Supplemental nursing system

[shannoncorrin]

So LO is 18 weeks and only weighs 12lb 5 oz.  I posted my freakout on here a few days ago.  My pedi recommend I start to supplement and fill his bottles with 6 Oz instead of 4.5oz.  I work 12 hour days and only pump 2-4oz a pump, so I knew supplementation was inevitable even though I did want to wait 6 mo.  Oh well, I have come to terms with this decision to add formula. 

Questions:
1.  Do you know how long it takes to bottle feed a baby with a slow flow nipple?  FOREVER.  On days that I am with him, I have been breast feeding him first, then giving him a few Oz of formula afterwards. Sometimes he will take 4 Oz!  It takes him over an hour to eat!!! I was contemplating moving up to a medium flow nipple, but I was concerned that he might not want to breast feed because it would be harder for him.  He is very laid back and tends to roll with the punches, so it might be fine, but I just was wondering. 

2. Along the same lines as question #1, I was contemplating getting a supplemental nursing system, so I can feed him and give formula all at the same time.  Does anyone have any experience with these?  I'm worried that it may make my supply tank. 

3. I'm really worried that my supply is going to tank, so I was going to get some fenugreek maybe, and see if that helps?  I was going to add a power pumping session or two in the mix, the problem is finding the time.  any other suggestions?

Thanks!

[MasynSpencerElliotte]

Hmm...my DD3 weighed in at 13lbs at 23 weeks and there are no concerns (I start offering formula but for other reasons). I have no experience with either SNS or supplements for supply but for question 1 - is it possible he is satisfied from the bf and is only taking the feed because he is laid back? An hour feed is super long and makes me think he just is not hungry for it. I can understand upping the bottles for while you are at work though to see if he will take more (I can't pump well at all - one reason we are offering formula is so I can have the option to leave her with dh or mil).

Oh out of curiousity does he take quicker bottle feeds when the bottle is all he is getting?

[Fiver]

I was contemplating getting a supplemental nursing system, so I can feed him and give formula all at the same time.  Does anyone have any experience with these?  I'm worried that it may make my supply tank. 

The whole point of a SNS is that your breast is being stimulated while LO gets milk on every suck from the SNS to keep them interested.  I have used one, but they can be tricky to master and I found that trying to use one with formula in (with DS) that he really wasn't getting anything much out of the SNS.  Now, that could be that I'd used the wrong gauge tubing (the Medela one comes with 3 different sizes - I used the medium one, as advised in the instructions) or it could be that I'd done it wrong, but I always wondered whether the formula was a thicker consistency than EBM might have been and that's why it didn't work as it should.

So the short answer is that supply shouldn't drop with a SNS.  In fact, if anything, it ought to do the opposite.

With regards to question 1, I agree with Heidi - if it's taking him that long, it sounds like he might be full from the BF.  Is he trying to push the teat away/turning away from the bottle?  I always found with DS that he was ready for the next sized teat when he started sort of chewing on it instead of sucking, but he was a lot older than 18w when we changed.

[shannoncorrin]

I know, I often wonder if he is not hungry too, but he is so hard to read.  When I take it away he looks at it and his mouth is still going, so I give him more. I don't want him to be hungry!  When he starts to just mouth at it I figure he is pretty close to being done. 

[Fiver]

With any bottle feeding, the key is to stop periodically to give LO a chance to realise they're full as it's easy for them to overeat because of the constant flow from the bottle.  With BF, there are natural pauses between fast and slower flows of milk and LO can stop sucking for a bit if they want a break, which is hard to do with bottle feeding.

Rooting can also signal wind as well as hunger, so it might be worth burping if he's still rooting after a feed rather than offering more straight away and see what happens.  If he's still hungry, he'll let you know and you can put him back to the breast (either the same side or switch to the other - or offer a bottle if you prefer).