Breastfeeding strategy/tips needed to drop baby formula

Family, Education, Health and Pets
21
I would like to share our experience with feed our girls.

Don't feel bad if you cannot breast feed. My wife couldn't. Just literally couldn't. We tried everything that we could read up on, all different things to eat drink, positions, pumping, everything, and nothing worked. And then she ended up depressed and started feeling like she was a complete failure as a mum. By 16 weeks there was nothing left, and we had to go onto formula full time. This happened with number two as well.

Now as a dad, I actually enjoyed having some of the feeding time with time with my girls and instead of detracting from mum bonding, it meant that we both bonded with our children, and we have a wonderful and tight knit family.

I will not say do not breast feed. All evidence shows that it is excellent for mother and child. There are nutrients and antibodies present in breast milk that are not and cannot be present in formula. There is something special that a bottle feeding dad cannot share with a baby that a breast feeding mum can.

All I'm saying is that if it doesn't work don't end up beating yourself up over it.

22
Thanks CK12,

We are using exactly that one but our impression is that now he is suckling less efficiently from the breast (getting only the easy-to-get milk)

23
Okay, so perhaps you could try either the syringe method, or using a sppon as suggested by ECB. I have aslo seen a cup being used, but more tends to drip out and be wasted.

Another technique I have seen ( with an adopted baby who was beginning to brestfeed) was to provide the expressed breast millk through a narrow tube, from an attached small bag ( I think you can get these from a pharmacy or perhaps through La Leche or other breastfeeding support groups)

The tube dropped down from the mother's shoulder to her nipple so the baby could get the extra milk quite easily, but stimulate the breast at the same time. With time, the baby was fully breastfed.

24
Formula sits in the baby's stomach longer - it's much harder to digest. If you are giving your baby formula with each breastfeed, that will be sitting in his stomach and making him not feel so 'hungry'...

Also, you can try just 'topping up' at the breast - feed off one side, try a few things like ticking the feet, tickling the palms of the hands, to wake him up a bit if he does fall asleep. Then if that isn't really working, swap sides. Maybe even try a nappy change in between to really wake him up, then offer the other side.

You can switch sides as many times as you like...your baby will tell you when they've really had enough!

All babies will 'take' a bottle, even if their stomach is full - when you put the bottle in their mouth, the sucking reflex takes over, and they also suck/swallow to stop themselves from drowning in the milk! - so whether the baby 'will' take the bottle after a breastfeed isn't a good sign of whether they are still 'hungry'.

Getting your confidence back, though, is really hard, and trusting your body to provide the milk, is also really hard - I think it's important to know in this situation that it's not a lack of milk that's a problem - it's a very sleepy baby with jaundice...who was under-demanding.

My mum was told to give up on breastfeeding me because I was an underweight, c-section, jaundiced baby - instead she spoke to a breastfeeding counsellor, and they suggested to try offering the breast ever 1-2 hours, and not stretch the feeds too much - I would never let a newborn go more than 5 hours between feeds... and in a week or two you will have a much more 'demanding baby'.

In this situation, having a more 'demanding' baby is not a sign that your milk is running out, it's a sign that the baby is now 'waking up' from the newborn sleepiness, and has the spare energy to make those demands - if you just breastfeed every time you think the baby could be vaguely hungry...you may find that the situation turns around very quickly.

At the moment, the baby's stomach is no bigger than their fist - probably even smaller - so they need to be fed frequently.

If you do hang in there, I wouldn't be surprised at all if you post back in about a month (when the baby is 6-8 weeks old), complaining that you now have 'too much' milk

I would definitely recommend seeing a lactation consultant if possible. Paediatricians generally have minimal breastfeeding training, and not all 'maternity' nurses are breastfeeding-friendly. Also, a lactation consultant should give you 'options'...

25
Actually can you tell us how a session from a lactation consultant looks like ? Formally, what is the job description of such a person ?

Our Hebamme, at last Stillberatung session she looked for few minutes if latching / suckling goes fine and that was it ... should be more ? i.e. asses the positions, measure the quantity of actual milk intake, etc, etc

26
Sorry to ask dumb questions but where do you get these ? Apotheke or any store ?

27
If you aren't getting any nipple damage or pain, and you're feeding your baby up to 12 times in 24 hours, then you're probably doing everything absolutely right!

The lactation consultant should be able to reassure you - more than 'measuring' what you are doing - if everything appears to be normal, then maybe it is!

It's such early days, I think you could ask the Hebamme about how you should cut back the bottles/formula - what did they suggest ? It's quite easy to build your 'supply' up - your breast is never truly 'full' or 'empty' - it actually makes milk throughout the feed, and afterwards you will find you have a good 'supply' within half an hour, even if you felt like your breast was 'empty' before...

Expressing the milk and feeding it back to your baby takes a lot more effort than breastfeeding directly...it also takes a great deal of technique - pumps are not as good as a baby!

28
Along with all this good advice, I'd advise adding Galactogil to your drinks, it has malt to increase breast milk. You can find it at the pharmacy. Also drinking non-alcoholic beer works for me.

29
the person I know was able to get an initial supply from a hospital, but then got more ( they came in cartons of about 100 I think) from a pharmacy. In the past, I have also seen the same syringes being bought via farming supply stores as they are someties used to "drip feed" a newborn motherless lamb.

I agree with Swiss Pea, regarding the continuous making of milk - that is my understanding (from various readings) as well. I also totally agree that having the baby on the breast is less time consuming than doing any expressing and is the goal. She is also correct in saying that formula sits longer in a baby's stomach as it cannot be absorbed as fast or as efficently; that little breastfeeds are probably all your baby needs and that if a baby is squealing for more, s/he is actually strong enough to be wanting to nuzzle and suck for more ( which will then be made due tot he supply and demand reaction)

However, in the case of a "sleepy" baby ( the one I referred to earlier was also prem) a spoon, tube, syringe etc( a relation of mine was fed with an eyedropper) maybe a temporary solution - I certainly don't recommend it as the most suitable solution for most babes.

finally, I do totally agree with the comment that it is important to have confident support. A qualified breastfeeding advisor has seen it all many times, and will definitely be able to give the correct support after meeting with both parents and baby. Enjoy!

30
I was in your situation a few months back. My son was in the neonatal ward close to a month. He was very weak and was fully fed with a feeding tube for the first 3 weeks and in the last week at the hospital a combination of bottle and feeding tube. Initially he was given formula milk by the hospital but once my milk came, I fed him only expressed breast milk. Throughout his entire stay in the hospital I tried to breastfeed him a couple of times but he just was not able to breastfeed as he always fell asleep after a couple of minutes. So, I effectively only started him on breastfeeding when we brought him home when he was 1 month's old. The 2 weeks subsequent to that was a real challenge as he only wanted the bottle and refused the breast and was such a sleepy baby. Somehow I managed to overcome the problems as he is fully breastfeeding now for all the feeds and is also able to take the bottle as well (when my hubby does the feeding). This is what I did:-

To keep up my milk supply - I drank at least 3 liters of water everyday, ate healthily and made sure I had enough rest. Hubby and I took turns with the night feeding so each of us could get a full nights rest every alternate day. I also drank Stilltee and Silacten (you can get them from any apotheke). I also made sure I pumped every 3 hours religiously for 15 mins (when baby was in hospital as he did 3 hourly feeding then). When baby was home, he was on a 4 hourly feeding schedule so I pumped every 4 hours for 15 mins (on the occasions when he refused the breast). I am personally a fan of scheduled feeding (Gina Ford follower here).

In my first week home, I was in total despair as baby just refused to take the breast. But I persisted and I always offer him the breast first and then top up with the bottle (with expressed milk). In the second week home, it became slightly better as baby took the breast longer then the first week. By the third week home, baby was fully breastfed. :-) The key is persistence and don't give up! Also when your baby is bigger and has put on sufficient weight, he will have enough strength to stay awake and start breastfeeding.

I hope this helps.

31
Congrats on your little one

After the birth of our little one I got litres of "Lindenblütentee" in hospital, as this stimulates the milk production.

Once home I drank the "Mutterschaftstee" from Migros, which is just as good as the "Stilltee" (tried both). This might sound weird, but alcohol also stimulates the milk production. Just be careful as to when you have a glass of wine: the alcohol level in your milk is highest 1 hour after you had a glass, so you need to really plan..

Our son also fell asleep during feedings. What helped for me was to ensure he was not too warm, change sides every 10 minutes and (what really helped) to stroke his cheeks when he started suckling less, as this triggers the sucking reflex.

Good luck for the time to come, it is a very stressfull yet beautiful time with your little one.

32
Hi,

We also struggled with BF, as my baby didn't want to, and we suffered from the same sleepy baby vicious circle and after 4 weeks I decided not to persevere with BF and continue expressing. I think once your baby has gained weight and is a little older and stronger and both of you want to BF then it's possible to break the circle. My MW/HV told me the same. In the meantime I think you have to pump to keep the supply up. I think I used pump an hour after a feed or so - then there was time to replenish for the next feed and if BF didn't work then I had a reserve of expressed milk ready. I felt the Calma teat did help with his feeding though - around 3-4 weeks there was a noticeable improvement in his ability to BF. Also as the baby has to suck the milk out (ie it doesn't flow out), s/he controls how much s/he takes. My baby always stopped when he had enough and one year later still decides for himself when he's had enough to eat or drink.

Have you rented a hospital grade pump? These are available from to rent from the hospital or some pharmacies - you can check on the medela website for your closest one. The cost of renting is partly reimbursable by the health insurance if you have a prescription (although my reimbursement came from my complementary insurance).

I was pumping 6x per day at the beginning and usually had enough at least for the first 1-2 months, but I know this varies from woman to woman. Drinking lots - I was recommended fennel tea and ovalmaltine and some brown herbal medicine (begins with an R I think) as well. Some women find looking at their baby or a photo of their baby helps - personally Grey's Anatomy worked for me!!!

Skin to skin contact is also supposed to help with the supply.

In our commune we have a centre with nurses, where you can take your baby to be weighed and they also give advice and can come and see you at home if necessary. My MW was also able to come as a breastfeeding advisor - i think you have 3 sessions that are covered by the health insurance.

Just to add: - we started with the syringe method - besides dripping the milk in I was also shown to put my finger in his mouth at the same time (think it's called finger feeding - check out Dr Jack Newman's site) but by 2 weeks my MW said that it would not really be feasible to continue due to the amount of milk that you need to give so you will need to be bottle feeding if you're giving around 90 ml per feed.

33
Lots of sensible things have already been said. Definitely get yourself an appointment with the breastfeeding consultant (there should be one at the local hospital).

Try not to worry too much. With our son I was told the same whilst in hospital (also jaundiced and not re-gaining birth weight). The first thing the midwife told me to do was throw away the pump. The amount you get from a pump does not correspond to the amount your baby drinks as you get the hormonal reaction when the baby is drinking which you don't get with a machine so you will produce less milk when pumping. If you do need to supplement, or give what you've pumped, then don't use a bottle, use a small beaker (5ml) or a spoon.

Make sure you drink lots and are eating enough.

At this stage you need to let them eat when they want, 2 weeks is tiny and they go through a growth spurt at this age. My baby (now 4 weeks) was feeding every 90 mins 2 weeks ago. Find a comfy seat and some good books to read

The tips I was given to keep baby awake during feeding are to tickle the feet, under the chin and not let him get too warm. Bear in mind that the jaundice makes them sleepy, so once this goes, baby should be more alert for feeds.

The only way to increase supply is to cut out the formula and follow the baby's lead. Even though it's exhausting!

Good Luck and congratulations

34
Yes, the finger in the mouth ( placed so the finger pad is in the roof of the mouth) was also being done by the person I observed. This was to encourage sucking in a similar way as to when the baby would have a nipple in the mouth, whilst the expressed milk was being dribbled in via the syringe.

90ml is a very big feed - I think a baby who is having that much would certainly be alert enough to not need a syringe, spoon or cup dribbling, so could just be happily nursing from the breast.

35
Definitely, it is not about the amount of milk that comes out, nipple stimulation is about the length of time the nipple gets sucked on (baby is a lot more efficient, they get this weird gnawing trick down the first few days, that they really consciously start using, in order to kick in your prolactine). So, as it was said, nurse, pump a bit after on each breast, then pump an hour after nursing and nurse again. Pumping after each nurse and in between nursing for a couple of weeks trippled my supply.

A good lactation agent will see if the baby has a proper latch, listens to swallowing since you can hear the amount of liquid being swallowed, will check your technique, will check the frequency of nursing withing 24 hrs and a few days span, will check your diet and will see if baby is calm, happy and not fidgetting hungrily and fussy. Will check for swallowing air, since often with some latch problems or babies eating too fast, there are reflux symptoms, without the reflux itself, but baby ends up with belly full of air and a colic. Will also probably ask you about night nursing, in order to prevent full night sleep, since it might kill your lactation. A good agent will never suggest supplementing unless you exhausted all your possible nursing ways. Since the amount of supplement will automatically decrease the amount you produce. Even with pumping, it is a pain to get it into some babies, and, some moms do not respond well to having milk mechanically sucked out, the let down might be troubled. The sucking on pinkie while squirting milk with syringe worked for me really well. It is so annoying for the baby, next time it has a nipple anywhere near (they smell it fast, syringe does not smell as nice to them), they will opt for a nipple as opposed to the annoying syringe and get to work.

I just jotted down some quick tricks, there is a bunch of really good stuff already written down.

When I was going through some major lact crisis, I had agents on call, all the time. Just ask here if you need help, do not rely on agents if you do not fully trust them. Nor pediactricians, nursing is often not a priority, so the advice might be off.

Good luck and it's fantastic you are determined. Don't be afraid to let your child be a tad hungry, instead of supplementing too quickly. One feeds it's a failure, another one it goes. Then it goes more frequently and regularly, then you realize it is working. They just need time to figure it out. Often, they learn through the few tough days that they have to work for their milk and get the technique down automatically. They are wired to succeed, so are we, wired to feed them and have just the perfect amount of milk for them. Just trust your body.

36
I just want to share my experience as giving advice is very difficult when every baby and mother are different.

My son, who is now 6 months old, was also a very sleepy baby. This, however, only lasted about 2-3 weeks and then he became more alert. In the hospital I was told to almost pinch him to wake him up, which I didn't like doing. When I brought him home I would try to feed him for as long as possible at a time by undressing him, putting him down on his mat during a feed and changing his nappy. I also fed him very regularly during the day but let him sleep for 4 to 5 hours at night. Feeding took ages, which didn't please my 4 year old daughter. But it got better and he began to take more and more at each feed so that I had 3 to 4 hours between feeds during the day and from about the 3rd month from 7 to 10 hours at night.

My friend didn't have the sleepy baby problem but had cracked nipples so she had to supplement her feeds with formula because she could not pump and her baby was not gaining enough weight. She did this for a few months - always offering the breast first and then topping up with a bottle. When her nipples hardened up she gave her baby less and less formula until she was only breastfeeding. Her baby, who is 5 months old, now refuses the bottle.

Hang on in there - as Rangatiranui put it, the only certain thing with babies is change!

Good luck!

37
Congratulations!

Lots of great advice already from some very experienced and helpful ladies but I just wanted to reiterate the point about the pump.

I had a Medela Swing which I persevered with for 3 months. It used to take me about 45 minutes to get just 3-4 oz on a good day (and that's just one boob). I finally got fed up and hired a Medela Symphony from my local pharmacy. It's the hospital grade one that's got 2 pumps and cost 100CHF deposit, 3.45CHF per day rental and you have to buy the bottles and tubing which was about 30CHF per set. It's worth every rap: I can easily get 7-8oz (3-4 from each side) in about 20 minutes and it's much more comfortable.

I also had a sleepy feeder who for the first 3 months would take 45 mins-1 hour for a feed. I was constantly tickling toes, undressing her, doing nappy changes, swapping sides. Not much fun in the middle of the night when you are totally knackered. But it does get better. She's now six months and can drain both boobs in about 8 mins

Good luck!

38
We rented an electric Medela Symphony, so I guess is good enough.

39
Thanks all for the kind words and supportive thoughts that you addressed so far. BTW, behind the keyboard types the hubby, mummy is resting, she was very very moved to hear your experiences and advices. Hope I will meet some of you also in the real life so I can properly thank you !

Current status: since Saturday lunch we cut completely the formula, mom was confident and I supported her to try feeding him every 2hrs (or 3-4 during the night) even though it required to wake up the little one. She felt a bit of increase in the milk supply, also there were always 6 wet diapers / day but apparently not conclusive enough for the scale. Why ? See below:

Today we went to a IBLC consultant at ZH Unispital, they said the little one drinks correctly (they didn't measure for how long / quantity though). However, on scale he lost 50g since last measurement Friday, today he is 17d old and has +30g above birth weight. The consultant said is a bit at lower normal grow rate, therefore told us to reintroduce and drop the formula gradually, 50ml after each session for 2 days, then 40 and so on. Also she told us to remove the 2hrs clock between sessions and to feed on demand (but not waiting more than 6hrs). And to renounce at pumping, the milk-flow looks good enough.

Other thing that worries me now is the abdominal gas, since Friday evening no poo. Sometimes after bf sessions, he is striving and crying and after a fart he stops crying. I thought if we exclusively BF him the transit should be ok, right ? Mom tries to stay away from the "well-known" gassy meals which BTW in the end doesn't let you with too many options left to cook. This reminds me of another topic: please tell me post partum recipes / takeaway suggestions that worked good for you.

Thanks again everyone.

40
Really great to have your feedback and to hear what good care you are taking of Mummy and baby!

Pooping babies- ah ha! Finally a subject I do know something about. Breastfed babies can go A Long Time without pooping .. my second set up a 12 -14 DAY routine in the first few weeks. It evened out at about every 5 to 7 days after about the 3 month mark. I asked the doctor and was told that with breastfed babies anything from several times a day to 2 weeks is normal. Plus babies are gassy, farty and burpy (sorry no other way to put it really) so per se it is not a problem unless you see accompanied pain/discomfort. Also do not be alarmed at how they appear to be pushing for their lives when all they are doing is a little windy pop. Their facial expressions are alarming to say the least but this too seems to be quite usual - even now, youngest (age 4) produces an alarming array of facial expressions and beetroot red face when producing a poop! Again, only be concerned if it is prolonged and accompanied with obvious pain (as opposed to momentary discomfort).

Mmmh - post partum meals - what she fancies I would say. It was bacon sandwiches for me! Of course, nothing in excess - she is meant to be eating healthily but so far just for one - you need up to 500 extral calories a day for breastfeeding but this is only really once little one has got into his stride and is taking big full feeds at each session. Of course this is not an excuse to eat two extra pieces of cake a day, but within reason and particularly so early on, I am a great advocate of a little of what you fancy does you good.