BF & supplementing w/formula

Hey Mamas!

I posted this thread in my Feb 2016 mom board but didn't get all that much feedback. I'm hoping you ladies may be able to help me as well since this board specializes in breastfeeding topics :)

I wanted to EBF our daughter but this plan quickly changed when I was diagnosed with a a medical issue that requires immediate attention following her birth. I will be receiving a transplant and consequently placed on high-dosages of steriods for several months that will effect my milk supply. The procedure will be scheduled for 4-6 weeks after her birth.

I was heartbroken, and decided to EFF so that I wouldn't have to worry about her transitioning from breast milk to formula. At the time of my shower EFF was still the plan so I don't have much by means of BF supplies aside from some nursing pads.

After speaking to my husband at length about it and our LOs pediatrician, we have decided to both BF and FF for the 4-6 weeks leading up to my procedure. That way baby girl is comfortable with formula and bottles when Mommy has to begin sorting out these health issues.

Some questions I have been wondering, since I am a FTM:

1. Can I start formula with BF from the get-go or will I need to demand feed for a while to make my milk come in?

2. Can I pump right away to try and build up a stash for her before my transplant or are newly BF moms supposed to wait a while to pump?

3. Does anyone currently supplement with formula and have any suggestions on integrating the two? (I know the kind of formula will depend on baby)

4. As far as supplies go, is there any must haves I should get before her arrival?

Any advise or tips anyone can offer is greatly appreciated. Since I didn't plan on BF for my whole pregnancy I haven't spent the last 8 months preparing like I wanted to. I know the hospital will have an LC but advise from other Moms is always a plus :)

Re: BF & supplementing w/formula

  • Congratulations and I hope all goes swimmingly with the transplant.

    1. Yes but also yes. :) It took me 4-6 weeks to really get the milk 'in' fully, and I was nursing and pumping (but the nursing was inefficient due to a tongue and lip tie). So you do need to demand feed or pump to stimulate production but don't be discouraged if it takes a while.  My cousin's wife supplemented for the first two months, and only THEN did her milk fully come in. 
    2. You can pump and stash right away!
    3. It will depend on how your baby behaves and her/his preferences. I know plenty of babies who drink a combination of formula and breastmilk and they do just fine with both.  Others prefer one or the other. You can play around with different bottle nipples to discourage or encourage bottle preference/tolerance.
    4. I highly recommend the Spectra pump, or the Medela Symphony (hospital grade). At my hospital, the LC was useless (and too busy) but the LCs I saw in the weeks following the birth were amazing.

    How long will you have to be on steroids?
  • @marijaa333 thank you so much!! Anywhere from several months, to a year. Then I have to get another transplant for my other eye and then go on steriods for that too. Apparently, they can keep me on a low dosage steriod indefinetly to avoid rejection. Though I hope that's not the case, since we would like to eventually have more children.

    I'm finding out how to get a pump through my insurance and then will look into stuff for packaging so I can try to have a stock pile for her. I'm super excited, but very nervous since I feel unprepared.
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  • So are you hoping to create a stock pile in the first 4-6 weeks or will you at all be able to breastfeed after the transplant at some point?

    Pumping is hard work, and in the beginning your supply may not be huge (or it might be, who knows!). So if you find that it's just too much, please know that formula is perfectly fine. The most rigorous study (of twins) showed absolutely zero differences in long-term outcomes. 
  • My main concern is to BF her during the 4-6 weeks, and attemlt pump some to for a stock pile. I will be unable to BF at all after the transplants.

    I'm fine with her having formula, as myself and my husband were formula babies. Truthfully, I mostly want it to work out for selfish reasons lol Since my vision is being compromised I feel like BF her will help me bond with her and, make feedings a little easier when I am home alone with her. The added bonus of it being good for her just makes me want to do it all the more.

    I just hope everything goes smoothly and that her tummy lets us supplement with formula!! My biggest fear is having a baby who post-op is fighting a bottle and formula since she has never had it before.
  • Oh you will cuddle her lots and bond perfectly, I have no doubt! As for rejecting the bottle, rest assured that she will not let herself go hungry. You may have a few days or weeks of adjustment but it will all work out.
  • krissyberbkrissyberb member
    edited January 2016
    Since you're only going to pumping for a few weeks, I'd recommend seeing if your insurance would pay for you to rent a hospital grade pump like the Symphony. As far as freezer bags, I like the Lansinoh ones. They lay flat which makes freezing and thawing easier. We were given some Medela bags as a gift, and I hated them. So many leaks!

    ETA: after you've had your surgery, be sure to get a LC to help you with weaning off the pump. Long story, but i ended up with mastitis because I had a huge over supply from EPing for my tongue tied baby. I was so desperate to stop pumping after he had the revision and could nurse well. Worst decision. You do not want mastitis when you're recovering from surgery!!
  • I second the recommendation for a Symphony and for Lasinoh bags. NUK ones are just as reliable if cost is a concern (they also have the double zipper and lay flat, their only downside is that it's harder to label them without a sharpie).
  • I think it's wonderful you want to try, but I agree with one of the PP you need to be careful especially if you are pumping and feeding, then need to stop suddenly, you don't want to have to deal with plugged ducts and mastitis while going through surgery. In that first month or two I couldn't go more then 4-5 hours without insane engorgement and plugged ducts. I would think you would want to ideally be completely weaned by the time of your surgery or you will have to pump in the hospital.
  • I've been nursing, pumping, and supplementing with formula since the beginning (LO was losing too much weight because he came 4 weeks early).

    To get your supply going in the first weeks, I would recommend BF for almost all feedings throughout the day. Then after 5-8 days let your SO give 1 or 2 formula bottles per day. I would then pump during the formula feedings. This should help establish your supply and also get LO accustomed to FF + give you a little break. Having LO relay only on you for all feedings gets overwhelming very fast!

    I agree with PP to plan to pump (likely pump and dump?) while you're in the hospital and make other plans to avoid engorgement after your surgery.

    Positive thoughts for a speedy recovery!!
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