SUPPORT THREAD FOR MUMS WHO CHOSE TO BREASTFEED & FORMULA FEED

[Samuel's mum]

Sorry - I've only just seen this.  Does she take a bottle well?

It sounds as though you've already started introducing it I'm not quite sure what you are asking .

What have you been doing so far?

[summersusu]

I have some questions.
I had some PPD issues with my first child which lead me to stop breastfeeding at 3 weeks old.  I want for my next child to be breastfed but I want to save my sanity this time as well,  Is it possible from day one to breastfeed during the day and bottle at night.  I think the sleep deprivation really increased my PPD and if I could get some sleep next go round I think I could avoid the PPD as much!
What do you think?  Oh, I also had a c-section so that didn't help with all the other stuff that comes along with being a new mom!

[Fiver]

Hello, I'm new to this particular board, but have just been advised by our paed to supplement DS with formula as he wasn't putting on weight.

He said I should continue to BF, but give him a bottle afterwards.

How do others manage this in terms of timing for making a bottle up??  I'm pretty confused as I've never done this before!  Any advice gratefully received!

[Samuel's mum]

summersusu - it's theoretically possible but it's not going to be easy. This is because the supply is so governed in the early days by stimulation and demand. Several nights feeds are useful in the early days because the hormone prolactin is around particularly at night and this is what kickstarts your supply. Your best bet is to feed at night even if it's just for a few days to get the milk in - get someone to carry the baby to you, do the winding/burping and settle the baby back to sleep and feed lying down if you can. After that you may need to do some extra pumping to get your supply to the levels needed for the day. You could also consider taking a galactologue like fenugreek to boost supply but the best way to boost supply is by more feeding. The only other issue is that some young babies do find it harder to move between the bottle and the breast as different techniques are needed. You need to make sure you get really good advice on your latch. It might be better to give the formula at night another way - e.g. a syringe or dropper until he is definitely feeding well at the breast.
With a c-section it's also super important to get the 'stimulation' aspect up and running as you may have a delay to starting feeding. Good Luck.

Fiver - we've had lots of recent discussion about weight gain and the advice to supplement on the bf board. You may want to check out the WHO weight charts on the bf FAQ board and see how he does on those - some doctors are still using the formula baby charts. Weight gain slows down for a number of reasons - more activity, it's a natural stage after the 4 month mark for many bf babies. If you feel confident supplementing is the right thing for you - the bottle can be made up in advance and sit there for quite a while until it's needed (certainly the length of the breastfeed). You should make sure he's completely done at the breast first (offer the second side and even go back to the first - 'third' side - there will be more there). If you do want to chat about weight gain issues do come and start a new thread on the bf board.

[Fiver]

Emma - thanks for that.  I've checked out the WHO charts and he's not even on the first centile curve on that.  Also, in the last 3 weeks he's lost weight (back to where he was 6 weeks ago), so supplementing is something we're going to have to at least try.

[Samuel's mum]

Fiver - hope all goes well.
You could think about using a SNS system too - which stimulates your supply at the same time. If breastfeeding is something you'd like to maintain in the long-term then I would suggest you have a chat to a breastfeeding specialist/ lactation consultant.
Here's a bit more about an SNS system - Lactaid is another brand:
http://www.lowmilksupply.org/abs.shtml

[summersusu]

Samuel's Mum
Thanks for the advice.  Maybe I should look at some safe PPD meds so that I can successfully breastfeed and be a happy mum.  I was really stubborn last time and refused to take anything and just cried it out.  I don't know.  I just want what's best for the baby but keep my sanity too.  It is a whole lot easier to breastfeed than pump for me.  Pumping was like a job within itself!  So I don't know how well that would go the second time either.  I am going to continue to pray and read about the best option for me and the next baby, assuming I will be blessed again.

[Samuel's mum]

summersusu - there are lots of mums on these boards who have continued on their meds while nursing. Just start a thread on the bf board and you'll see. The population suffering from depression contains a large amount of mothers post natally. And a large number of these women need to take meds. And a significant proportion of those nurse their children. It's an area that has been studied at length.

There is more about taking PPD meds and breastfeeding here:

http://www.kellymom.com/health/meds/antidepressants-hale10-02.html
Dr Thomas Hale is one the leading world authorities on this subject.

http://www.kellymom.com/health/meds/antidepressant-ref.html

Good wishes to you

[Johanne]

Hi, I have had pretty severe PPD - and I am taking sertraline and breastfeeding (lots!) even now my baby is 1! I have to say the last 4/5 weeks have been fantastic depression wise so i think we have finally found the therapeutic dose. I'm overjoyed, I can't tell you. Hang in there!

Jo xxx

[Samuel's mum]

That's great news Johanne

[Muriel - Elisa's mama]

Hello!
I just discovered this board at a perfect timing! I am just starting to do a combined feeding for my LO of 4.5 m. She got sick ( A very big flue, hopefully no pneumonia!) the last two weeks and did not gain too much weight and as I also got her cold after that (already being very tired of having to worry so much for her!), I decided to cut the pumping at work during the day and only breastfeed morning, evening and dreamfeed! So she get two formula bottles a day now at the daycare.
As we just starting with that, I do not have much experience on how much she should take, what I can see is that some days (especially at the day care!) she eats a lot and generally the days with me (week ends) she eats much less form the bottle. As I have no way of knowing how much she eats via the BF, I don't know how much she takes the days she eats few from the bottles. Should I worry about this or as long as she is smiling, growing OK and not waking up at night to ask for food, just let her do?
I also have another question on the combined feeding: do I have to make special care of my milk supply or it will adapt on the 3 feeds a day by itself? do i have more risk now of low supply than before with the 100%BF?
thanks for the advise!!

[Samuel's mum]

I also have another question on the combined feeding: do I have to make special care of my milk supply or it will adapt on the 3 feeds a day by itself? do i have more risk now of low supply than before with the 100%BF?

Everyone supply behaves differently but basically there are a couple of principles if you are going to try and maintain a reduced supply - firstly make the transition as gradual as you can. When people drop feeds suddenly and especially more than one in quick succession there are more likely to find their supply goes into freefall. So I would suggest you introduce the formula feeds but then continue pumping at work for a bit longer. Ideally continue pumping at the same times but gradually pump less and less. If you've already given up pumping then keep an eye on it but you may want to reintroduce at least one pumping session during the day to keep your supply up - and then taper it off until you are just pumping a trickle. (Clues you may be having problems would be extra wakings where she seems hungry, difficulty achieving a letdown, frustration at the breast).
The other 'principle' is to keep the existing feeds at regular times so your supply adjusts accordingly - which you are doing.
It also helps if you do bf feeds at the weekends and during holidays (although you may be slightly uncomfortable at the beginning of a working week and need to express a little for comfort at work).

3 feeds a day is enough that you should be OK. We've had a couple of people on the working mums thread on the bf board who've experienced some problems maintaining fewer feeds but one I'm thinking of particular went to only 2 feeds. The general rule is also that the younger the baby when combined feeding begins the harder it can be to maintain supply.

At her age I would offer 6-7oz in a bottle (with formula you've got less worries about any being wasted) and see how much is left at the end and you may take a couple of days to work it out. With expressed ebm a baby often takes a little less because it's absorbed more efficiently and has a slightly higher fat and calorie content (So a 4.5 month old baby may only take 4-5oz of ebm but the same baby take 6oz of formula).

HTH
Good Luck

[Muriel - Elisa's mama]

thanks for the nice advise! i did not thought of giving her the breasts even on week end, if i see i start to have low supply, then i will try then! so far i never had supply problem, more too much milk at about 3ms than not enough so with luck i will manage! i keep all the feeds at very regular times as we are now on a 4 hours easy, so i hope it helps too!
well for the formula, she seems to eat less formula than the expressed milk! she was eating about 6oz and now barely takes 4 the last days, with me or at the day care!! i tasted the formula milk and the hypo-allergic that i am using is very salty as taste compared to the ebm!! so she probably has to get used to, but as she does not wake up at night or seems hungry i do not worry too much yet!well, or try to!!!
muriel

[newmama12]

Hi everyone!
About 4 weeks ago I started dd on a formula feed at night. She will occasionally get an additional 3-4 ounces during the day if we're in a bind or if she wants more. My question is...ever since she's been on the formula her poop has been green and pasty. Is this normal? I read somewhere that green poop can be a sign of too much iron or a virus of some sort. What do you gals think?

A little background....she started on Nestle Good Start and last week her dr switched her to Enfamil Lactose free. She is very gassy and seems to have tummy aches all the time. So dr thought maybe it's a lactose/dairy sensitivity. She seems to have the most problems during naps and bedtimes. She's a tummy sleeper and will not lay flat on her belly. She sleeps on her knees with her legs tucked under her. It's as if she doesn't want to put pressure on her belly. Any suggestions on a formula for this issue as well? Think it's a lactose problem?

[Muriel - Elisa's mama]

Hi well here in the netherlands the mid-wifes advise you to use hypo-allergic milk based on soya and not cow milk when you combined the BF & formula to avoid allergy or other problems. The make i use here is called NUTRILON, i am not sure you find that where you are but this one works for us so far (even if the taste is salty!
i hope it helps!
muriel