Why would a baby put on loads more weight when switching from breastmilk to formula?

[Caz10]

This is just curiosity - a colleague of my sisters has a 5mth old baby who has been exclusively breastfed until now, but who has had terrible reflux. The mother has been advised to switch to formula, which she was quite happy to do, and baby's reflux is now much improved, and her weight has absolutely shot up, more than triple in a week what it has previously been. Everyone very happy at baby putting on more weight, but I thought it sounded a bit unhealthy to gain so much so fast.

I breastfeed my dd who was a very slow weight gainer to start with, so not v knowledgeable about formula - is it massively more calorific? I never knew this and just wondered, thanks!

Have recently started giving DS formula (long story) at 13 months. The difference is that with formula, it tends to be more organized - i.e. the baby has a feed at specific times, the feed is made up, measured powder/water etc, whereas with breastfeeding, it's all based around the baby. If they are hungrier, they feed longer. If they are hungry/upset between meal times/feeds, then give them the breast.

Formula tends to be more of a rigid system. If a baby is unsettled between feeds, the reaction isn't to make another bottle as there is the confidence that hunger isn't the cause.

My conclusion which is based on absolutely no scientific fact, is that by keeping to structured feeding times, a formula fed baby will consume more all at once, whereas a breast fed baby will consume little and frequently.

At least that is my experience for what it's worth...

peppa pig - always open to discussing ideas

Lol - I can just see the funding appliaction. "The project was designed late at night over a glass of wine and mumsnet"

Seriously though it would be interesting. I am more interested from a psychology / health side of things...have always thought it would be great to work with someone lab based and scientific.

ILOVEMYDOG - thats one of my conclusions really - that breastfeeding is baby led, formula feeding has more to control. That could lead to over feeding but not necessarily. I know what you mean though - on the one occasion DD accepted a bottle I was watching the ounces, encouraging her to finish it, worrying about what she was having. Very easy to get concerned I think.

If you want you can contact me offline to see if there could be anything interesting in a project my email is academicmumatyahoodotcodotuk

Sorry for shameless hijack...

Oh, and the other thing that breastfeeding moms forget is that a baby may just be thirsty! Obviously it doesn't cross your mind if the baby is being exclusively breastfed, but I called the Dietician in a complete flap; that DS was consuming a tremendous amount of formula, waking up in the middle of the night. She suggested trying water in the middle of the night, and it worked!

So, suppose what I am trying to say is that one cannot differentiate the cause of a breast fed baby waking up or wanting a feed; it may be hunger; it may be thirst.

Just to clarify: breastmilk is consistent in quality. This does not mean it is always identical in composition - of course fat content varies, this is physiological and it is related to the amount of milk in the breast at any one time. This does not matter a bit. Over the course of a day, the baby gets what he needs (as long as breastmilk transfer is effective). We have known this for well over 20 years. The studies have been done - don't reinvent the wheel!

Early morning milk is lower in fat because the breasts have more milk in them at that time. There is no mystery in this

Breastmilk does not differ in nutritional quality from woman to woman - every mother can be confident that what she produces is top quality and as long as her baby is removing it (ie getting it into his stomach) as frequently as he needs, he will thrive.

When breastfeeding is insufficient, and the baby does not thrive, it's because the baby is not getting sufficient volume of it.

I struggled (and persevered) with breast feeding. Looking back, my breasts were rarely 'full' of milk (I was only sore a couple of times, and leaked once) and was feeding frequently and for a very long time each feed. DS was solely breast fed to 16 weeks, and kept pretty smoothly on the 9th centile line for weight.

I tried to pump, but failed miserably - I just never had a point when I was full of milk to make pumping easy to learn.

At 18 weeks I started to introduce formula in preparation for ds going to a childminder when I went back to work when he was 23 weeks. No sign of rejecting the bottle - he drank everything he was offered (which wasn't much until I actually went back to work). I then kept the breast feeding going night and morning, and during the day at weekends. Plus two formula feeds during the day. He shot up the weight curve over about 10 weeks from the 9th centile to the 75th. Then at about 8 months he firmly rejected all further offers of formula, his weight stabilised (stayed on the 75th centile) and we were back to solids plus breast feeds night and morning.

The local midwives and HVs were extremely supportive of breast feeding, but fairly ignorant of both the biology and the practicalities. They did their best, but there really wasn't any specialist help available locally. As an agricultural graduate (where you learn a fair amount about the biology of lactation) I found some of the advice I was given pretty suspect. Equally, my HV was rather startled when I told her that he had just demonstrated classic compensatory growth! (It was a real pain, because I had estimated his weight forward on the 9th centile to buy various bits of baby kit, and he promptly outgrew them in less than a month)

Ds eventually came off the breast around his second birthday, so I don't think I did too badly. It helped a lot that I was absolutely determined to bf, because of a family history of allergies. If I hadn't had that motivation, I am sure I would have given up pretty quickly.

So in answer to the Ops question, I suspect that the weight gain is down to quantity rather than quality. Provided the baby is not being pushed too hard she should settle down and her weight stabilise again.

I don't believe anyone is talking about reinventing the wheel. There are still many, many unanswered questions about neonatal nutrition and some of these would be interesting to explore. (Just as there are many unanswered questions about adult nutrition, an area which I have spent years looking into). Further, there are many unanswered questions relating to the effects of maternal diet/health status during pregnancy and lactation. That is not to say that nothing is known, but as with many areas of science, we still have many, many unknowns. That is what makes science so absolutely wonderful !!! (excuse the nerd in me)

Eeeek....I have no wish to stifle research, AcademicMum I agree - there's lots we don't know. I actually think the big holes in research are not in the technical/what's in breastmilk/maternal diet area, but in the social, psychological and cultural areas, which would help support breastfeeding more effectively. This may reflect my pre-disposition, I know.

But we do know quite a lot about the topics you brought up, including diurnal variations in breastmilk. Obv, there is never a 'last word' in any of this. So carry on

The weight gain in the baby sounds like it could be linked to the improvement in relflux seeing as that happened when the switch to FF took place.
If baby is no longer vomiting up lots of milk but taking in the same amount (whether BM or FF) then that will have an effect on weight gain surely.
I'm sure it will settle down when baby adjusts to the reflux improving.

Tiktok- I would disagree that there are no more big holes in the "what's in breastmilk" area. If we knew it so well, formula would much better reflect the composition of breastmilk (within the obvious financial constraints of the formula companies - they want to make a profit after all), but we know that whilst it is an adequate substitute for BM, it does have nutritional disadvantages. As I say though my main (research) interest is adult health/nutrition.

Academicmum - I agree we don't know everything about precise composition of breastmilk. I think what I am meaning is closer to 'I am personally less interested in knowing the precise composition of breastmilk beyond what we know already'

I am not convinced of the practical value of knowing the minutiae to the generality of the bf experience, to be honest.

But its a good job we don't all think the same

And once they figure out the exact composition, a formula company with trademark it

ilovemydog - very possibly. There is no reason why babies who are not breastfed should be given anything less than the best science and technology can give them.

I would be unhappy about the trademark. This means that only one company could produce this replica milk, and that would be a poor deal for the consumer. If the replica milk is that good, then all babies who are not bf should have it.

I would be surprised if this would in any way be 'as good as' breastmilk because the chances of this happening are about the same as the development of blood, or lymph, or cerebral fluid, from an animal source for use by humans.

In any case, for me, the question of how the milk is delivered is important, and the experience of having milk direct from the mother has different qualities from the experience of having replica milk in a bottle.

I would agree absolutely that there is more differences between the breast and the bottle than the simple difference of the actual milk that is delivered and the bond between breastfeeding mother and infant is something very special. This bond possibly has as much to do with the infant's healthy development as the physical process of nourishing the baby. I think this is also why differences between breast and bottle are so difficult to study because we can not distinguish the physical and emotional differences between the two feeding methods.

I'm guessing it's because the baby is now keeping the milk down..rather than any calorific content difference

Very interesting to read all of your posts, and glad that my little ponder has led to such interesting debate!

I feel relieved that there have been so many sensible explanations for the baby's weight gain, and I am genuinely nerdily always interested in learning more about BF!

You never know, maybe in the future it will be possible to create a breastmilk substitute from a human source for human use?!

Tiktok - "there's lots we don't know. I actually think the big holes in research are not in the technical/what's in breastmilk/maternal diet area, but in the social, psychological and cultural areas, which would help support breastfeeding more effectively. This may reflect my pre-disposition, I know. "

This is what Im trying to do with my phd really. Look at the differences in consumption/weight gain and consider why this might be - from a physical perspective but more importantly from a psychological perspective...and then how we can go about helping mums who want the support.

You are most welcome to a read if you are interested or the papers from it...that would bring the total number of people who read it up to four lol (after me, my supervisor and the examiner...actually thats presuming they read it too )

Am wondering whether the flood gates of stem cell research will have any impact on the discovery of genetic composition for breast milk?

I don't know.

But it is an ethical debate to have now rather than the bionic speed of science.

Aside from the bonding element between mother and baby, and aside from the fact that anything manufactured is inferior, the amazing thing about breast milk is the ability to adapt to the baby, so is personalized in a manner that science would really struggle to keep up with.

I think you're right that science couldn't keep up with the personalised nature of breastmilk. This is after all the holy grail of pharmaceuticals, personalised medicine. BM is personalised food, providing the baby with the exact requirements that individual baby needs. Sometimes however something can go wrong in this mechanism and in this case, formula can be a life-saver (literally). In other cases the BM may need to be "tweaked" abit. For example, my ds2 has a cows milk protein allergy and suffered with eczema, blood in his stools and many other classic symptoms of milk allergy despite being excl. BF. When I first tried him with yoghurt he went into anaphylactic shock and since then I have removed all dairy from my diet and his symptoms have cleared up.

I also think though we have to accept that formula is part of 21st century life (just as in the past women who didn't want to BF had wet-nurses) and it is important to learn what effect having the majority of the population starting life on the milk of another mammal will have on the long-term health of the whole nation.

Academic - my DS is the same. He's even intolerant to Nutramigen, so is being prescribed the holy grail of amino acids...

I wasn't so much debating breast feeding and the place of formula here. In any case, feel that when a baby has extreme medical intolerances/allergies, then it gets into the realm of medicine.

My point was more directed the the potential of science to create breast milk in the future; knowing the exact genetic make up and using technology to mimic this.

I don't mean formula, but perhaps anything that is made in the lab is formula, but more from the stance of knowing the genetic markers and re creating this.

Would be excellent if this were possible ....