why do peds place a formula-feed schedule on a BF'd baby!

[micah'smom]

hi everyone,

my 4.5mo was 15lbs, 26 in at his 4mo visit. big boy! i have him on a 4hr easy so i feed him 4 times a day, once at night. the dreamfeed never worked for us b/c he'd still wake up hungry.

i asked my ped when i should drop the night feed especially considering he's EBF'd. she said i can try NOW. is that true?? even though he's a big boy i think he still needs his food. we're also starting rice cereal so she suggested giving some at night to fill him up.

my milk supply has gone down as it is, and i had to give him formula before bedtime last night (he's been waking 3 times lately!)

so when do you think it's safe to drop his nightfeed? does "sleeping thru" depend on weight or development?

thanks!

[Erin (redstarfalling)]

He's your baby so obviously these decisions are really up to you!  But for my 2 cents :wink: , I would really caution you against starting solids so early.  The World Health Organization and the American Academy of Pediatrics recommended that babies be exclusively breastfed for the first 6 months.  Your ped may not be entirely up to date... :oops: There are a number of downsides of starting solids too early and not really any benefits.  Contrary to popular belief, cereal won't help a baby sleep through - often it's the opposite - sore tummies from trying to digest something like that too young can keep them up!  There are fewer calories in cereal than in breastmilk and it's digested quicker anyway (carbohydrate vs fat and protein), so it won't really keep them full longer.  I know a lot of people with big babies start solids young because they think milk can't fully supply their needs, but that's really not the case.  Both my sister and a good friend of mine had babies at least as big as yours (one was bigger at 4.5 months!), and they were able to wait until 6 months to start solids with no problems - one baby was already sleeping through.

Many bf babies still need a night feed for the first 6 months or even longer.  You could try dropping it, but he may very well just need that extra feed. You mentioned a decrease in your milk supply. Have you looked into why this might be?  Are you getting enough rest and fluids? Also, keep in mind that by supplementing with formula, you will decrease your supply even more.  If you want to continue breastfeeding, you might try other method to up your supply...

Finally, as to your question about sleeping through.  My personal opinion is that it depends on many things - how much baby is eating (not so much "weight" though) during the day, developmental stage and what sort of behaviours have been reinforced.  Some babies just have less mature nervous systems, so they wake more.  You can stuff them silly during the day, but it may not always help!  :roll:

I hope that helps to answer some of your questions!  Feel free to ask more if you have them! 

[GG]

Erin made a good point.  If you're giving him formula, this may be contributing to your supply going down.  I was in the same situation and decided to give my DS formula for a couple of days as a supplement before I could call his pediatrician (it was the weekend).  When I spoke with him, he told me that giving him a full bottle of formula will only make my supply go down.

Based on what he's told me and what I've read, I suggest making sure you're drinking enough water and eating enough calories.  If you're already doing that, there herb fenugreek really helps increase supply.  If you need to supplement until your supply goes back up, have about 1 oz of formula (2 oz maximum) handy when you bf your ds.  If he's still hungry after you bf him, offer him the formula.

I don't think you need to stop the nightfeed.  Is he the one waking up to eat?  If so, I'd say definitely don't stop because he needs it.  If you're the one initiating the feed, you could try a night of not feeding him.  See if he wakes up on his own or see if anything changes during the day.  If so, then continue the nightfeed.

I've also heard the same thing about cereal that Erin said.  I would wait until he's older to offer him solids.

HTH! 

[cazao]

you really don`t need to start solids early just because you have a big baby. we have a very big, 99th percentile baby (15lb 13oz at 4 months) and we only started solids at 6 months. breastmilk is all they need before then. just make sure they`re drinking enough of it. and the way to do that is to ensure your supply is good and to do that you need to stop supplementing, and feed your lo frequently enough that your supply is stimulated. so i`d suggest keeping the night feed until your supply is more, and maybe clusterfeeding in the evenings. our lo slept through the night on just bf from very early, but we made sure to get the calories into her during the day...we were still doing 3 hour EASY and fed before and after bath at that age. you could try that, but if the 4hours are working for you concentrate on getting clusterfeeds in during the evening, possibly restarting the dreamfeed, and only once you`ve done that think about dropping the night feed. hope this helps. good luck!!

[GraceKellysmom]

Actually, the best thing for your supply is to feed him at night - or more frequently during the day. My big baby still eats occasionally during the night, I love that quiet time with him, and the fact he sleeps later when he eats during the night.

 And his night wakings could be developmental, he is learning to roll over and sit up, his limbs tingle, etc. He could also be growth spurting - trying to get your supply to increase by more frequent feedings. Try to sneak an extra feed in during the day before his longest nap to up your supply too.

I firmly believe that most pediatricians lack breastfeeding training, and are bombarded with information/free stuff from formula companies. The books they read/distribute are written by formula companies. The free lunches and workshops that they attend are paid for and presented by formula company representatives. Formula is a huge $$$$ business and formula companies must *get* us mothers from the angle of "my doctor told me..." Formula is the 'easy' answer to all breastfeeding problems, according to the limited knowledge a pediatrician has. Also, and possible most important, pediatricians don't have TIME. They don't have an l/c on staff, they only have 10 minutes with you in their office, and they don't have the time to spend helping with and teaching about breastfeeding. A quick "answer" - solids or formula - is all we get. And both of those can send our lo's right to WEANING UNIVERSITY.

Isn't it sad???  :cry:

If you have access to a La Leche League or other breastfeeding support group, or a certified lactation consultant, the information you get from them is the best, most accurate info you can get.

[micah'smom]

thanks for all the advice. gracekelly's mom, that all makes a lot of sense- i'm just disappted that my ped doesn't seem too supportive of "demand" BF'ing.

erin, i thought a sign of being ready for solids is doubling birth weight, interest in watching you eat, and feeding more often? that's why i thought he was ready. well i guess he's feeding more often b.c i don't have enough to give!

it's so frustrating b/c for the first 3 months i had too MUCH milk...i wonder if i went from feeding every 2hrs to 3hrs to 4hrs too quickly and not pumping enough at night.

well last night i clusterfed before and after his bath, and he was still hungry so i supplemented about 2oz. enfamil (which he did not appreciate). he slept at 7:30, woke at 10:30 apparently hungry but didn't feed much, then woke at 2:30 and did a full feeding. then woke at 7 for the day. MUCH better than the 4+ wakings we've had lately.

i definitely do need more rest. vicious cycle- ds is cranky and won't nap/sleep well, so i don't rest or eat well, etc etc.  i was afraid to feed more often during the day b/c ds ends up snacking and only taking foremilk.

aghh! I just gotta calm down. thanks again for the advice, hopefully today goes better!