Formula top up - worried about milk production :(

[RMarieClaire]

My DH is 8 days old, and at her 5 day check up came up as quite jaundice with high weight loss - however both also within the boundaries of normal. (IE less than 10% weight loss).

We have been told to top up her breastfeeding with expressed milk and formula. I'm only able to express about 20ml max, as my milk is still coming in, so have been giving her about 40ml formula.

I'm so scared this will effect my milk production and already worried it's making her reluctant to bother with breastfeeding - at lunch she only took about 20 mins in total (12 mins on one and 8 on the other).

For 8 days, 60ml feels a lot of formula and it feels like I'll not be at that level myself for ages - if ever. We have a medina pump which has a 'natural' feed teat, but it's still seems she prefers it to boob.

Any tips on what to do to make sure my milk catches up with her diet? Or reassurance that

I'm not sure about your question but the UK Breastfeeding Support group on Facebook is amazing.

I had a similar problem with DD - my milk was delayed by massive blood loss during birth, so DD lost over 10% of her birth weight by day 5. I was advised to top up with expressed milk, which was useless as I couldn't get hardly anything off so we resorted to topping up with formula. We didn't use a bottle though, we used a 1ml syringe. It took ages, and was messy but worked.
I carried on bfing and we carried on topping up and she gained weight. We then decided that we preferred combi-feeding (bfing and formula) as it gave me a break and we continued with this. We didn't introduce a bottle until about a 1month in and she was fine switching between breast and bottle. She was weaned off the formula at around 1 and she weaned herself off the breast at around 19months.
When we had DS, we knew from the outset we'd combi-feed. Thankfully I had no issues with supply this time. We finished the formula a few days ago (DS turned 1 a few weeks ago) but he is still bfing 2-3 times a day, and has a bottle of cows milk at bedtime.

Formula feeding can affect supply, as the baby is drinking that rather than being latched on you which will help to stimulate more milk. However, you need to decide how much you are willing and able to do re feeding and pumping. Your baby's stomach is tiny and breastmilk is much easier to digest than formula, so it may appear as though she is feeding off you all the time, and not getting enough. But the only way you'll know for sure is if she does/n't put weight on.
Do you have any breast feeding support groups? An Infant Feeding Team at your local hospital, etc that can off you one-to-one support and advice? Has your latch been checked, tongue-tie checked for by an expert?

If I were you I would try and have a consultation with a lactation consultant. If both the jaundice and weight loss were normal...even 9% weight loss is ok...then unless there is another reason then you shouldn't have been advised to top up with formula. Who advised this? Most hospitals have a breastfeeding coordinator, I would try and get her on the phone for a discussion about your situation.

As long as you keep expressing regularly your body will keep producing. I done both expressing and formula (not fed from breast) and my milk stayed as long as I kept up with the expressing regularly - the more i expressed the more milk I made in my experience

Thank you @user1471457757 - id not heard of this group but I'll definitely check it out

@boredpanda84 - feeding plan came from a doctor - midwives seemed a bit taken aback by how aggressive it was. Trouble is, she's now able to have 60ml top up, so my milk is not enough for her. I managed to express 40ml this morning then dropped it on the floor, which was heartbreaking.

I'm trying to express every time i feed in the day time, but it's a bit much at night - id never get any sleep.

It's normal for baby's to lose weight after birth so don't worry about that if they're happy with baby's weight.

With the breast feeding/expressing thing, midwife told us that you should express 8 times a day (but obviously if you're feeding on breast then miss 1 expressing session each time you breast feed or you'll destroy your nips!). Did your MW give you details about local breastfeeding support groups? Definitely worth trying one of them

Please get a second opinion from a breastfeeding expert. Your baby does not need to gain weight so rapidly and if you want to fully breastfeed you absolutely can. Unfortunately, many doctors are ill informed about how breastfeeding works and give advice which ultimately leads to production issues and babies favouring bottles.

Have you tried a haakaa pump? I was recommended this by several friends and it’s amazing. Just stick it on the opposite breast to which you’re feeding from and it collects the let down. I use it at home when feeding and can collect anywhere from 10mls to 3oz by doing nothing x x

I had to mix feed with all four of mine due to jaundice, tongue tie, etc. I kept pumping, and also tried fenugreek with the last one. Two spoons of seeds a day. I think it helped me, I did smell a bit odd though.

I kept up the mix feeding until they weaned then carried on BF after weaning. My last really needs to stop now but it's a gradual process. The formula seems such a small proportion of the journey, all four carried on BF long after bottles. It isn't ideal, but it doesn't have to be the beginning of the end, which is how it felt for me EVERY TIME.

Please make sure to follow doctors advice jaundice might be quite serious. fedisbest.org/

My ds lost more than 10% in the first 5 days and my milk took forever to come in. I couldn't express enough for top ups so used formula and ate a ridiculous amount of porridge oats and my supply increased really quickly. He piled on the pounds and is now a healthy, giant 3 year old.

I now have an 8 day old dd who lost 11% but my supply seems ok. Dh gives her a bottle of formula so I can go to bed for a couple of hours at night and she's putting the weight back on quite quickly. I was worried about supply decreasing because of the bottle but she cluster feeds a lot in the evening before I go to bed so I'm hoping this makes up for it.

Ring your midwife on Monday and request a visit to talk it all through. The early days are stressful enough without the complications of top ups and expressing so I would definitely double check that it's necessary x