Giantkatestacks - this is happening to us just at the moment, DS is only having very short breastfeeds during the day. I would describe them as a drink more than anything else. The only time he is having a long, good feed is when he wakes during the night, which at the moment is around 11:30pm and then again at about 5am. He will then take another big BF when he wakes at 8am.

Latestaddition - I know you've said you want to keep going with the formula in the night, but maybe consider switching to BFing during the night time instead. Your DD will get more breastmilk and it will help your supply because you will be feeding more regularly.

Can I offer a theory? When my baby isn't satisfied after a feed, I swap him to my other breast, and back again and so on and so on until he has had enough. Because I have never used forumla (apart from a little in hospital when DS was first born) it never occurs to me to look anywhere other than my breasts.
Because you are using top ups, (and I'm not saying for a minute that there is anything wrong with this), when you feel that your baby isn't satisfied your instinct is to give more formula because you have lost confidence in your supply and your ability to provide enough milk - and with the formula you know she is getting a certain amount.
All I can say is that your body will produce more milk if your DD feeds more, and if she is wanting to have her milk at night rather than during the day, as I have found with DS at times, then you perhaps need to think about BFing her during the night, at least for a time.

What is happening is exactly what Ali is saying: I've lost confidence in my supply, it seems I also used to exclusively breastfeed (very happily, too, although it was exhausting...but that's normal up to 4-5 months I think). And at that time I distinctly remember that I never doubted my supply even during growth spurt times.

The thing is though, we weren't getting much sleep at all (again, normal-ish, but it was a bit of a nightmare, waking every 1 hour or 2 hours for months on end) which is why we moved towards some changes at 4-5 months. One of them was giving formula at night. The other was structuring the feeds a bit more during the day. Gradually my daughter started eating better, slept better, & is now happily on solids (eats very good amounts). I think it's exactly what GiantKate & Ali say, she's having very short feeds on the breast, only the early morning one seems longer (today at 6.30). To be honest, at the moment I'm just giving the one top-up at 7 pm (before bed) just because particularly at that time I really really feel she wants more milk. I mean she had a brief, frustrating breastfeed yesterday at bedtime, & clearly wanted much more, and was far too sleepy & crying & ready for bed to keep switch feeding... She drank 140 ml from the bottle and slept undisturbed until 10.30 pm. So I have no idea how to cut that particular top-up. Maybe one idea might be to
a) put her on the breast more up to bedtime (I'm already doing that) & avoid any top-ups until then
b) do a bit more expressing, to get about 100-140 ml all in all if I can (which will also help my supply)
c) offer this EBM at bedtime instead of the formula

I'm really reluctant to breastfeed again in the night (even at 11) as we're working towards better sleep for all of us. My daughter is still waking all the time (for other reasons, not hunger) so if I start breastfeeding her again at night I'm pretty sure it'll create an additional problem. After 7 months of continued sleeplessness (as I said, not due to feeding only) I'm not happy to go a big step back. I know that sounds like something that goes against the breastfeeding, but I'm just looking for some ideas that will take into account our particular circumstances. I know there's no ideal solution, to be honest...