Guilt about not being able to fully breastfeed and to now combination feed

[HazelEagle]

Hi all - I really wanted to feed our newborn exclusively however it has become really difficult having pumping constantly and not having enough supply for a feed. This meant we had to introduce formula to top him up.

Ive tried nipple shields and it just hurts and im thinking about combination feeding with pumping (expressed breast milk) around 4 times a day with the rest being formula.

However i just feel so guilty for our LO like im letting him down not being able to exclusively give him breast milk. Also worry about the developmental impacts of this too, giving him formula as they always say breast is breast.

I'm sure there will be a lot of people along to offer support for breastfeeding and advice. But as another mother who ended up formula feeding - I just want to say it's absolutely fine if that is the route you take. No one can tell when they're weaned if they took breast or bottle. Your bond will be absolutely fine. There is nothing more magical than watching your partner or grandparents giving them a lovely bottle.
You're not responsible for all the night feeds as your partner can do them equally (I had a night in the spare room each week to let me get back to myself, it did wonders!!) And you can share the load. No cluster feeding, being stuck on the sofa for hours. Dad is more involved so can really bond. The baby doesn't know any different or love you any less. You aren't failing them. You're feeding them. Plenty of women can't breastfeed. It's not a failure. Formula is there for a reason. Your baby is just happy to be full and warm.

OP, please do whatever is best for your LO.

I was desperate to feed DS1 myself. He didn't have a strong enough suck and by 9 weeks he was referred to a consultant paediatrician for "Failure to Thrive". I had to combination feed and I felt like a complete failure. However, DS1 turned from being a screaming, demanding baby into bring a delight because he wad no longer hungry.

I felt horribly guilty but, looking back, it was absolutely the right thing to do. He is now 27, a picture of health and no lasting trauma as far as I can tell!

Please be kind to yourself. I'm sure you're a great mother

You are not letting him down, and the breast isn't always the best!

I struggled with breastfeeding a lot. My supply was never enough no matter what I tried and how much I breastfed.
I ended up breastfeeding for comfort during the day, and I topped up with my expressed breastmilk from the bottle. Give formula during the night.
This system worked for us so well- I had a very happy, good sleeper baby.

You need to find out what is best for your baby and for yourself. Struggling with exclusively breastfeeding or letting a baby go hungry was never an option for me. It's very hard not to think that your body is letting you down, but believe me, it isn't. Not everyone can breastfeed it's just so much judgement about formula or pumping that mothers are too scared to talk about it.

Oh, OP, this is so common. I had to mix feed all three of mine because I had low supply. The advice I was given was that they were getting ALL my milk, and all the goodness that comes with it, and then something extra too. By the time I got to number three I was able to shed a lot of the guilt (although perhaps not the envy of those who didn’t have the faff of formula!) and just enjoy their babyhood.

They are all robust kids with minimal illness. But then so are many children who are formula fed. Stats are on a population level and there are so many other factors for child health to add in.

One thing that really helped me when I was feeling tearful about supplementing was a random meme that said ‘one day you are fretting over breast or bottle and the next your child is eating a three day old chip off the floor of the car’. Obviously you may not get to that point (!) but it does put it into perspective. Your child has a parent who cares deeply about their wellbeing, and that’s the most precious thing.

I have a perfectly healthy 11 year old who I felt terrible over for failing to breastfeed. She’s fine, I have no idea how any of her friends were fed as babies at all. I know it matters now, but I promise it won’t matter in years to come.

It sounds like you really want to exclusively breastfeed but haven’t been able to so far.
That sounds so frustrating for you and there is support out there . Could you write a little more detail about what’s happened so far so people can support you? Ie why have you been pumping?
It may be that you use the formula as a way to keep BF going. While you seek support.
Have you had help from your midwives or HV or specialised BF support? You can also call the National breastfeeding helpline 24 hours a day. I’d definitely recommend getting help

http://www.nationalbreastfeedinghelpline.org.uk/

Sure! We’ve been getting lots of support from HV and infant feeding team.

he wouldn’t latch so we checked for a tongue tie but didn’t score enough for it to be an issue. So they recommended pumping as well as a nipple shield.

Sadly the nipple shirks caused trauma so it meant I stopped for two weeks. However I get pain from the nipple shields which is why I’m thinking to combination feed.

Hope that helps? Ideally I’d love to be able to get enough supply for the whole day but realistically it can’t happen.

I struggled for 5 weeks. He wouldn't latch, pumping was exhausting and I was miserable. Finally gave formula and he was so much happier and so was I. I gave it up but felt horrendously guilty for a few days afterwards.

He is now about to turn 6 and he is tall, strong and bright. Do what you need to do to survive and enjoy motherhood.

Please please don't worry or feel guilty. I had the same thing and ended up stopping BFing after 5/6 weeks. Actually once baby started on formula he did so much better, grew better, developed better, he wasn't hungry all the time. Do what is best for you and your baby and never let anyone make you feel guilty or ashamed, formula is amazing life saving stuff and your baby will thrive on it.

I couldn’t feed BF DD exclusively- she had ‘failure to thrive’ noted in her red book. She’s now 25 and perfectly healthy.

I BF DS for 2 whole years. He’s 17 now and drinks Monster and eats non stop junk food 😬 he’s also (mostly!) perfectly healthy!

If you can and want to breastfeed- all good.
If you can’t, or even don’t want to, all good too.

We do our best.

I hear you, OP.

I combi fed DD1. She was in NICU, very small (0.4th centile) and we just never got breastfeeding established properly. I also think my supply probably never recovered from the stress of her being so poorly. So i combi fed for 6months and then switched to formula. She is now 3 and thriving.

For DD2 (currently 10weeks), i was adamant to do everything right. Skin to skin, loads of rest, water etc. I saw 6 or 7 different NHS midwives, HV, specialist breastfeeding midwives, breastfeeding drop ins etc in the first six weeks. Weight dropped to 2nd centile - put on a triple feeding plan (again 😫). Noone could tell me why. In the end, i paid for a private lactation consultant who immediately identified a 90% tongue tie. NHS wouldnt divide it because she was already taking over 50% of her intake as formula so i paid to have it done privately and it has made such a difference. So i would definitely recommend getting a second opinion on the tongue tie, just in case, because i feel totally let down by the NHS on this.

But as my experience with DD1 shows, combi fed babies absolutely thrive and all the professionals ive seen have reassured me that they will get benefits from any breastmilk you can provide. So you have not let your LO down at all.

I was wondering if a tongue tie was there - that would have been my next question :)
ok so.. are you saying there wasn’t a TT or there was but they said it wasn’t bad enough? If the latter then it clearly was or he would have latched. It is SO frustrating when mums are told that. I mean it’s either impacting on feeding or it’s not. If it wasn’t then why did they say to pump? Like it’s one or the other! If you want a second opinion you could try here

https://www.tongue-tie.org.uk/find-a-practitioner

if you’ve had help from your infant feeding team that’s great - but don’t feel like you can’t go back. Tell them you’ve tried and that even shields are hurting. Maybe they will look at the TT again.

did he latch and slip off? Or latching was painful? Or was he too sleepy? All of those answers can help to build a picture and help in terms of what to do next :)

shields shouldn’t hurt - did you know you can get them in different sizes? They can be effective for some mums.

in terms of pumping if you wanted to do it to replicate a baby feeding you’d need to aim for 8 sessions a day. This article is really helpful on how to maximise your output. And put a sock over the bottle so you can’t see what is coming out!

https://med.stanford.edu/newborns/professional-education/breastfeeding/maximizing-milk-production.html

Also make sure any bottles you give are paced fed. And that amounts of formula are different to breastmilk so don’t expect to pump the amounts you’d see on the back of a formula tin. It may take a while to build up the supply you want to achieve.

Id definitely recommend giving the helpline a call and asking your infant feeding team for more help. And if you have any local BF drop ins go to them. I’ve seen babies latch when they never have before.

You could also try giving some breast milk or formula, getting him into the suckling motion then try to latch him. I’ve seen this work before too.

TT is also genetic so it may also be that your first baby has it. It’s so hard when mums have to spend so much time and money! To find this out. And it’s so common second time around as you often don’t know about it the first time.

I also had the same thought about DD1! The consultant i saw was brilliant and showed me how to feel for one, so i had a good rummage in DD1's mouth and I'm fairly sure she doesn't have one. But it crossed my mind as well. I do think that i have one though!

@HazelEagle , the other thing i forgot to add was that this time i decided to invest in a pump that sits in your bra (last time i just hired a medela symphony for the time i needed it). Ive found it to be much better, less intrusive, more protective of my mental health (pumping 8x per day with a pump that made me look like a cow destroyed my MH last time). I bought the elvie stride which was pricey, but the lactation consultant i spoke to said the pipetta one is a good cheaper alternative (although not as powerful).

@fashionqueen0123 yes, so much for breastfeeding being the "free" option: £50 on the LC consultation, £200 on the pump, £450 on the TT division... Quite sick of spending money now!

If you have one I suspect she does then! :) honestly us mums so often assume it’s US but it’s nearly always not! If she had a posterior one you probably wouldn’t even be able to find it yourself. But crikey £450? Most places I’ve come across are about £150.

ooh that’s a good suggestion about a wearable pump!

Sounds like the nipple shields are not a good fit for you. What pump do you have? Have you got the correct flange? The correct flange can be the difference between milk retrieval. Are you pumping every couple of hours to build supply? Are you letting baby suckle on breast directly to stimulate (via saliva feedback cue) breastmilk production? Would you like to bring baby back to breast? Would you like support for combi-feeding?

There are some great influencers on Instagram who could help you reach bf goals, whatever it right for you.

Instagram; 'pumpwithpurpose'
; 'thebreastfeedingmentor', 'thebreastfeedingqueen'

I had a dreadful time feeding ds and gave up after 8 weeks, after infective mastitis and a breast abscess. I felt a complete failure. Especially when he developed asthma and eczema and intractable ear infections.

I managed to breast feed dd until she was 9 months. And she developed asthma, eczema and intractable ear infections.

One went to Oxford the other Cambridge so impact on development went poof too.

DS cannot remember being bottle fed, dd cannot remember being breast fed. They do remember their favourite dinners, their first days at school, plenty of family/holiday stuff, special books, DS his first try, dd her first solo.

Giving an infant milk (any milk) is a very small part of being a parent and if doing it hurts it is not, in my opinion, worth it. At least not in a first world country with a safe water supply.

Just enjoy your baby @HazelEagle and be well.

We are in London and it was done by someone recommended to us in the private wing of a big London hospital. So i suspect we paid a premium. But it was done within 3 days of being identified, by which point DD2 was already nearly 8 weeks so i was just happy to get it sorted there and then!

I can understand :)

I wish they would just listen more to mums. There is nearly always a reason if a baby isn’t gaining enough weight etc

Looks like you have a great start on some advice from PP, I just came to say you have nothing to feel guilty about, don’t give yourself a hard time. If you want to continue with the tips you get from others, set yourself small time-based targets to meet and assess how you are feeling about how well it’s working when you get there, and if you want to stop, then stop. Your baby will be fine on formula or combi-fed 😊

Thanks all! I’m going to try and continue pumping but around 4/5 times a day as previously been doing 7/8 which is too restrictive. The rest of the time I will give formula where needed.

Ill continue getting support from infant feeding team. Unsure whether I need a second opinion on tongue tie if he isn’t latching correctly (as it’s hurting) though?

Please don't feel guilty. My eldest daughter has Down's syndrome (so also hypotonia) and had a big tongue tie at birth (snipped a couple of weeks later). I was determined to breast feed if I could, nipple shields worked for her and allowed her to actually latch on, but she was still a really inefficient feeder, so even then I had to supplement with top ups (she was not putting weight on quickly enough when I wasn't also doing the top ups through the night). BUT at 4 months she was able to feed without the shields, 3 months later she no longer needed the extra top ups and she carried on breastfeeding until she was 2.5. Hang on in there!

Do you have a breastfeeding clinic? With DD2 the HVs on postnatal completely dismissed my concerns (after DD1 I spotted the tongue tie straight away, but because I also said she was feeding ok - which compared to her sister she was! But short and snacky feeds... they weren't concerned). But when I went to the breastfeeding clinic (also in the same hospital) they quickly diagnosed her with an 80% tongue tie and booked her in for the snip a few days later.

It’s always worth a second opinion. I’ve lost count of how many mums I’ve met who had people check and then it was found by the last person. Also if it’s not tongue tie then they may be able to support you with getting to pain free feeding. It shouldn’t hurt and a baby should be able to latch. Sounds like a good plan. Then your baby is still getting the anti bodies from the breast milk :)

My grandmother never was able to produce enough milk. She was lucky her sister had children the same age and plenty of milk so she would breastfeed my mum and sister to top them up.

Supply issues have been an issue for as long as time the difference is we don't have a village in the same situation

My dad was born at 28 weeks in the 60s and he was fed condensed milk as a baby.

Any breastmilk is amazing for as long as is good for you and your family. I ebf my daughter for 8 months spent 2 months trying to get combifeeding to work and failed due to a bottle aversion. She was then formula fed from 10-24 months. She thrived on breast milk, she thrived on formula. I wasn't thriving breastfeeding at least not consistently. I think I would have thrived on combifeeding but it didn't work for us. Formula feeding allowed me to thrive. I had severe pnd, my wellbeing took a kicking as my daughter had severe silent reflux and multiple food allergies not truly appreciated and diagnosed until 17 weeks. She screamed a lot because my milk was stuffed full of proteins that she was allergic too. It was only by going on an amino acid formula that we got her allergies under control.

Feeding babies is so much more nuanced that breast is best. They need a full tummy of milk where it comes from doesn't really matter.