How much is too much?

[happyspider]

I have a 3 weeks old baby boy who's constantly hungry. I breastfeed him, but he also needs a top up with the bottle.

Lately though he's been demanding more and more formula milk, even though he still gets milk from my breasts at every feed.

I feed him every 2 to 3 hours and he normally gets through 150 ml bottle at every feed, sometimes even 180ml(that is 6 and half ounces!), otherwise he won't settle or sleep.

I am worried he's eating too much as he's so little and was tiny when he was born.
He's putting on weight and has never been sick so far, but I wonder how much is too much for a baby so little like him?

Happyspider - have you tried a dummy? Breastfed babies who are offered a bottle after a feed will invariably take it because it is something different. It is the same scenario of you being out for a meal. You may feel really full but once the dessert menu comes you suddenly have space for it. He certainly is taking a large amount of formula. If you would like to contine breastfeeding I would reduce the amount of formula you are offering him after feeds. Babies do not always immediately sleep after a feed, so perhaps he does not really need so much milk.
Are your nipples better now? Do you feel he is fixing well? If so, then it would be OK to give a dummy because perhaps he just likes to suck. If you feel you do not have enough milk, and you are B/F every 2-3 hours, you might want to try Domperidone (Motilium) tablets. Apologies if I have posted this to you before. It is a medication that can be bought over the counter. It is used for bloatedness but a side effect is to increase prolactin levels which in turn increases milk supply. You take tablet (10mg) 3 times a day for 10 days. We recommend it to mothers in our hospital who have supply problems, especially those expressing for babies in special care. When you say he feeds every 2-3 hours, is that from the start of one feed to the start of the next, or is it the end of one feed to the start of the next? Usually the timing of feeds is classed from the start of one feed to the start of the next so he might be going longer than you think. Just a thought...

Thanks Mears, I think I have seen your posting, but I am not sure how much he's getting from my breasts, that is why I haven't tried domperidone yet. Sometimes I feel like he's using my breasts as a dummy, even though they are full when he latches on and look less so when he leaves them.
On the other hand he used to spend 25 minutes on each breast and now only stays for 10 minutes.
I am going to express my milk today to see how much he gets at every feed.

When I say he feeds every 2-3 hours I mean from the start of the feed. At night though it can sometimes be every 4-5 hours, but only if I give him a big bottle.
As for him not being hungry, I don't think it's the case since when I stop bfeeding him he starts eating at his hands and goes into a frenzy mood, cries and will only settle if I give him more food

Hi Happyspider - if he is still hungry after a breastfeed then you need to produce more breastmilk which is totally possible. Once you have B/F him, do you ever put him back on the breast, rather than give him a bottle? Especially since he is only feeding for 10 mins. What you sometimes find is that babies who are regularly getting bottles tend to not spend so much time at the breast because they get conditioned to expecting a bottle afterwards. They then are not at the breast long enough to stimulate adequate milk production.
You can reverse the trend by offerring an ounce less of formula after each feed on a daily basis.
That means he will go to the breats earlier because he will not be so full. You could also express your breast post feed while your dh gives the bottle, purely to stimulate more milk production. The domperidone could give you a kick start.
Beware of thinking that the amount you get expressing is the equivalent of what the baby gets. Your body lets down milk to the baby more efficiently than expressing. Some women never get good at expressing and it can knock their confidence. However, it would be good to do it for the stimulation value.
I am not criticising your choice of mixed feeding either. In your case it sounds as though the bottle is going to take over if you are not careful. I am just trying to help you increase your breastfeeding element. Your body is capable of producing the milk your baby needs. Sometimes it just needs a bit of direction. However, you may be happy the way things are, in which case just ignore me

Happyspider - Could he be crying from wind ? When they are windy babies confusingly think that they are hungry - is he drawing his legs up to his chest, whining and crying ? After ten minutes you think he is hungry, give him some more food - just compounding the problem.

I was doing this with DS2 ( you think I should know having done it before ). Now if he does this I just grin and bear it and wait for him to come out the other end - then he returns to being happy chilled out fully satisfied baby .

I sympathise with the mixed feeding - as your experience sounds very similar to mine. I am still mixed feeding at 5 weeks as I seem to have come through the pain barrier, but it is tough and I do seem to be falling into a pattern of more bottle feeding. Any breast milk is better than none - maybe you can concentrate on increasing breast milk at the least stressful time of the day ( for me the morning ). Then at least you will feel confident to breast feed him at one time of the day.

Also, I understand that babies tend to go through a growth spurt at 3 weeks - so he is likely to be hungrier anyway.

How are you getting on happyspider?

Hi mears, thanks for checking on me!
baby is gaining a lot of weight, mainly due to formula milk I have been told by health visitor.
I am trying to bfeed as much as I can to increase milk supply, but he is still hungry at the end of each feed, evenings are worse, I have tried cutting on the amount of formula he gets, but he will cry his eyes out if I don't give him as much as he wants, then he will fall asleep like an angel.

I have actually found an article on the internet re tongue-tied babies and bfeeding and find it very similar to my story. it's available at
home.clara.net/abm/pages/magazine/tonguetie.htm, I wonder if I should have him checked?
Do u know anything about this topic?

Hi kaz33, he's not windy, in fact he's very good at burping and looks very happy with the bottle! He will sleep only after I have fed him as much as he wants from breast AND bottle. He is never sick and never complains.
Except from the food tantrums, he's a complete little angel

My dd2 is doing the same of whining and crying - I was wondering if it's wind, what do you think?

Funnily enough happyspider, I was recently at a breastfeeding conference where one of the speakers was a surgeon from Edinburgh who 'snips' tongue ties. Has your baby got one then?
Babies with severe tongue ties find it difficult to breastfeed because the tongue cannot protrude enough to attach to the breast properly. It has been out of fashion to separate tongue ties surgically for years but his opinion is that the babies referred to him are able to feed much more effectively and the mothers are happier. His father was a surgeon and also 'snipped' tongue ties. One of his own children had a tongue-tie too.
He snips them there and then at his clinc. It does not bleed because there are no blood vessels and the babies do not appear to find it painful. Most feed straight away.
It is his opinion that it is unfair to deny a child the chance to lick an ice cream, stick their tongue out at someone or even french kiss
If you feel your ds has a tongue-tie and is not feeding properly I would definately advise seeing a B/F counsellor to confirm your suspicions. If he is not effectively emptying the breast then it is really important to express as well as feed, to maintain your supply. You would then be able to build up a stock to be able to give him EBM as well as, or instead of, formula.
If he has a tongue-tie that needs surgically treated you would need a referral to a sympathetic surgeon. I will get details of the speaker I heard incase you need support of the practice of 'snipping' them.

just read the article - the surgeon speaking said that there was no point putting a baby on a waiting list for surgery because the problem would only get worse. That is why he 'clips' them there and then. Sounds a great man.

Happyspider, you can see if your baby has TT yourself by seeing if he can extend his tongue. If he has a short frenulum, he won't be able to do this, and in extreme cases, the tongue looks heart-shaped at the tip.

What happens if you put him back to the breast if he appears to have finished the breasts? Or if you put him back to the breast after he has had some formula?

To build up and maintain a good breastmilk supply, babies of his age - three and a half weeks - usually feed many times (8-10 or more) a day, but the feeds do need to be effective, of course. Hope things go better for you.

Motherinferior - could be wind !!

My DS2 was getting very stroppy between immediately upto an hour after a feed - lots of pulling up of legs, whining and seemingly rooting for food . The test with mine is - is he rooting when he is not pulling his legs up. If not then he is not hungry and you just have to wait until he works it out of his system - half an hour later he is happy contented baby.

I have been giving him Infacol and it has made a difference, also the proper spacing out of feeds has helped. You are breastfeeding arent you - I find it really difficult when breastfeeding as, as you never know how much food they have the temptation is to put them back on the breast. If i try to and he is not hungry then he doesn't latch properly and squirms about a lot.

I'll try and see what happens with the legs...I was thinking she's too little to space feeds at the moment but I might try a bit more - I am waking her to feed if she kips for longer than 3hours in the day, I have to say.

How are you anyway kaz? let me know on the june/july babies thread!

Went to gp today and he said that the baby has a mild form of tt, but should not prevent him from bfeeding. He's against snipping..

Not sure if this is the cause, I am keeping the mix feeding as it is working for me now. The gp opinion is that the baby was tiny at birth and he's now making up for it, in fact he's just about average for his age now, whilst he was under average when he was born.

Mears, I would like to have the name and no of the surgeon anyway.

by the way, baby James is lovely both when breast feedning and bottle feeding, as he stares in my eyes and eats at his heart content: it's a pleasure to look at him!!!

DH loves feeding him too, which is great

I have been away on a course for a couple of days. Haven't been able to find my study day info yet - it is filed on my bedroom floor amongst piles of other documents. I will look again if you would still like it though. Snipping of tongue ties is usually reserved for babies who have the severe form where they cannot put their tongue out at all. It is good that your GP says his is a mild form. By the look of the June/ July babies thread, feeding is improving

Mears, I am domperidoning myself currently. I didn't realise it was 10 mg x 3 daily so just increased to this dose after 5 days. My concern is, you have to stop taking the medication after 10 days, what happens then, do you start drying up or will your supply maintain with feeding/expressing.

Have to say I'm a poor producer with expressing, only get 2-3 ounces with double pumping for 15 mins(equivalent to 30min single, I think) and the endless sterilising. B/feeding is much easier IMO, if only it would fill him up. Also DS1 has been going mental during b/feeds doing kamikaze things to get me to stop feeding the younger one. He has just started trying to hurt DS2. Another reason bottle might creep in more.

Clucks - how old are DS1 and DS2 - I am having the same problem with my boys with my gorgeous happy boy suddenly becoming stroppy and clingy.

Kaz, just read your sibling rivalry thread which I will follow with interest. My DS1 is older than yours almost 3 and is a loving, eager to please child. He was very happy with DS2 to begin with and now the novelty has worn off. Yesterday, he tried to hurt him and again today and for the first time DH smacked his bum as he had punched DS2 in the tummy. I wasn't here today when this happened and am aghast (at the punching and the smack). I have to say I have a nanny once a week to entertain him and it helps so much I may get her to come more often. Bit extravagant for a playmate, as she has no newborn experience.

So, b/feeding, bottle feeding, holding the younger DS is a nightmare and yes, we do give DS1 lots of praise and attention, maybe it's the heat.

Feel less guilty about the mixed feeding now too.

I know how you feel regarding no.1 attacking no.2. The same thing happened with me, but that behaviour will go onwhether breast or bottle feeding. Breastfeeds at least can be easily interrupted frequently for periods of time - bottles perhaps need reheated if baby likes milk warm etc. so would be more hassle IMO. For me I decided that the baby needed me more. Ds 1 had had all my attention and needed to adjust - which did happen. I think you have to start as you mean to go on. If the baby gets less attention because of the older child's demands, then the older child has 'won' if you like. They cannot dictate who gets your attention, and they will soon learn that the rules of the household have changed. Make sure that when the baby is sleeping, you make ime for them. As older babies become expert feeders, you can B/F and entertain a toddler, believe me.
Kaz, I read on another thread that you are mainly bottle feeding just now. That can be reversed if you want, your milk will increase again with more frequent feeds and offering less formula. Perhaps you could enlist help over a weekend - extra feeds over 24-48 hours will boost your supply. Perhaps you could get the nanny in for a couple of days and you could concentrate on frequent breastfeeding. That along with the domperidone will increase your production no end. You might find that you would get more milk by switch pumping - that is only pumping one side till the milk flow lessens then switchingsides. Then switch from side to side rather than pumping for a certain length of time. Hand expressing is more stimulating as far as expressing is concerned and can be quicker.

Stick in there all of you. It will get better, and so will your toddlers, honestly

Clucks, 10 days of domperidone will probably be enough to kick start more milk production. Actual breastfeeding will keep it going. Don't be concerned about the amounts you get. Some women never get very much.

My production of milk has increased thanks to fenugreek, I really recommend it.
Fenugreek is a herb and can be bought over the counter in health shops, it's not a drug and is completely natural.
My milk increased straight away after I started taking it.
I haven't tried domperidone as was told by chemist I needed prescription (?), and then was advised that I could use fenugreek.
You cannot use Fenugreek if you are pg or if you have diabetis.
Mears, have you heard about it?
My research on the net showed that has less side effects than domperidone and can be used at any stage (i.e. you don't need to be 100% sure you're not producing enough milk).

My ds is now happy after I breastfeed him, I am keeping the bottle for when we are out and about or for the evening feedd, to put him to sleep

Good news happyspider.

I have heard about fenugreek too, didn't know could get it in pill form. I have used it in cooking and it's rather whiffy. Will try our health shop for some. I've unfortunately run out of domperidone after increasing the dose and can't get out today to get anymore.

No I haven't heard of it happyspider. That's what I love about mumsnet - you get to hear about all sorts of things. Glad to hear it has worked for you. I will definately research that one.

how's it going kaz?

Thanks for asking Mears - I have got caught up in my DS1's behaviour and must admit the breast feeding has gone out the window. Not quite sure if I want to put in the effort to re-establish it I'm afraid to say. Don't know if it is co-incidence but both with DS1 and now DS2 I have suddenly felt a lot happier when I have stopped breast feeding. I have conflicting feelings.

We have a lady with loads of experience with newborns coming to work for us three days a week, starting tommorow. Think I will see how it goes.