New to FF and quantity of formula

[-Maya-]

Hi all wonderful bw fellows,
I just moved from BF to all FF in an attempt to survive to sleep deprivation. It actually worked, now my lo eats at 21, 2330 (DF) and between 4 and 6 in the morning (*). This is a huge step forward with respect to 3+ nw when he was breastfeeded.

Since a couple of days, he consistently drains all 5 bottles of180ml of formula I give him. I asked to the pedi whether to increase the bottle I give to him but she said NO. She did not gave me any reason neither she considered my lo weight! How is it possible? Is 180ml a so big quantity of formula for a 4mo baby that weights 8kg? And moreover how am I supposed to last until he is ready for solids?

I am trying to move to a 4h easy but honestly I do not kow what to do since he wants to eat every 3h or even less!

(*) Note that our EASY goes from 9 to 21, so roughly 1-2 hours later than the standard one.

[MasynSpencerElliotte]

Here there is a max recommendation for formula, but for his age it is 36 oz/1080 ml per day.

http://www.health.gov.sk.ca/how-much-formula

Personally if my lo were draining bottles I would make them larger so he could finish when full and not just because the bottle is done. Is there a health nurse or another dr you could ask? It seems a bit odd not to take into acct size or the fact that he is draining bottles!

[-Maya-]

Next week I will ask to another dr, for sure!
Anyway do I have to include also the df as a separate feed?

I think tomorrow I will try to increase to 210ml all bottles he takes during the day, not the night one. But what about the df?

[MasynSpencerElliotte]

The df would count in the total for the 24 period. Is that one in addition to the 5 other bottles?

[-Maya-]

Yes it is in addition now. You got my point. He is eating 6 times a day, now. Yesterday food intake was:
05:00 180ml (drained whole bottle)
09:00 150ml (drained whole bottle) -> I gave him 30ml less but I do not remember why
11:45 180ml (drained whole bottle) -> I was not able to wait even three hours because he screamed a for 45 minutes for his bottle
14:45 180ml (drained whole bottle)
18:45 150ml (he did not finish his 180ml bottle!) to get a 4h span I had to listen to his cries for 1h15min
00:00 150ml (drained whole bottle) this is his dream feed

So we are at 990ml, that is really close to the limit written on the website you linked before. But now he's only 4mo!

I really do not understand what I am doing wrong: why does he want so much food? He is not overweighted, he is tall and 8 kg at his age is in the highest percentile but he is obviously not the only one.

[creations]

I would increase all the day bottles. Guidance on milk intake is *guidance*. Unless there is a clear problem with weight gain or weight loss then follow your LOs lead for quantity. Some parents are advised to begin solids early if their LO takes large quantities of milk so that might be something you discuss with your health care provider, but even then it is your decision to introduce solids earlier or not to, maybe read up on the benefits of waiting and decide for yourself.
My LO is petite and drank very small quantities of milk (roughly half the daily guidance!), so the opposite of yours, I was worried for so long and eventually realised it's just what his body needed and he knew that, weight gain was fine. Mine was eager to get to solids earlier than 6 months whilst I was determined to wait...eventually he had his first bites at 5.5months.  It might be worth looking into now so you can work out how you feel about it and aren't caught on the hop when you speak to a health professional.
and you are right there is nothing to be concerned about to be on the highest centile - the lowest to the highest are all normal.

[-Maya-]

I think that being in the upper or in the lower part is not good when dealing with statistics. There are always issues. Everyone keeps saying that I must wait 4h between feeds to my lo and that I must regulate what he eats. I try to reason myself and to take a decision that is right for me and my lo but being always questioned is rough.
FF is someway scaring for me, I felt BF less error prone; it's a pity that my lo and I were not able to find a balance to make BF working for both of us! Anyway, no regrets allowed now!

Edit: while searching info about percentile I realized that he was in 50 when born and he's now in 95!
Thank you for your support!

[creations]

If your LO is 8kg and 4 months old then, using the WHO chart for boys, that makes just under the 91st centile which is actually quite a long way off from the highest centile on the chart. I believe that there is some variation with age anyway but understand there to be nothing out of the ordinary if a child goes up the centils lines but that if they went up over 2 lines then they may need some attention. The lines are not for every centile or course, and an increase from 50th to under 91st is less than 2 centile lines on the chart.
 
http://www.rcpch.ac.uk/system/files/protected/page/A4%20Boys%200-4YRS%20%284th%20Jan%202013%29.pdf

When I look at that chart it seems to me there is a long way to go for your LO to reach a weight of the highest centile or to be concerned about his weight gain (9.5kg at 4 months would still be on the chart although at that point I might wonder why he went increased 4 centile lines iyswim). I'd just follow his lead and be confident in that.

In the UK the guidance is to feed on demand for FF and BF new borns and I was never told anything different.  My DS also couldn't go longer than 3hrs between milk feeds until he was 6 months and had the solids meals between milk feeds, he then managed 4hrs between milk feeds.

hugs WRT the switch from BF to FF. I had to make that very hard decision at 4 weeks old as our BF journey was doomed. xx

[Lolly]

I know some of our US mums have been told not to give more than x amount of formula in a day, but I've never known it in the UK. Here we are told to feed to appetite and increase bottles when they are draining them.

What you will find is that if you increase bottles he will be able to go longer as he is taking more oz and you will actually drop a bottle as he will be having 1 less feed. The total amount over 24 hours won't change that much, but will be more spaced out.

I also wouldn't worry about the charts, where they are as babies doesn't always correlate to their childhood patterns. At 4 months my DS was 91st centile for height and 75th for weight and taking 8oz in a bottle, but now at nearly 8 he is 25th for height and 9th for weight. His Drs have said that some babies are born bigger on the charts than they will end up because they had good nutrition in utero, as they grow they will settle to where they should be. My DS is following his Daddy who is not tall for an adult and was very skinny until he met me

Laura

[-Maya-]

Thank you for your answers ladies! Today I started giving him a bottle with 210 ml (roughly 7oz instead of 6) and of course he ate only 5. Lo is always a surprise!

I live in Italy, and I have been told to feed on demand when breastfeeding, but to try to stick to fixed hours and quantities when FF. Main reason I got is that babies can have digesting problems if feeded too frequently. Sometimes these advices are mixed up with old knowledge, like "I used to do this way and my lo grew up perfectly".

[creations]

Yes I think there can be a lot of mixed and out of date advice as guidance is always changing. I think one reason for feeding at regular times with FF is that you have to make the formula up and shouldn't keep the same bottle going for hours so it is not on-tap like BF.

[-Maya-]

Ok I think I must remove that 5am feed because it jeopardize the whole easy day. Today my lo did again this bad pattern: he woke up at 5am ad he drained 6oz. Then he slept again till 830. At 830 he was not so hungry and he ate only 4oz. Then 2h of A and just 30min of S because he is hungry after just 3h. But he ned more sleep than 30min.
What is a good plan to remove that 5am feed or at least to reduce its impact on the day?

I would like to get 5 feeds of 7oz each, 4 during the day and 1 df.
If I were brave my plan would be:
2300 (previous day) 7oz: increase oz, now he takes 5
0500 4oz: decrease oz, now he takes 6, if he ates at 6am reduce even more
0830 7oz: now I am offering 7oz but he just eats 4 or 5
1230 6oz
1630 6oz
2000 6oz: reduce last three to avoid too much food during transition days

Is this a good plan?

[creations]

A few things come to mind:
- some LOs don't like to eat immediately they wake up, ever been the case for yours? He might take his WU milk better 30 mins after waking
- short naps could easily be your routine which needs a tweak rather than due to hunger
- you could give a smaller bottle at 5am rather than totally drop it, hopefully to make him hungrier for the WU feed. I'd be hesitant to drop it as he seems to need it and 5am is not an easy time to get LO back to sleep

[-Maya-]

Ok, I try a smaller bottle tomorrow morning.

Wrt short naps, I think he needs to sleep more than half an hour. Today he has slept only 30m chunks the whole day and he was so tired that he has screamed the whole afternoon. Unfortunately when he's so tired he cries a lot and it is increasingly difficult to put him to sleep. Put him to sleep in the crib is a nightmare but also using stroller does not guarantee a success.

Sadly tomorrow will be a bad day because I have things to do both in the morning and in the afternoon, so I cannot put him to sleep in his crib even for his first nap... I hate this. I try to ask my mother to put him to sleep in the crib he has at my mother's house, but she is not enough committed to make him sleep.  "he cries when in the crib, he does not want to sleep; looo, he's smiling" she always says. And then she wonders that half an hour later he screams a lot.

[creations]

I think he needs to sleep more than half an hour. Today he has slept only 30m chunks the whole day and he was so tired that he has screamed the whole afternoon.

It sounds like you could do with having your whole routine looked at. Perhaps you'd like to begin a thread on the Naps board so you can get some help with your routine?  He may be UT or OT for his naps or need some help to learn to self settle and transition from one sleep cycle to the next.
I agree he needs longer than 30 mins nap and he doesn't sound very happy. If you suspect he is waking at 30 mins due to hunger have you tried giving him a feed before the nap?  I wouldn't suggest it all the time but it would rule out the possibility of a hunger wake.