Vomiting/spitting up after breastmilk

[The Vern]

I'm feeding my 5wk old some breastmilk (low supply) but mostly formula.  I have noticed a pattern that she will spit up copious amounts when I've preceded the formula with breastmilk.  The formula is dairy based.  When getting fed only formula, she might have small amounts of spit up, and sometimes nothing.  What could cause this? Would I be better off to stop the breastfeeding?  Could she be allergic to breastmilk?!   Any similar experiences out there?  Any suggestions? Thanks.

[annamum]

The only thing that comes to my mind is that she probably has quite a lot of your breastmilk and then is topped off with formula. In total, she gets too much to eat. I haven't heard of a baby that is alergic to breastmilk but there may be something in your diet that makes her uncomfortable, usual culprit is diary, beans sometimes tomatoes. But since she is on diary based formula, I think she is just overfed when you feed her both. When a baby is nursing from a breast, she can regulate the amount she drinks, with a bottle she can't. We usually tend to feed them everything that is in a bottle.

Why do you think you have supply issues? The more you give formula the lesser your supply will eventually become. Some women believe they have supply issues and are adviced to introduce formula but we can help you here to increase your supply, it is still not too late. It takes time for your body to produce an adequate amount of milk for your baby. Babies go through growth spurts when they seem to be starving and nursing moms think they don't have enough milk for them, I have been there too!

Let me know if we can help you with that .

[First Time Mom]

I couldn't agree more! During my lo's first week I was told "I didn't have enough milk" in the hospital so they gave her additional formula and so when we got home I was always concerned with supply, especially since my dd was always crying. My dh thought I was starving her so he bought bottles and formula for the evenings and we would top her up AFTER bfing. She would cry more and spit up great amounts yet she always took the formula (so we thought she was hungry). In week 5 I decided to stop the formula and only bf and she has been fine since. I think some bf'd babies will take a bottle regardless if not hungry as the formula comes sooo easily out from the bottle and they are not used to this. It's rare for a baby to have a reaction to bm, way more common to have problems with formula.

[The Vern]

The supply issue is real as I had a breast reduction 15 years ago.  I tried the lact-aid supplemental feeding system which drove me and my husband nuts, so we stopped that in favour of bottles.  I'm on Domperidone (med to increase supply) as well as herbs (fenugreek and blessed thistle). Am also doing lots of compressions when she's at the breast.  I think you both are probably right about the overfeeding, but it's so hard to know exactly how much she is getting from me, and she does still make hungry signs (rooting, etc.) when the breasts are emptied, whereby I follow with the bottle.  I will try to be more vigilant as to when she might be full.

I have heard that babies can get more out of the breast than I can by pumping - is there a way of knowing for sure how much?  When I pump, I range from 1-2.5 oz total from both breasts, depending on the time of day.  Is there an estimation as to how much more she can get herself?  Thanks again.

[daisymelan]

I truly don't think there is any way to calculate it.  I have never been successful at pumping, only yielding at the most maybe 3 oz at one time.  I know ds gets a lot more than this.  I guess maybe the only way to truly know is if you give her a bottle of expressed  breast milk and see how many oz she drinks. 

Good for you to contine bfing despite the supply issues.  I have to admit that that's the first time i've heard a story similar to yours.  Soundsike you're doing a great job. 

How much does she takw when you top up?  You can also increase your supply by pumping after you have fed her.  But again, I don't know anyting about breast reductions and how it effects supply, so this may not work.

Again, good for you for bfing!

[LisbonMom]

When dd#1 was a few weeks old we were told to supplement with formula as she wasn't gaining enough weight. She would spit up huge amounts too, so we decided to limit her formula intake. She eventually weaned herself off and became exclusively breastfed. I'd suggest you try to find out how hungry she is after you bf, so you only give her the bottle in absolute necessity. I know this is easier said than done, and wait till you pass the 6 week growth spurt, but like it has been said she might be just eating out of pleasure rather than hunger. Does she eat the same amount of formula with or without bf?
Also, remember that babies root and suck even when they're not hungry!

Good luck, HTH,

Sara

[annamum]

Also, remember that babies root and suck even when they're not hungry!

Absolutely agree with that. She may be tired and looking for food/bottle/breast to get to sleep. It is so hard in the first weeks to figure out their cues. My dd also always rooted when she was sleepy.

As for your breast reduction, you may be able to ask your surgeon or a nurse if that could possibly affect your milk production. I know that some surgeons cut through milk ducts and that certainly has an effect on it, while some don't, you should ask.

Good luck!

Edited to add, I just found this: http://www.bfar.org/, it is a site for breastfeeding moms after breast reduction. You may be able to find useful info there

[The Vern]

Thanks for all your replies.  Last night I thought I had it figured out.  At 4:30 a.m. she only ate from one breast and seemed satisfied, so I put her back to sleep no problem. Didn't follow with the other breast or bottle, like I normally would have - and also no vomiting. Yippie.  However, she then woke up at 6 a.m. she woke back up (she's usually on 3-hr easy, like clockwork). Tried to soothe her with paci and pat/sh, which worked for about 10 minutes at a time, then finally at 6:30 a.m. I fed her the other boob and 50 ml from bottle. Seemed ok.  But, what I'm worried about is losing her good schedule. 
Perhaps what I will do is pump and feed her bm from bottle, at least then I know how much she is getting, though I'll miss the bfing...

[First Time Mom]

You mentioned that she ate from one side, you can offer the other side and see she if she wants more. I know in the book it says to do one sided, at the time I read the book (my lo was 5 weeks) I tried one sided and she fussed and ate every 2 to 3 hours so I switched to both sides (altering each time). Currently my dd takes 10 minutes on each side (she pauses sometimes) and she's 3 hours (you could set your watch to her). I think at your lo's young age they may sometimes want to eat more frequently so I wouldn't worry about 2 hours, I think you'll find it will range in the 2-3 hour mark. What if you pump throughout the day (after feeds) and put it in the fridge, offer her both sides at each feed and if she then seems to still be hungry offer her the pumped milk? Offering her both sides would probably be enough and would really get your supply established well.

[deenz]

I'd just like to add that I'm not sure feeding ebm via a bottle will give you any better idea about how much she gets from the breast - she may drink more ebm from the bottle (than breast) as it flows out quickly, and it's harder for her to regulate her intake.  Also, if you were only pumping (with no time for your dd at the breast) it would be much more difficult to maintain your supply.