Breastfeeding

Considering switching to formula

My son is ten days old. At first doctor visit, he was underweight, and doctor is having us supplement with formula now.

From the beginning, LO did not seem satisfied with my milk, and always hungry. At this point, he will be on the breast for over an hour eating, but still be screaming for more when he comes off. He has a good latch and I can feel him drinking, but I can tell its from hunger because of his movements rooting, sucking on his fists. It's extremely frustrating, regularly bringing me to tears because I can't satisfy his hunger.

I am stuck on the decision to switch to formula. When he got a bottle, he ate efficiently, was full, happy, and slept well. On breast milk he is cranky, never satisfied, and doesn't sleep. I am so conflicted.

Re: Considering switching to formula

  • It is normal to nurse your young baby for hours on end at that age. The more you nurse, the more milk you will make. If you are concerned that your child isn't getting enough buy or rent a baby scale and do a weighted feeding. You can also contact a LC. There is nothing wrong with supplementing but it will hurt your supply, So I would do it if you intend to wean or under the direction of a LC.
  • AmyG*AmyG*
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    The things you say about baby that makes you "know" baby is still hungry are actually signs all newborns do, and they really don't always mean baby is hungry.  See newborns can't distinguish between their own feelings very well.  I am hungry = root around, suck fists, and want to nurse, but I have a wet diaper = root around, suck fists, and want to nurse; my tummy hurts cause I need to burp = root around, suck fists, and want to nurse, I am tired = root around, suck fists, and want to nurse, I want to be held = root around, suck fists, and want to nurse. 

    In other words, newborns have an insatiable desire to nurse because it is an instinct they are born with to ensure their survival.  A baby that is latched on at the breast is the happiest newborn around--because for over 9 months in utero they never felt hungry, they never felt cold, they were always held, and they were always attached to the mom. 

    So because baby seems unsatisfied after nursing, doesn't mean you have to nurse them.  you go thru the motions, change diaper, swaddle tightly, burp very well, offer pacifier if necessary, and hold and rock them and see if they still complain.  and you know what you do when they still complain and want to nurse after all that?  You nurse. And for a while it will seem like all you do is nurse.  and that is normal for human newborns

    When born baby's tummy is the size of a marble, or one swallow of amniotic fluid.   this isn't even an ounce, more like a teaspoon.  after about 3 days, baby's tummy stretches to the size of a shooter marble, then up to the size of a golfball or their fist.  It should remain small like that to match the amount of milk your body is producing, which until you are past the 3 week growth spurt may not be eve 1 oz per hour yet.  So it is normal for them to want to eat very, very often and for a long long time to get enough to eat. 

    Basically if you have a weight gain issue (perceived or real) you go see an IBCLC lactation consultant for a pre and post nursing session weigh in on a very accurate scale and expect to see less than 2 oz per nursing session at this age.  If you see a lot less than 1 oz per nursing session then yes you may need to supplement a little bit per feeding. 

    But the first thing you do is nurse more often, every 2 hours around the clock for one day, nagging baby to nurse longer and stronger.  sometimes they'll stay latched for an hour but the active nursing is only for a few minutes.  nag baby, bend them into a sitting up position, cool washcloth on their toes, tickle them, don't swaddle, etc to get them to actively suck for about15-20 minutes.  then burp well and try for a bit longer of active sucking.

    If diaper count is above 6-8 a day, I probably would not supplement without proof that baby isn't getting enough.  If nursing is going well you may see 10-12 wet and or poopie diapers a day.   lower than normal weight gain would be a concern, but verifying the amount of weight gain is important.  normal is 1/2-1 oz per day, or 4-7 oz figured from baby's LOWEST weight after birth, which usually occurs the day your milk comes in (average day 3-5).  from lowest weight if baby lost a lot of weight, it may take longer than 2 weeks for baby to regain birthweight, even if they are gaining on the high end after a slow start.  a weighted feeding will verify if supply is a problem.

    if number of diapers a day is low, plus lower than 1/2-1 oz a day weight gain from lowest weight, then I would supplement no more than about 1 oz a feeding.  so I would nurse for the 15-20 minutes, burp, try the other side, then burp.  then give 1 oz a supplement very slowly so baby doesn't come to prefer the botle.  then pump for 15-20 minutes at least, or maybe longer to collect 1 oz of supplement for the next feeding.  once you can pump 1 oz very easily, then you know supply is not the issue.  that's where an LC can help you make sure that baby's latch is fine and strong and wean off the supplements so you can just nurse.

    often low weight gain is just a matter of dr opinion that baby should be gaining weight like a formula fed baby, so be sure your dr is comparing your breastfed baby to other breastfed babies.

    go read at www.kellymom.com for more info on what to expect the first weeks of nursing, how to tell if baby is getting enough and how to supplement a bf baby without causing other issues with your supply.

    AMYG*

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  • I was in a similar situation, supplementing due to weight.

    Are you pumping? Have you seen a lactation consultant? My pediatrician and lactation consultant would have me do weighted feeds before supplementing and then after nursing I would pump until dry and then continue pumping for another 5 minutes. This sucked because something was attached to my boods almost 24/7 but after about 1.5 weeks my supply started to increase and we slowly weaned off the formula and now baby is 8 weeks and we haven't given formula in over 3.

    I also did other things to help my supply like oatmeal, mothers milk tea, fenugreek supplement and drank a minimum of 12 glasses of wAter a day.

    My LC also helped with getting us a better latch which in return allowed for a slightly shorter eating time because LO was a better eater. A bettwr latch also might have provided better stimulation resulting in More milk production. However, at 10 days I believe it's very normal to be nursing for long periods of time 8 to 12 times a day.

    If you want to BF I encourage you to stick with it. I cried so many times in the first month but we are finally to a happy manageable point.

    GL

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  • Do whatever is best for your son...there are tons of women who switch to formula.  I do know that while diaper count is important letting a baby feed for hours isn't doing much bc they are burning more calories eating than they are ingesting...and sometime by the time a Dr notices insufficient weight gain its been weeks where your lo is uncomfortably hungry.  I would book an appt with your Dr.  and have he/she go over the best course of action. Good luck:)

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  • Mmm79Mmm79
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    I'm sorry you are having such a rough time.  I remember feedings early on where we were both in tears- it was so, so hard.

    If you really want to give breastfeeding your best try, I would definitely reach out to a lactation consultant (LC) zoo.  There is probably one at your hospital, but you could also check with your pediatrician's office.  As other have mentioned, they will probably do weighted feedings so you know how much milk you LO is transferring. 

    In the early days I was doing the crazy dance of trying to nurse, pumping and supplementing (with formula and expresed breast milk). I felt like I was going to drop dead.  But once things settled- around the five week mark- it got better.  We were able to move to just nursing by 5/6 weeks and now it is so much easier than warming up a bottle- especially in the middle of the night.

    If you do decide to switch to formula, make the decision and move on.  Don't dwell on it or feel bad as many women do.  Taking care of your baby and yourself is the most important thing.

    Good luck. 

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  • Our ped is having us supplement because he's nearly a pound away from his birth weight at 7 days. He told me to nurse, and then offer formula, of which he'll usually take about 1 oz. Ped also told me I can do a full feeding of formula and pump to keep my supply going, but I always feel so guilty when I do that, like I gave up on feeding my baby, even though I've not really had a strong opinion either way when it comes to nursing vs. formula. Hopefully with our doctor visit this week I can get some more answers.
  • Here is what no one told me. Breastfeeding is hard! My LO is 5 weeks old and the first 3 weeks I thought for sure I would quit. Jack wasnt gaining weight and I had to supplement with formula on for the first week. But then my milk came in and I stopped the formula. 

    He went from 6lb 2 ounces to 8 lb 10 ounces at his 1 month appointment. That was all breast milk and 3 days of a couple of bottles of formula.

    Here is what I do to save my sanity. I breastfeed and pump one bottle at night for my hubby to do. On the weekends I pump the evening bottle and one morning bottle so I can catch some extra sleep in the morning on the weekend.

    Make small goals for yourself. I set 2 weeks as my first. I though for sure I would quit. Then 2 weeks came and I said, ok 1 month. At one month, everything was falling into place, routine, his efficiency and now I do not see quitting.

    Your nipples will hurt, the first couple of weeks, you will be exhausted. It does get easier. It really does.   

     

     

     

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  • AmyG*AmyG*
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    so what day did your milk come in?

    how many wet and or poopy diapers?

    how often are you nursing, every 2-3 hours during day with one 3-4 hours at night.

    what are actual weights?

    what % of weight did baby lose?

    10% is within the realm of normal. so an 8 lb baby may lose 12.8 oz and be within normal.

     But Unless baby weighed 10 lb at birth,

    a whole lb down means yes you do need a bit of help getting things going well with breastfeeding with short term supplementing.

    your goal is to regain birthweight about 2-3 weeks of age, so you have time to fix this and breastfeed if that is what you want to do?

    dr's advice to give 1 oz of supplement is probably reasonable. but you HAVE to pump after every nursing session to get that 1 oz and you HAVE to pump to get a whole feeding if you just give a bottle instead of nursing. There is no reason to give formula if you can pump enough oz instead.

    baby is almost always more effective at getting milk than a pump is.

    but if you are giving bottles you need to pump for every bottle will help maintain and increase your supply to be able to nurse exclusively.

    like I said an LC visit is a great way to get reassurance and professional help. they can tell you exactly how much milk baby is getting at the breast and how to get supply to match baby's needs andhow much supplement is needed.

    unless dr is doing pre and post nursing session weigh ins, dr is just guessing how much baby needs in a bottle.

    I personally would want to know what is going on and how to fix the breastfeeding situation from a breastfeeding professional. then with that info if you still choose to swith to formula you are making an informed decision,rather than doing it because you don't know what else to do. It will help keep you from feeling badly about it. you sound conflicted and maybe you have a stronger opinion about breastfeeding than what you originally thought you would feel. that's ok.

    AMYG*

    I don't type posts; I type novels.

  • You can try to pump and supplement with BM. This will help build your supply. When the twins were born, I would nurse and then pump after I nursed. DH would use the milk I pumped to supplement the next feed and then offer formula as needed. (I did not pump in the middle of the night.) I also agree that a LC could really help. At the end of the day if switching to formula works for you and your family then do it. GL!
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  • image Ashfann93:
    Our ped is having us supplement because he's nearly a pound away from his birth weight at 7 days. He told me to nurse, and then offer formula, of which he'll usually take about 1 oz. Ped also told me I can do a full feeding of formula and pump to keep my supply going, but I always feel so guilty when I do that, like I gave up on feeding my baby, even though I've not really had a strong opinion either way when it comes to nursing vs. formula. Hopefully with our doctor visit this week I can get some more answers.

    Your ped is an idiot.

    If you are offering formula, you need to be pumping. Period. For at least 20 minutes and with a hospital grade pump.  Pump and/or BF every 2 hours during the day and every 3 at night.  Feed your LO the supplement bottle while you pump - make a hands free bra from an old sports bra by cutting holes in the nipples, support LO on the boppy. Or cuddle LO skin to skin while you pump.

    We went through a very similar rough spot, but switching to formula never crossed my mind.  EPing did, but I'm glad I was talked out of that. At over a year my LO and I are still successfully BFing -- because I got the good advice to pump whenever we had to supplement in the early days and because I sought the help of a LC to get LO back to breast when she was 2 weeks old. We had another week of supplementing and she didn't get back to birthweight until 4 weeks - but her weight was artificially inflated b/c of fluids I had during labor.

    Have your LO checked for tongue and lip tie...and don't give up!!

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  • If you want to BF (if you don't then that's okay too) you need to see a lactation consultant asap! A lot of pedis just aren't as educated on BFing and can jump to formula as a cure-all. If you think it's supply related a weighted feed will tell you how much your LO is getting. A LC can also give a second opinion on the weight gain/loss. Some pedis put a lot of focus of birth weight as opposed to the current weight compared to the lowest point.
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