Balancing BF and FF

Litgirl77

From what I can tell, there are more than a few of us who are supplementing BF with formula. I'm in the same boat and really struggling with the decision of whether or not to "give up" on breastfeeding.

Right now LO is almost 3 weeks old. I'm feeding LO 7-8 times a day, and doing 15 minutes on each breast, plus around 2oz of formula, then pumping for at least 10 minutes afterwards. The whole process takes at least an hour (plus, time to change LO and get him calmed down and back to sleep). This has been happening for the last week, at the suggestion of a lactation consultant (the second one I've seen). I also tried fenugreek, but it made LO and me both very gassy, so I stopped it. 

It's honestly getting to be too much to keep up with when I'm not seeing any improvement in milk supply, but I'm resisting throwing in the towel. I'm terrified of skipping a feeding (having DH just do a bottle so I can sleep) for fear it will adversely impact things. 

I know no one can tell me what to do and that this is a decision I need to make for LO and myself. I'm just curious to know how other people are doing who are balancing BF and FF. Thanks!

 

jac409

I have been doing the same thing and I agree, it is too much. A couple of days ago I started pumping on one side while DD breast feeds on the other side. I think I pump more milk this way and it saves me a ton of time. It was hard at first to manage both at once, but we are getting the hang of it.

valeriegp

My LO is 3 weeks old and I was doing almost the same routine, and it was just too much. It seems that your problem is the same as mine -- your LO is just not getting enough when he is nursing. 

 I have stopped nursing altogether (after trying many things) and am exclusively pumping, and this has actually helped us get off the formula. At first I pumped every time he ate. Then I pumped every two hours during the day, then when he woke at night (which is only 2-3 times; he sleeps one long stretch usually, and with the pedis blessing we are no longer waking him to feed him).  Now I'm pumping every 3 hours during the day and when he wakes at night. This is working out well and my milk production has increased on this system, and today I actually started freezing some. 

 I'm lucky in that  my partner is home with me, so it makes the feeding and pumping easier. I do miss the time with him, especially at night (during the day I can feed him because my pump time usually doesn't correspond with his eating time), but him getting breast milk is what is most important.

 We might try to get him to nurse again, but he and I were both so stressed and upset when trying to make the nursing work. It isn't good for either of us for me ( and him) to be crying and upset while trying to get nursing working. We are both happier with this than when we were doing the nurse-supplement-pump routine. I don't know how long it will last, but for now he is getting breast milk and thing are much better all around.

 Long story (I'm pumping right now), I know, but maybe it will be helpful.  Good luck!

S & R + r

I'm also in the same boat. I nurse as much as I can, even it it means 40 minutes on each breast. I even went for 3 hours one time. The more stimulation the better! Even if LO is not getting enough milk as long as he'll stay sucking, I leave him on. But of course I have to supplement after I BF. Then after he's full, happy and ready for bed I begin to power pump for about an hour. I usually get about 2 oz from that 1 hr session.. So if things play out right I can BF then supplement with my breast milk (He normally eats about 2 oz from my breast on a good day) and he's good to go! The less formula I have to use the happier I am! 

I agree it is very hard. I have low milk supply and LO can't latch that well. I noticed a small increase by mothers milk tea, skin to skin and pumping/nursing. I have an appointment with the LC on tuesday and I'm hoping to fix some things. I just need to try my absolute hardest, I personally can't give up just yet.

If I were you, I would nurse a little more & pump while LO is asleep. Power pumping is awesome! Also try skin to skin. It's a lot of effort but the benefits are worth it! I also agree that many of us Dec moms are struggling with this so thank you for posting! I'd love to hear how others are dealing with this.

JessAnnJ

I nurse once a day for about 30 minutes but it's so painful during and after I can't see increasing it much. She gets frantic while we are trying to latch and then falls asleep quickly and gets frantic again when I wake her up. She also still eats about 2 oz after each feeding. I mostly pump and I get about 2 oz she eats 3 and my milk supply doesn't seem to be increasing. I'm also struggling with what to do. I'm not sure how I will manage when my husband goes back to work. Pumping is very uncomfortable so I haven't figured out his to do much else while I pump. She tends to time meltdowns with pumping and I can't really hold and comfort her while pumping.

SingleMom31

We're in the same boat... Pumping, nursing, supplementing... All of it. I agree that it's too much, but I'm also hesitant to give up. I go one day at a time and figure that if tomorrow is horrible that I can always give her an extra bottle or skip pumping once or twice or decide to give it up altogether. So far, tomorrow hasn't been horrible.

GL and whatever you decide will be okay... I'm sure this isn't how you pictured it either, but we're getting through it.

gakester8

our routine is similar - I feed for ~15 minutes with a nipple shield on each breast, pump for 15 minutes and supplement with my milk and formula using a nipple shield and tube each feeding. it takes an hour with DH helping, an hour and a hour and a half when I'm alone. I've been taking fenugreek too and seen the hospital lactation consultants 4 times since leaving the hospital 2.5 weeks ago. we're still trying, hoping things will get easier. it is really hard and tiring though. we're still supposed to wake him up every 3-4 hours if he hasn't eaten.

anytime we've tried to simplify a step (like using a bottle to supplement at the end) it has made DS have a harder time latching and then we have to go back to the old way. the one thing we have done to make it easier is that I don't pump during 1 middle of the night feeding. we also are still seeing the lactation consultants.

have you considered taking a prescription med for supply? They were mentioned to me if fenugreek doesn't work. I was also told to eat regular oatmeal cooked on a stove.

Litgirl77

AmyG*:

well my answer of how to do this, and best way to proceed nest will depend on more info from you about your situation.

 how much milk you are getting while pumping, how long do you pump, what kind of pump you use?

as well as how much milk baby is getting at the breast when they nurse (from a pre and post nursing session weigh in), how long baby nurses at the breast, and whether they nurse on one side or both sides with or without breast compressions.

  I would also want to know if baby has been checked by more than one source for tongue tie, suck swallow issues, or high bubble palate, and how sore your nipples are?  or if you are you using a nipple shield? 

How many wet and poopy diapers a day you are getting?  And what color they are?

I would advise that if you are giving 2 oz in a bottle 7 or 8 times a day, that is 14-16oz.  To me that means the LC thinks baby is taking in only about 1 oz ish at a feeding only at the breast?  what is baby's weight gain so far? 4-7 oz a week after your milk came in, or lower or higher than that? 4-7 oz a day is normal weight gain, soif baby lost more than 10% of their birthweight it may take til 3+ weeks for them to regain birthweight even if breastfeeding is going well.  Big initial drops in weight can be due to a lot of variables, including how swollen you were at the end of pregnant or how much IV fluids you received during labor, and how often you have nursed daily right after birth.

And I would certainly suggest you find out what change there is in milk intake and pumping amounts  if you nurse 10-12 times a day-- most 3 weeks olds are nursing that often. especially with a 3 week old going thru a growth spurt they usually do nurse that often at least for 4-7 days or until sometime after the 6 week growth spurt.    A breastfed baby takes in on average oly 25 oz a day at the breast, so if you nurse 12 times a day and then pump/supplement you'd only need to give about 12 oz of supplement a day as an example of one way moms are able to increase supply,   but I understand sometimes that's already been tried. 

I do know that eping is a common option, it does come with it's own hazards(like low supply).  And that choosing a time or two a day to only give formula is also an option if you are driving yourself nuts , but if you did that I would recommend lowering the supplement amount, nurse every 2-3 hours during the day followed by pumping and then give yourself a 3-4 hour time off at night without pumping and give just formula for that feeding.  I would try not to go longer than 4 hours without pumping, maybe 6 max.  Many women find that to fully bring in a full milk supply with pumping they need to pump every 2 hours for at least 20 minutes.  if you are nursing too you nurse for at least 20 minutes, then pump, once milk supply slows you pump for 5-20 minutes after the milk stops flowing to signal a higher supply.

There are other herbs aside from fenugreek to take for lactation, as well as lactation cookies, oatmeal.  make sure you've had your thyroid checked fully, and there is no chance of retained placenta. domperiodone from inhousepharmacy.biz or your dr to write a short term rx for reglan is an option as well.  lots of options.

 

 Thanks Amy - I really appreciate you taking time to write such a detailed response with advice!

To answer a few of your questions:

-I'm pumping after each feeding, both breasts at once while doing compressions, for at least 10 minutes using a Medela pump in style. I accumulate 2oz total over the course of the day, so not much at all. 

-The LC weighed LO pre and post feeding, and he took in a little over an ounce. So again, not much at all - which is why our doctor wants us supplementing due to his weight loss.

-LO was down 11% at our first doctor appointment, and is now almost back to birth weight, so although I haven't liked supplementing, I know we did what was best for him to keep him healthy. I feel like it probably damaged my supply in the long run, but I try to tell myself we did the best we could with the info we had.

-My doctor mentioned Reglan to me, but I'm hesitant to use it since depression is a side effect and I'm already struggling with hormones and have a family history of depression.  

I really like your suggestion of pumping, and I'm going to try more sessions today to see if that helps. Thanks again - I really appreciate the information! 

gakester8

bloomraiser:

I'm in the same place. I can't keep up with the constant feeding, burping, diapering, bottle washing, pumping, feeding, burping, diapering, washing...when am I supposed to sleep? Not complaining...I signed on for this....just not sure its going right. Newest problem is BM leaks out of flange and runs down my belly. What a waste. Will try different flanges, diff pump if necessary. Symphony hurts and pisa is ineffective. So frustrated I could scream!!!

I was also having issues with the flanges and switched to slanted ones and use them upside down. maybe that'd help you too? I loose a lot less now. also, make sure you've got the right size for you.