Is giving the odd formula to BF baby really that bad?

[Positron]

Hi all, am new here.

I am a bit mixed up in the head about this whole breastfeeding thing.

I wasn't able to BF my DD (now nearly three), and was determined to BF my DS who is now 4 months. I had problems with latch initially but now BF has been going reasonably well since.

However, I am having to give him the odd "rescue" bottle of formula now and then (mainly when it's his last feed before bed), because I simply have no more milk left to give him. I have found however that this is happening on a more regular basis. The poor guy is getting hungry and frustrated and it is really upsetting me that I cannot offer him any more breastmilk - hence the formula. I feel that the healthcare professionals might look down on me for this, but what else am I supposed to do? I'm trying the usual advice to keep up my milk supply, but not always working. I want to stop beating myself up about this, but am finding it very hard, as everywhere you look, there is a poster advising exclusive BF for first 6 months. Is having the odd bottle of formula here and there so bad? Please help.....want to feel sane again!

Hi Positron,
Well done for making it to 4 months!
Giving a bottle of formula will mean your body doesn't know that baby needs more milk - so it won't make extra milk. This is probably why you feel your supply is dropping.

The good news is that your marvellous body can sort this out pretty quickly. Just let your baby suckle (even if you feel he's not getting much). The breast will make more milk if the baby suckles. It may take a few days of frequent feeds but after that, as long as you avoid formula top ups you should be fine.

Expressing will also up your supply. You could express at a time you have lots of milk and give it to ds later on.

Hope Tiktok is along soon.

Hi Positron, the odd bottle of formula is not bad but it does have an impact on your milk supply as you have already noticed.

I did the same with my first baby and was devastated when my supply dried up when he was 6 months.

I was completely useles at expressing so couldn't use that to boost my supply/ give bottles + I was unaware that my supply was dwindling.

I think what I am trying to say based on my experience is don't give too much formula if you want to keep breastfeeding.

When I had baby number 2 I was paranoid about formula and breastfed until she was one.

Hopefully Tiktok will be along soon.

Thankyou for your kind messages.

I do have a mammoth expressing session every night (anytime between midnight and one in the morning). I manage to get anywhere between 3 to 5 ounces when expressing, and give that to DS the following day (luckily, he has been good at switching between breast and bottle).

I think what has happened is that I have been away on a long 7 hour journey to visit my parents - was a flying visit - just stayed there a couple of nights, but it totally disrupted his routine - we arrived at 01.00 am and he just wouldn't sleep because he had spent the whole time sleeping in the car (he normally gets down for around 8pm). Then I was too tired to express, so I guess my body thought I didn't need as much.
I hadn't expressed for the last three days, so this must have had an impact. I did express last night and got 4.5 ounces, so will hopefully get back into this routine.

I guess though, what I am also trying to ask is this: even after expressing every last drop, and I find the milk supply is still not enough, then what do I do, as formula seems to be the only last resort at that moment when he is completely ravenous and distressed! I tried to ask the breastfeeding couseller this yesterday, but she just wasn't straightup with me as to whether this was ok or not......

Personally I wouldn't even express - just feed him as often as you can (offer as well as when he wants it), within a couple of days your supply issues should be sorted.
What makes you think you have poor supply on a night? There's never no milk as it's produced on demand, obviously the difference is if your breasts are full he'll get a mouthful fairly easily.
The main issue with formula is supply as you're finding, and that once you're in a routine of giving one bottle a day, another one seems the solution when he's hungry at other times, rather than letting your body sort it out, and that can lead to stopping breastfeeding before you planned to as your supply diminishes.

The supply/demand thing seems to be a leap of faith but it really does work. I had major supply issues after a hospital stay when DS was about 4 months but managed to re establish supply. I'm currently feeding my 2yo and my 8week old, didn't feed the 2yo recently for a couple of days and could really tell the difference, but again it sorted itself out.

Hi Positron,

If you are having plenty of wet/dirty nappies then your baby is almost certainly getting enough! I know what you mean about 'doesn't seem satisfied', but he's just working hard to get your supply up, that's all. At the end of some feeds DT1 does this too, writhing around and punching the boob (quite comical to watch, as if he thinks it's broken!), but within a couple of days the supply has responded and there is enough. He put on 1 1/2lbs in the last 2 weeks, despite the writhing, pulling off and going back on and the frustrated boob punching!

Within the bounds of being sensible (wet/dirty nappies etc), I think breastfeeding is a bit like flying in Peter Pan - hold your nerve, keep believing it is working and you are making enough milk, and you will.

(a bit 'out there', but it works for me smile)

Positron - nothing you say here makes it sound as if there is a chronic 'under supply' issue, honestly.

There is some good info already on this thread - you may need to raise your supply now, because the odd bottle does impact on supply, especially when you are also giving him expressed the next day....this means the gap between breastfeeds is artificially extended (it's irrelevant that it's extended with a bottle of ebm). Gaps between feeds = less breastmilk being made.

This is why frequent feeding, from at least both breasts each time if your baby co-operates, increases your supply. Doing this for a few days inc. at night (and no expressing at midnight - not needed) should turn things round for you and your baby and the formula should not be needed

i'd like to join in if i may because i am doing something similar: ds is now 11 weeks but for the past 4 i've been giving him 5oz of formula at bedtime - in addition to the hours of b/feeding he already does, not as a replacement. he glugs it straight down, like he hadn't eaten for weeks (despite feeds prob every 2 hours or so, with both breasts), and then has some more breast before being completey zonked and going to sleep.

the health visitor recommended this at about 6 weeks because he had barely put on any weight in the three weeks since he was last weighed, despite feeding on demand for as long as he wanted (lots of wet nappies, not so many poos).

he lost just over 10 per cent of his birth weight and took 2 weeks to get back there again. also, he is incredibly "busy" and never stops moving - sitting in his chair his legs are constantly kicking, and he doesn't sleep much during the day so i guess he uses up a lot of calories.

i've spent hours reading all about supply and demand etc but if he was not putting on weight then surely he needed a supplement?

Thanks again to all.

I also express milk to have with me when I'm out and about, as I don't do breastfeeding in public all that well, so I don't wish to discontinue that.

I do appreciate the issue of supply and demand, and the fact that longer gaps between sucking at the breast by giving a bottle (whether expressed or formula) is not helping. When I express at night, I get every last drop out that I can get. Shouldn't this in itself be a stimulus to make more milk?

Maybe I need to just persevere with frequent feedings, but if DS refuses to suck when he's frustrated, then gets distressed, I'm at a loss......that's when formula seems like the only option left.

Positron: I too have been given my DS, now four months, a bottle of formula at night since he was born, or thereabouts. He clusters feeds like mad in the evening - every hour or so - and my boobs end up like empty socks. He pops off the boob, crying, and despite countless people saying 'you never run out of milk' cannot believe this is true.

After an evening of feeding and grizzling, he guzzles a bedtime 6 to 8oz of formula like a starving man.

My supply may have dwindled slightly, but it's enough to keep him going the rest of the day, so can't be that bad...

Sorry Camflower, hadn't seen your post when I wrote my last post. I certainly know what you mean about baby glugging down formula like he hadnt eaten for weeks. I guess the difference here is that DS weight is ok, with plenty wet nappies etc. But he just doesn't seem satisfied at times, despite me feeding long enough to give the hindmilk. I wouldn't disagree with your health visitor to add formula if weight was an issue. I hope that all gets back to normal soon.

Thanks herbaceous - know exactly what you mean!

My understanding is your breasts are never truly empty, less full perhaps, but not empty. Is your worry mainly milk supply or are you interested in the risks of formula?
There's some really good info on Kellymom - not sure if I can add a link here but will try :- www.kellymom.com/nutrition/milk/infant-formula.html
How is baby's behavior between feeds...or at the end of feeds? Does he do anything in particular to make you think he's still hungry?

It's true that a few women, whatever they do, find it very hard to make what we could define as a full supply of breastmilk for their babies. For some of these women, the maximum they can make may be affected by a less than great start to bf in the early days - read up on the prolactin receptor theory for more details. So unpicking what happened after the birth can sometimes throw light on what is causing an apparent under-supply weeks or months later.

On the other hand - breastfeeding can often be improved and enhanced by more frequent, effective feeding, and this is so often not suggested to women. They're told to supplement with formula before anyone who knows what they're looking for can help amend the way the baby is positioned, or before they have even been supported to feed on 'more' sides, more frequently, or explored the option of feeding more at night. Formula is only one way to get more calories into a baby - and it has several drawbacks. However...in some cases it may be the preferred option if none of the above work quickly enough to ensure the baby is growing healthily.

Sometimes, building up a milk supply does mean weathering the storm of a baby being apparently unsettled and frustrated for few hours - lots of cuddles, jiggling, and so on, and that can be hard.

The way a baby downs a bottle of formula gives no clue to his real level of hunger - many babies love to suck and they will suck on a bottle and if milk is 'attached' to the bottle....down goes the milk.

Positron, yes, expressing does stimulate milk production because it removes milk. But that can be totally overridden by using the ebm which creates a gap between breastfeeds.

Hindmilk, by the way, is not related to time on the breast so much as amount of milk in the breast - emptier breast = more hindmilk. So secondarily, that can be related to time on the breast, but not necessarily.

Thanks tiktok.

I'm prepared to try even more frequent nursing, but what is frustrating is that they say BF gets easier and feeds are more spaced out in time. However,I feel as if I need to nurse him more and more...at 4 months!

I have often wondered if the reason my supply is running down is because I didn't get off to a good start with breastfeeding in the early days. I was worn out after the birth, and sick after the epidural. I barely recovered from all of that before the breastfeeding counsellor came to see me on the ward, when all I wanted to do was sleep (was in labour for 30 hours). Thus didn't take very much in. Problem was latch. It is to the community midwife that I owe the graetest of thanks for getting the latch sorted out, but this was approx. 10-14 days postnatal.

When I think about it all, so much emphasis is put on labour and the birth, and while I know that antenatal classes explain breastfeeding, for me, that part seemed less of an anxiety when you know you have to get baby out first! But it shows how important it is that expectant mothers are as clued up as possible about breastfeeding, which is arguably the hardest part of the whole business.

Oh, it's not going too well now for past 3 days/nights!

Despite frequent breast feedings during the day, DS seems to get frustrated in the evenings (earlier on as each day goes on) - he sucks and pulls off crying/whimpering as if something is bothering him - I feel it is that there is no more milk left (beacuse I then try and express some milk after this frustrating session, and low and behold - very little milk comes out). I end up giving a bottle of formula to settle him down for the night. Then, at around midnight, he is up again, and cluster feeds from each breast for much of the night, leaving me exhausted! I then find that he has started napping more in the day (prior to this, he was usually awake much of the day). Now it's as if he doesn't know his days from nights, and everything is just not as it should be. After much cluster feeding last night, I caved in at 14.00 this afternoon with formula (simply had no milk left, and he was ravenous!) Can anyone shed some light on what is going on here? I'm this close to just caving in with formula more and more (although still want to breastfeed whenever I can). At the end of the day, no matter what people tell me about supply and demand, it can't be right to leave a baby hungy and frustrated, can it?

It sounds like you're really struggling.

How much milk you can express is not a very good indicator of how much milk your DS can get out. You can just keep switching boobs, even when your breasts feel empty - they are rivers, not buckets, always refilling themselves.

I don't think you should be relating how much milk you're able to express to how much your baby can get out of the breast... babies are so much better that this than pumps are. I express but would never do so after a feeding session - I don't think I'd get much out!

Getting day and night the wrong way around must be frustrating for you though.

I think in your position I'd cancel all plans for the next couple of days and basically allow the baby to cluster feed all day - initially offering the boob at least every two and a half hours even if he doesn't ask. If at the end of it you're still not convinced he'll sleep, by all means give him a bottle of formula last thing - but hopefully you'll then teach your breasts they are required to produce more in the day - and teach your DS the daytime is about feeding, the nighttime about sleeping - and eventually be able to knock the formula on the head.

The key thing is getting day and night sorted out, if you can. Don't listen to people who bang on about how babies should be going longer between feeds by a certain age - that's secondary at best. I've had this advice throughout with DD and have never paid the slightest bit of attention. Some days she's on the boob loads, some days she's not. It's up to her.

• "at this" not "that this"

Hi Positron

I am doing the same as you for my 4 month year old, despite feeling terribly guilty about the formula which she gets about once a day.

I know exactly how you feel about the 'empty' feeling. I tried and tried to do all the stuff everyone has already suggested - extra feeds to boost supplies, feeding at both breasts every time etc but she simply seems better in herself and more satisfied with this extra one.

I express the feed I miss so that my body doesn't drop supply and I have some back-up feeds for going out etc. Whatever anyone says, I also feel this gives me an indication of how much I am producing.

I don't think we should beat ourselves up about it, we're doing our best.

Bobbieboy - I agree, women who are doing their best don't deserve to beat themselves up about the way they're managing.

The facts are clear though - expressing is not an indication of production. Pumps can work better than babies sometimes, and sometimes not as well. One of the real downsides of expressing is that women cannot help but judge their 'performance' by the amount in the collection bottle - and it is so misleading.

In any case, production itself is not the issue...it's the amount getting into the baby that counts!

Thanks to all for yor replies.

However, if my milk is supposedly still there, why is he pulling off the breast in frustration at times? That's what makes me want to cave in!

Are you sure he's pulling off in frustration though? My DD has started pulling off several times in some feeds after three months of feeding very peacefully - I suspect it's because she's hungry and yet also a bit bored. It never happens when she's tired, but when she's on the go she doesn't want to stop and lie/sit still. She's also discovered her thumb - it's her new toy - and she doesn't see why she can't feed and thumb-suck at the same time!

All I'm saying is there are all sorts of reasons why he could be pulling off. And don't forget the "river not bucket" analogy - you can make milk as it's needed. In fact, when you express, you can sometimes see this in action - the amount you're producing goes down and down until the breast empties and then suddenly you're back to seven or eight jets of milk despite the breast feeling completely empty

Well, he's pulling off and seems frustrated or distressed by soemthing. If he pulls off and then I leave him off the breast for a second, he wants to go back on it, but will pull off seconds later, again in some kind of distress.

positron - I can understand this is enormously frustrating for you....someone needs to watch you feed (someone who knows what to look for...) and find out more.

It is certainly possible there is a supply issue, intermittent or not....the use of formula can create this, and then make it worse. I have no idea if this has happened to you, but it's possible. As I say, someone needs to observe and discuss, in real life