Breastfeeding help- have I messed it up?

[Cremad]

Hi guys, praying for guidance. My lo is 5 weeks and my maternity nurse has always encouraged me to ‘top up’ my breast milk with formula. The problem is the formula is now doing most of the job and I’m not producing enough milk to keep her satisfied from my breasts. Am I too late to start producing more milk for her, i would love to exclusively BF but don’t know where to start as she’s in a good 4 hourly routine. Any help much appreciated thank you xxxx

Your maternity nurse has encouraged the move to formula because a 4 hour routine is rarely compatible with bf. If you see that as ‘good’ maybe how you have it is worth keeping?

Otherwise no one can really tell about your supply. Depends on your body’s response but what you need to do is remove milk as often as possible - baby or pump but much more frequently than four hourly. Domperidone helps a bit if appropriate for GP to prescribe but there is nothing that beats milk removal. If you call a bf line they would help you make a plan and know how to have a sense of whether it’s working .

Offer breast more frequently, top up rarely. Breastfeeding is not a routine thing, it's responsive. Your maternity nurse is showing up her lack of knowledge. Breastfeeding in the night is also crucial to help your body 'know' that it needs to produce more milk.

Exactly, I’m not surprised your maternity nurse suggested a formula top up - if your were EBF it would likely be much more frequent. You can get back to EBF but you’ll need to feed feed feed on demand and put up with cluster feeding. Upto you how much it’s means to you.

Feed, feed, feed. You can’t have a four hourly routine and breastfeed. Why was the formula recommended. If you want to ebf you need to get rid of this maternity nurse and get support from someone who knows about breastfeeding.

This!

Spend a few days in bed or or the sofa skin to skin with baby and letting them breastfeed completely on demand. You’ll probably have to completely loose the routine atleast to start with and work back to one later.

Most breastfed babys need feeding every 2 hours at that age.

Its a shame that your maternity nurse didn’t prioritise breastfeeding if that was what you wanted to do.

Do you have a breastfeeding charity locally? Surestart used to offer breastfeeding support, and some local councils have breastfeeding groups in children's centres. They were an amazing support for me, better than HV.

As others have said, you make milk due to demand. The more baby demands the more you will make. Night feeds are critical, as they are essentially putting the order in for the next day.

You can change the pattern, don't give the formula. Baby will be latched for most of the day/night to establish supply. Get a good box set, snacks and water (loads of water) get comfy! Loads of skin to skin/physical contact will encourage supply too.

It's supply and demand - feed lots, and lots of skin to skin. I'd recommend seeing an IBCLC if you have any worries or need a hand-hold 

I would just breastfeed your baby as much as you can. If you must use formula, then cut the amount you use in the bottle. I breastfed all my children with no formula. I just fed them when required. I didn't have a routine.

What an amazing community thank you all so much. My worries we’re about my maternity nurse’s lack of knowledge but she always responded rather hurt like I’d dated question her experience. It makes me feel a bit sick as all I wanted was to EBF. Now terrified if I try I’ll be undoing the good routine work and upset with the maternity nurse as all is said was how much I wanted to EBF

Breast feed on demand.

EBF rarely have routines, maybe when they are older.

The choice is yours.

Yes sorry, this advice has been incorrect from the maternity nurse and the “top up trap” is known to reduce milk supply and make EBF harder.

Some good advice here -
kellymom.com/ages/newborn/nb-challenges/decrease-formula/

kellymom.com/hot-topics/low-supply/

It may be worth speaking to a lactation consultant/ IBCLC for some advice.

All the best!

Personally if you are producing, and are absolutely determined to bf, I would offer the breast every hour to try build your supply and then inbetween say 3/4 of the breastfeeds if your baby still seems hungry then offer formula then.

When DD was born she lost a lot of weight and they wanted me to pump, feed and top up with formula. It was too hard so after 2 days I sacked it off and offered breast every 45 mins instead to build my supply. However that was when DD was 3-5 days old. I appreciate you have an older newborn so not sure how it works definitely, plus every baby and mother is different.

Sorry that wasn't clear, I mean it would potentially look like:

7am BF

8am BF

9am BF

10am BF and then top up FF but less, if still hungry

11am BF

12 BF

1pm BF

2 pm BF and then top up FF but less, if still hungry

3pm BF

4pm BF

5pm BF

6pm BF and then top up FF but less, if still hungry

7pm BF

8pm BF

9pm BF

10pm BF and then top up FF but less, if still hungry

11pm BF

2am BF

4 am BF

7am again

THIS is just an example and I am not a qualified infant feeder. This is just how it looked for me in the early days without formula though.

Please though, if your baby is losing a lot of weight after this , consider topping up with formula again/seek support to increase milk supply as the main thing is a healthy and fed baby. X

You have not failed whatever you do. If baby is loved, clothed and fed, and have safe and clean conditions, they are content. Xx

I've also heard night breastfeeds are incredibly important for building supply

It's bloody hard work breastfeeding in the early days !

What qualifications does your 'maternity nurse' have?

I was exclusively breastfeeding but found out at 4 weeks old that my baby wasn't gaining enough weight. The paediatrician wanted me to put her on formula but instead I contacted a private lactation consultant.

She put me on a programme of:
Pump
Breastfeed an hour later
Give baby expressed milk from earlier
Give a little formula if baby was still hungry

I couldn't let more than 2 hours pass without emptying my breasts, which included setting alarms during the night.

I did this for 5 days after which I started power pumping twice a day. About 10 days later I stopped topping up with any kind of supplementary milk, formula or expressed. I weighed my baby weekly to ensure she was gaining enough weight (she started thriving!).
She is 5 months old and I'm still EBF.

It is not too late to EBF but it requires direction from a qualified lactation consultant who actually understands lactation, as well as a huge amount of commitment as its a gruelling process. But it is definitely possible. Pm me if yiu like.

Be prepared that if you do this it's likely that your baby will cluster feed (as in only break when you need the toilet!) for hours at a time. This is normal. If she is fussy then that's also normal as she will have to work harder to get milk.

You will have to grit your teeth through a few days / week until your supply matches her demand. It wont come immediately but it does adapt pretty quickly as long as you literally don't do anything else for the next few days.

And yes to water water water. Get a sports bottle and have it constantly full. Try to aim for a bottle every feed or every hour. And make sure you're eating properly - I swore by a huge bowl of porridge first thing!!

The routine will disappear completely - again, this is normal.

Make sure you also keep feeding through the night as this is the most important time. Maybe try to get some extra rest in today, tonight and some extra naps In the day tomorrow then start tomorrow evening so you're ready for a sleepless night just in case??

Just keep feeding her as often as possible and gradually reduce the formula. It might 'feel' like you don't have enough but as long as she is putting on weight then you have enough milk - your body will magically make it but the demand is stimulated by the baby suckling more. Get a good box set on, snacks at the ready and just sit on the sofa and feed feed feed!!!! Good luck xx

Oh, my baby was exactly 40 days old when I realised my milk had fully come in. I really thought it would never happen and almost lost my mind during the process, but it worked.

The first 6 weeks are crucial in building supply so if you act now you should be absolutely fine to get back up to exclusive bf. First stop listening to the maternity nurse cos she clearly hasn't got a clue!(I found a lot of professionals tell you you have to do what they did not what's best for you) And yes what everyone else has said about not being compatible with a 4 hours routine. You already have a supply so that's great but if I were you I'd be searing for advice in relactation (there's a good section on kellymom) and following that advice asap - the sooner you take action and reduce then cut out formula (assuming that's what you want to do) the more likely you are to have success.
In general you want to feed as much as possible - like offer the baby all the time! Drink loads of water and make sure you feed at night as the milk producing hormones are higher at night so feeding at night will increase your supply quicker than the equivalent feed during the day. Be prepared for a week of doing nothing else and you'll get there. If you're finding it's not working or baby won't take the breast as much as you'd like (they can get used for the ease of bottles) you can look up power pumping.
You definitely can do this and breastfeeding is easier in the long run than bottle feeding (imho having done both) so you're investing time now in making it easier fire or yourself later.

Haven't read any responses. I have no authority, be free to ignore at will.

You've been very badly advised. A 'four hour hourly routine' is never good for a breastfed baby. Your lo needs to be at the breast 24/7. They suckle and doze, returning to the breast ever 20 mins or so - or more frequently - for a few sucks. This allows the baby to give the right message to your body about how much milk is needed.

The good news is that five weeks is nothing! Hardly a beginning. Few first time mothers have it all sorted at five weeks. If you are eating and drinking normally, resting a lot (holding your baby at the breast) and giving complete access to the breast your milk supply should build up in a few days. Bed rest is best if you can manage it. You can gradually reduce formula, offering on your four hourly schedule, but as your breastmilk increases, lo will need less and less. I am 100% confident about this because I did it myself and the baby is now 40 and in fine form. She was fed until 4 years 3 months, and fed her baby for 4 years 9 months.

You can do it.

I'm a bit shocked at your maternity nurse. Is she private or are you not in the UK? She is very badly informed and you sound terrified of going against her which is odd. Top ups are absolutely destroying your supply.

If you want to keep baby to the routine, you may as well forget BF never mind EBF. Breastmilk is much gentler and easier to digest than modified cows milk which means babies need to feed much more often. It's not really a routine as such, simply getting yourself familiar with your baby's cues and offering as often as you can.

Every feed is creating demand for for more milk which means you basically need to spend a week or two putting baby to breast all day and most of the night. The good news is it will help you burn calories and produces lovely happy sleepy hormones.

Honestly, get Netflix on. Watch some films with a blanket and keep your boobs out. Literally how I spent the first few weeks! Don't forget to stay hydrated.

Thank you so much for your supportive and encouraging words. XXX

To guarantee your supply you need to be making about 750ml per 24 hours and to sustain it for a few weeks after that your supply can dip and elevate happily. The closer you are to that kind of number the easier but sometimes supply an he responsive even if you are a long way off. You need good bf support - any of the charities NCT, BFN, ABM, LLL are great.