Help a knackered ftm: formula the old-fashioned way

[Pessimist]

I have low breast milk supply so am having to use formula for feeding my newborn. The feeding plan is brutal and goes something like this:

1. strip baby to nappy (+ change if dirty) for skin-to-skin (3 mins)
2. boil kettle for formula
3. offer both breasts to baby (10 mins)
4. make up formula using 10-minute boiled water from kettle so it's hot but hasn't stripped all the nutrients, hopefully (2 mins)
5. console screaming baby while trying to cool the formula (150 years)
6. feed baby with lots of wind breaks (20 minutes)
7. pray baby sleeps and wash bottles for steriliser (2 mins)
8. settle baby so I can use the double pump (20 mins)
9. pump to encourage supply even though I probably have IGT (20 mins)

repeat every three hours. Try not to fall asleep standing up/while burping. Pray baby doesn't stay awake between breast and bottle cooling.

I'm broken. I'm terrified to use the perfect prep machine - my brother's baby was very poorly after an issue with theirs. I don't have the money for fancy gadgets like the rapidcool. My mum's telling me to pre-make the formula and put in the fridge and reheat, but 31 years later questions whether the warming up is safe and we know from hard-won experience that baby doesn't take cold milk.

I don't have family nearby and my husband has gone back to work today. I'm really struggling and need sleep. I set alarms to make sure baby gets fed every three hours and either the whole thing takes that long with settling, or I sleep through the alarms. By the time baby is awake, it's taking too long for my milk and the formula. I don't know how anyone does this 8 times a day.

I had a similar scenario to you OP and Perfect prep was a godsend, cos my eldest had reflux so no ready made bottles available. I know it's scary as you are terrified to risk anything with a newborn ❤️

I weighed up the risk of using it Vs making a mistake on milk temp from being sleep deprived with a baby screaming for milk.

Hang in there, ignore any judgement from others and remember that the newborn stage is pure survival mode - take whatever shortcuts you can to get through it!

Skin to skin isn't a fad it's very important for bonding however you feed.

I'm a huge breastfeeding advocate but I think you either need to get a plan from a lactation consultant to get off triple feeding or you need to ditch the pumping. You can still breastfeed as part of combi feeding.

Absolutely the exact advice I was going to give . Make up bottles for 24hours ,cool down ,fridge and then zap in microwave for 15 secs ,good shake and you are sorted!
My children all thriving adults,no health issues and were healthy babies.
Remember OP all the zillions of advice you read online etc are aimed at the less intelligent people who if left to own devices wouldn’t even bother with the most basic of hygiene ie wash bottles teats etc and would not check temperature of feed.

Exactly what I have said on my post!

Ok, I'll share my bottle routine I used in case it helps.

When baby needs a bottle
Take one from the fridge/insulated container if out or at night.

Lightly heat in the microwave, swirling after and testing it on my wrist first. This eliminates the risk of burning. If it, I'd sit it in boiling water instead. I even had a £10 second hand microwave next to my bed.

Hungry to bottle in about 20 seconds. No admin.

Fed baby

Give bottle a quick rinse and put with other 'dirties'.

Once/twice a day
My husband would wash the bottles and put them in the steriliser. It took 6 so we started off doing this twice a day and then moved to once. He turns steriliser on.

Me 10ish minutes later, take bottles out, make up with formula. Set to cool over a bath of running water (deep baking tray in the sink) for about 10m until cooled.

Put in the back of the fridge until needed.

The admin took us each about 10m.

I know the NHS/formula companies say to make up fresh, but they also give convoluted instructions that don't work with feeding on demand. The WHO says this is a perfectly safe method and we didn't have any issues etc it.

Likewise the 'don't microwave' thing is butt covering. There have been a couple of horrendous cases where parents heated it to boiling and fed it directly to their babies. So they guard against it, but the smallest amount of common sense and you're ok.

I had the same with DS2. Was a bit of a shock after breastfeeding DC1 with no issues!

What we used to do was use a bit of a pre-made carton when he was on 30-50ml, write the date and time on it, store remainder in fridge for up to 48 hours I think it was. The bit we put in a bottle was warmed in a mug of hot water, then once DC was having enough that it was more economical to buy an entire carton of powder, we started making a bottle up about 60 mins before the feed was due and letting it cool on the side, because by the time it was feeding time, the milk was about the right temperature and so didn't need any warming or cooling.

You are allowed to make up a bottle and leave it at room temperature for up to 2 hours, so this seemed fine. We didn't wait 10 minutes, just used freshly boiled water but if you're making it a bit in advance it wouldn't be so bad to wait the 10 mins.

But also, it got easier once I felt he was getting enough milk from the breast to collate all the top ups into a single bottle once a day, which DH would give at roughly "bedtime" (in the hope it would make him sleep - it didn't, really!)

I did not bother with pumping because I used to get so fucking enraged with the stupid pump and also my boobs seem to have something against them and just refuse to produce anything so it seemed like a lot of stress for no result. So rather than the pumping I just used to let DS2 comfort nurse basically as much as he wanted in between "proper feed" times. I also coslept and let him have free access at night. I'd do the "proper feed" routine about every 3 hours during the day and once or twice during the night. But when I had to prepare the formula first, I'd get it all ready (or get DH to) before I woke him up, stripped him down etc.

Warming up pre-made milk is perfectly safe, as long as it's once (don't reheat the same bottle multiple times). It's what NHS and WHO both advise for situations where it's not practical to make it up as needed with hot water. TBH if your mum was keeping it in the fridge 31 years ago, she was ahead of advice - apparently advice only changed to refrigeration in 2001. Previous to this a lot of people made up the day's bottles in one go and left them on the counter in the kitchen for the day.

I'm a mother and grandmother, and whilst all for breastfeeding, I'm more for the importance of the mother's health and well-being.

With my second child I had low supply and was told to combination feed, it's such a palaver because you're both breastfeeding and formula feeding. After a while I went on to formula and ditched the guilt.

Back then it was fine under the guidelines to make up all the bottles for the next 24 hours the night before with fresh boiled water, immediately put in the fridge, and then reheat in the microwave or bowl of boiling water, shaking thoroughly and checking the temperature on your arm. Never had a problem.

Decades later about 10 years ago I unexpectedly had sole charge of my baby grandchild for some time, the NHS guidelines had changed but the WHO said it was still fine to make in advance and store in the fridge so that's what I did without any issues. I never let the formula hang around, if baby didn't take it all I got rid of it.

I can't see that there would be any reason that still wouldn't be safe, as long as you were meticulous about washing and sterilising the bottles and using boiling water to make them.

I would also suggest getting another steriliser so you can sterilise enough bottles for 24 hours.

I do think skin to skin was helpful for us but would echo that it doesn't need to be every single feed, I used to do it for about an hour once a day when he was tiny, then once we were home it was a bit more sporadic, it would mostly be early in the morning so we could do it in bed and it was when I was changing his clothes anyway.

Remember that things like letting his hands touch your breast as you feed and just pulling down your clothing so his cheek can rest on your chest etc are all skin to skin as well - you don't both need to be totally naked.

TBH if your mum was keeping it in the fridge 31 years ago, she was ahead of advice - apparently advice only changed to refrigeration in 2001. Previous to this a lot of people made up the day's bottles in one go and left them on the counter in the kitchen for the day.

I'm pretty sure that's not right, my child was born in 1990 and I was told to refrigerate after making up the day's bottles, I never let the bottles hang around after the feed either.

Stop pumping. It isn't worth all of this stress.

Try a perfect prep machine, the vast majority of babies don't get ill from it. Just follow the instructions and make sure the filter is a perfect prep filter and nothing else.

If you really don't feel comfortable with a perfect prep, it is absolutely fine to make bottles in advance, rapid cool and store in back of fridge for up to 24 hours. WHO says it is the best way to make bottles after making them up fresh.

Skin to skin was a thing 36 years ago when my mother had me!!! It is extremely beneficial to newborns and for breastfeeding. Studies after studies have shown it is essential to start breastfeeding successfully and it helps babies regulate their heartbeat, their temperature etc.

That being said, this is about the first few hours/days of the child's life and especially helpful to premature babies. And also, babies get skin to skin when you put them on your chest. Just open up his PJs on his chest and put him on yours, don't strip him down.

And I would ditch pumping. Baby on the breast as much as possible.

Do you have a lactation consultant? I paid for one (sounds fancy but she was just a midwife with lots of BF experience and she did a few home visits - I think it's what HVs used to do in the past according to my mum) and it was the best money I ever spent. That moral support in the first few days of breastfeeding was essential. I will remember that woman for the rest of my life.

Triple feeding is brutal and you're not mean to do it past a few days which is telling me you are not getting proper help.

Skin to skin is amazing though. When my child was a toddler and very ill in hospital, she often had her sats clip attached. Cuddles lowered her heart rate. Skin to skin ones even more. It was amazing to see the impact out had on the monitor

This was why I didn’t manage to continue breastfeeding and only managed a few weeks. The constant 3 hour rotation of feeding, topping up with formula and pumping was just brutal. I honestly wish someone had told me at the time that you can do both, just put baby to boob and if they’re still hungry top them up a bit. The pumping just completely ruined it for me so that baby ended up with no boob at all and I was devastated at having to give up. I never really had a goal in mind of exclusive breastfeeding, I just wanted the closeness of feeding them and for that to go on as long as possible, instead, because of my midwives insistence on renting a machine and pumping and all the rest I gave up and it was very traumatic. It’s one thing I would do so differently if I were to go again and I say the same to you, if your goal is to just be close to baby and feed as much as you can for as long as possible, quit the pumping and just carry on and chill out. I have no idea if this is good advice and I might get flamed for it, but it’s what I would do again to preserve my emotional health. Pumping round the clock honestly ruined the whole thing for me.

The don't microwave advice is because a microwave doesn't heat evenly. If the bottle isn't adequately shaken after heating and before test the temperature there won't be an even distribution of temperature within the bottle so the drop tested can be an appropriate temperature but there can be bits of the bottle with a milk that is scalding hot. A thoroughly shaken bottle that has been microwaved would be fine the difficulty is whether everyone has the same definition of "thoroughly shaken" and this is where variability comes in and the potential to scald a baby even with milk checked to be the right temperature.

We’re having the same dilemma about how to make up bottles - the new model prep machines seem to have loads of issues with over or underheating the water, so I’m not keep to do that (despite happily using the old model with DD1), and the nubys seem like a total faff to clean and sterilise. FYI the WHO guidelines (and the nhs, if you dig far enough on the website) both say the fridge method is fine, but to avoid heating up in the microwave (use a bottle warmer or jug of warm water). Definitely go for anything that makes your life easier, your current schedule sounds exhausting!

I did boiling water in a flask that had been left to cool slightly, sterile cool water in a seperate sterile bottle, mix the formula with a couple of ounces of boiling water, shake, add the cooled water, check them temperature and feed. Basically the same as a prep machine

Name Changed, but babies in NICU units are being given formula that doesn't meet the NHS guidance and come to no harm. Preparing it with water over 70 degrees and then cooling quickly and storing in the fridge for up to 24 hours will be absolutely fine . If you're re-warming, be careful if using a microwave as it can cause hot spots, make sure you invert and mix the milk well before checking the temperature or use a bottle warmer/stand in a jug of hot water. The alternative is to keep cool boiled water in the fridge, and mimic a perfect prep machine, add enough hot water to dissolve the powder and then add cold water to adjust the temperature

Triple feeding like you are doing is brutal and bordering on inhumane IMO. It's not sustainable, and I would only ever recommend to our mum's for a max of a few days in specific circumstances, if it's needed beyond that other measures/plans need to be considered. It doesn't look at the holistic picture for mum/baby and I'm sure it contributes to maternal mental health issues, both from burnout, and that by offering a "solution" midwives/HCP professionals are making it harder to choose to stop breastfeeding because they feel like they just aren't committing to the plan enough and are being lazy/"giving up", with no acknowledgement that it's akin to telling someone they would have plenty of free time for hobbies if they just chose not to sleep - it's technically true but not attainable.

I've also never met a mum (and I've met hundreds) who have had the intended outcome of triple feeding, no doubt because they are all stressed and exhausted which, surprise suprise, impacts their milk supply.

Apologies for the vent, sending hugs, OP. I hope you are getting good in person support, but make sure you are making choices that work for you and your baby x

OK sorry - you're the second person to point this out now.

I've checked my source and it was from Why Formula Feeding Matters, but it actually quotes 1999 rather than 2001, and it does say that the advice was more about batch-making than when they were stored - it says "Sometimes refrigerated but often not" - so I think that whether or not parents were advised to refrigerate was a bit patchy.

I can't say first hand as I was at primary school in the 90s.

I do remember with DS1 born 2008 the advice on MN and in the NHS book centred very firmly on making up fresh each time rather than batch making, to the point a lot of the discussion on MN was about whether it was OK to make up with cool boiled water rather than just-boiled water. (Perfect Prep was not yet invented).

Holy shit OP you need to cut yourself some slack here and either go pre-made or buy a fancy machine to help you with this. Drop the pumping and everything. You’ll enjoy your time with baby more and that’s what matters most for both for you. I’d have done this in a heartbeat if breastfeeding hadn’t worked out. Honestly, look after yourself because it’s so hard and you’re making it harder. I understand why, but your rest matters more than anything. Happy mum, happy baby. Please look after yourself.

Not guidelines now but when DD was born I was advised to make up bottles in advance. By the time DS arrived 4 years later I was told that I wasn't supposed to do it like that anymore but did anyway
Boil kettle
Get sterilised bottles out
Let water cool for a few minutes
Add water to bottles
Add milk powder
Shake
Place in door of fridge
Microwave when baby wanted one
Throw away anything not used within 24 hours

As I said, not guidelines but worked for us as we were exclusively FF and nobody died

Ready to feed liquid formula for nights if not all the time. I refused to use a perfect prep too. Do the same, pre boiled cook water in the fridge. Make up formula with hot shot from the kettle and then top up with cold pre boiled water. You’ll work out the measurements for you for the righ temp, for us it was 50/50

Skin to skin isn’t “the latest fad” in any way. It was a thing when I had my babies over 20 years ago.
My 4 were born between 95 -2000 3 were premature. It was never a thing then and never mentioned.

Personally, I would stop the breastfeeding.

Poor you. In your shoes (and I was in similar ones!) I would do this:

Buy extra bottles - you need 5/6. A lovely big, plastic box they can be stored in after sterilising. (One day you will laugh at this nonsense)

Room temp, ready made bottles are your friend.

Perfect prep machine. The baby will be fine, I promise.

Formula feed and drop the breast faffing.

Hang in there!

You can stop breastfeeding, OP. I managed 10 days EBF with DD1. 2 more weeks expressing and mix feeding before realising it was insane.

I did relactate at 16 weeks and we mix fed until 12 months but the stress of pumping was gone.