Thinking of supplementing night feed - will this work?

[LovelyLilyandJack]

Aside from potential growth spurt issues going on at the moment, on a normal day my 6 week old takes at least an hour and a half to feed in the evening. When you add on time for a bath or nappy change, and the occasional missed cat nap, he's often been up hours by the end of his feed and just cannot stay awake long enough to finish it. Letdown can take a while for me in the evening and he cluster feeds from 4, so he ends up dropping off waiting for let down, then drinking for 15 seconds or so, then having to wait another 15 minutes or so for another let down and another morsel of milk! I had this with my daughter and feeds used to go on for hours and hours sometimes which i can't do this time cos my only chance for sleep is by getting an early night and i really need the hour between his bedtime and mine to eat dinner and wind down myself before bed.

Anyway, I wondered about letting him feed for 45 minutes to an hour and then supplementing with formula after that so both he and i can get some sleep. He is potentially growth spurting at the moment so won't start straight away but wondered if this approach will put my overall supply at risk during the day, or only potentially affect the evening feed? I'm hoping that if i let him have a good feed first then my supply won't be overly affected anyway?

Does this sound like it could work or is there anything else i could try?  I meant to say that I'm already using breast compression to get as much food in him as possible while he's awake!

[*Ali*]

BFing works on supply & demand. Milk is produced as your baby nurses, and the amount that he nurses lets your body know how much milk is required. Every bottle (of formula) that your baby gets means that your body gets the signal to produce that much less milk. So yes it will impact your overall supply. Which may be fine if you are planning to continue the bottle in the long term.
Also the fat content of your milk increases as the feed goes on so stopping before LO is done may mean he doesn't get to as much of the fattier hind milk.
Just because you don't feel a let down doesn't mean there is no milk flowing.some mamas never feel the let down and some get a couple in each session. That doesn't mean there is no milk.
Is your baby gaining weight ok?
I know low milk supply is not what you are asking about but this page has more info on the points I made above http://kellymom.com/bf/got-milk/supply-worries/low-supply/
Many people find the feeding settles down around 6-8wo so the constant feeding may well calm down very soon and this may be just a short term thing.

Before making your decision I just wanted to make sure you were aware of why it is recommended to EBF for the first 6 months. For those who have the choice - why exclusive breastfeeding is recommended.

If as a time saver you are happy to supplement in the evenings then do it. There are mamas who happily combination feed. We have this FAQ on it. A bottle (or more!) a day…  Mixed breast and bottle feeding

Another option you may wish to consider is pumping and giving a bottle of expressed milk which would have the same effect of cutting down the nursing time but with less impact in your overall supply.

[LovelyLilyandJack]

Thanks for all the info and advice. I guess i was hoping that if i fed for an hour or so then i wouldn't be topping updated much and would still be sending my body an hours worth of demand signals so it wouldn't affect supply.  We probably will move to bottles at some point but hopefully not for some time and i certainly don't want to be forced down that route early. His weight gain is fine and bf is going very well in all other respects.  I'll stick it out I think.  My daughter took even longer than jack to feed and we managed to get her to bed at 7 at some point so it must be doable eventually!

Thanks.

[Fiver]

Do feeds in the daytime take a similar amount of time to complete?

[LovelyLilyandJack]

No, daytime feeds take up to an hour but that often includes a nappy change as well. I probably actually feed for up to 40 minutes, but spread out over a long time as i have to keep waking him up. I just found an old post from when my daughter was 12 weeks old and i was giving her a bottle at bedtime then so obviously didn't manage to bf her for a 7pm bedtime after all. She would take 6-8 ozs and i just couldn't keep up.  I'd like to bf jack at bedtime if i can, but if he doesn't get quicker at feeding I will struggle to ever get him into bed when he needs it.  I already spend most of the day trying to decide whether eating or sleeping gets priority cos it's really hard trying to be confident he's had a full feed and get his A time right cos i feel like I'm rushing the E to get the S iykwim?! I do enjoy breastfeeding but find it very hard work routine wise.  Never mind, even though my daughter always took a long time to feed and jack may well do too, at least I know it gets easier as they get older and can handle more A time.

If only babies came with a fuel guage so i knew whether i really needed to feed for all this time or not! If i wasn't worried about hind milk we'd be done in about 20 minutes cos most of the feed is spent with me waking him up, winding him (to wake him up again), and putting him back on the same breast even though I can see he's barely drinking anything by the end cos he just falls asleep waiting for something interesting to happen milk wise!

Sorry, just whinging now but I found the long feed times and the uncertainty over whether they really needed to take so long really frustrating with my daughter and the thought of several more months of it with jack is quite depressing I'd really hoped it'd be better this time. It's wierd, in many ways he's a good feeder. I think it's actually me that's got slow flow or something cos he's got quite a strong suck and generally a good latch i think.

[Fiver]

Mmmm, I was wondering if you might say all feeds take a while.  Have you had things like upper lip ties and tongue ties ruled out?  Sometimes with issues such as those feeds can take a long time as the transfer of milk from you to LO isn't so good.  Of course, there are other reasons for that, but they're a couple I can think of right now.

Obviously hindmilk is important, but for some LOs, falling asleep can indicate a need to change breast.  One sided feeding isn't always optimal for all LOs at all times.  Have you thought about switching sides after the nappy change or after LO's fallen asleep?

[LovelyLilyandJack]

I have thought about switching sooner - the main reason feeds take so long is cos I leave him on one side for ages and then we get the sleepiness issues.  Eventually i do switch sides - usually after a nappy change as you say,  when he won't go back on one side any more or when he's really sleepy.  Then he'll finish off on the other side quite quickly usually. I think it's a confidence thing on my part not to switch sooner.  I'd love to cos it would probably half our feed times but worry about the hind milk.  Having said that, it really doesn't feel like he's getting much after 15 - 20 minutes one one breast cos that's when he drops off and if i squeeze my nipple after that point it's hard to get much out whereas I've had milk flying across the room at the start of a feed! I know there would obviously be a difference between the start and middle of a feed in that respect but i can tell from the lack of swallowing that jack's not getting much later on as well.

I haven't really considered tongue ties or anything cos he feeds so well at the start of a feed.  I can hear him swallowing loads - he seems to guzzle it down. Would that be the case if he had a tongue tie or similar?

[Fiver]

I think you've probably hit the nail on the head with the lack of confidence about switching sides.  If he's dropping off, he's probably getting himself tired and is often an indicator of when to switch to the other side.  If you want to make sure he's getting as much hindmilk on the first side as possible before he falls asleep, you could do some Breast compression

The transition from foremilk to hindmilk is very gradual too, so there isn't any definitive point at which milk becomes different (you might find this article interesting - http://thefunnyshapedwoman.blogspot.co.uk/search/label/hindmilk#) so you would probably be ok switching a little sooner.

[LovelyLilyandJack]

Thanks, that's really interesting, especially the bit about cluster feeding.  It means jack may be getting more sooner than i thought cos he clusters in the afternoon / evening and usually only has a feed an hour before his evening feed.

So if he falls asleep should i just break the latch and switch sides? Apart from when it's obvious he's drinking, how do i tell the difference between suckling and drinking really slowly? I often can't see him swallow towards the end of a feed.  Is it likely he's still getting milk then?

[Fiver]

If it were me, that's what I would do.  If you look/listen really carefully, you can usually detect some swallowing if there's some happening.  He's probably still getting something at the very end of the feeds as you describe it and every bit counts, but if he'll come off without too much upset, he's probably done.

[LovelyLilyandJack]

That's great, thank you very much for all your help! I'll try it at the next feed. 

I have one other question if that's ok? The other reason feeds can go on a bit is cos i don't have the confidence that he's done.  Although he'll take himself off  eventually, if i wind him or change his nappy he'll almost always go back on the breast and guzzle for another 5 minutes.  Should i just do this once and then assume he's done if he takes himself off again or keep offering him the breast?  If i offer again after that he will go back on, but i don't get another let down again for a while, which is where the long waits on the breast come in. He always seems satisfied at this point so in the day i take him off normally (sometimes i persevere for a bit longer first), but at night he often won't settle in his moses basket  til he's had more,  even if he seemed happy before that.  It knocks my confidence that i know when he's done.

 Is that common for the night feed or is it likely he's done after that first guzzle following winding? Because of course he might not be settling cos he's ot rather than hungry! That's why we ended up doing a bottle at bedtime with lily i think, cos we found teaching independent sleep at bedtime really hard psychologically without it! I'm not too worried about independent sleep at bedtime just yet but would like to move in that direction on the nights when he's still awake after a feed.

Thanks again for all your help! X

[Fiver]

I used to try to gauge it on whether DD seemed content after a feed.  Often at night she would just fall asleep feeding anyway and I'd just unlatch her after a while and put her back to bed.  It is really hard to tell sometimes, but it sounds like you're doing really well.

[LovelyLilyandJack]

Great, thanks.  Guess I'll just go by instinct and by watching him.  We've not (yet?!) had the 4 hour feeding marathons i used to have trying to put my daughter to bed at this age so things are already easier this time round. 

Tried watching jack like a hawk during his last feed btw,  and cut it back to 30 minutes!  Very happy with that! It was also more obvious when he was finished too cos he was awake. Fantastic! Thank you very much! 

[Fiver]

Good to hear