September 2013 Moms

XP: Help with formula supplementing

I have come to the conclusion that I am going to have to supplement with formula.  I am just not producing enough milk to meet my DD's needs and she is a lazy nurser.  I am looking for any advice/suggestions on what I can do to produce more milk or get DD to nurse better AND the best way to go about supplementing with formula.   
Background:  Around the 6 week mark, I noticed/realized that DD wasn't gaining weight at a very fast rate.  I met with a lactation consultant and did a weighted feeding and she did not consume very much at all at that time.  The LC recommended I nurse her for 15 minutes on each side, then pump, then supplement her with what I pumped.  I tried to do that, but it was very time-consuming and DD was not content to let me pump that often.  So I modified what the LC told me and started weighing DD before and after each nursing session.  Then I determined how much to supplement feed her (ie, if her weight increased by 1.5 oz, I would give her another 2 oz or so of previously pumped milk).  I was still pumping, but only about 3 times a day.  That seemed to be working for a couple of weeks.  I did not think there was a problem with milk supply, but rather DD is a lazy nurser. I got her checked for tongue tie and she doesn't have that issue.
 
So fast forward a couple of weeks and that system is no longer working.  I think the reason is two-fold:  she now requires more ounces per day and I am struggling to keep up with her needs and since she is sleeping for fairly long stretches at night we are usually doing 6 feedings per day so she needs more ounces at a time.  I am still weighing her before and after every nursing session to see how much she takes in (in the am, its around 3 oz, but as the day goes on it is less and less, sometimes only about an oz).  Since last Friday, I have been pumping after almost every nursing session in an effort to boost my supply.  Right now I am trying to make sure she gets 24 oz per day.  I started taking Fenugreek on Saturday and have been drinking water like crazy.  With all of that, I'm just barely keeping up with milk production.  And the whole feeding process can take over an hour which is starting to take a toll on my sanity. 
So, I've realized that I'm going to have to supplement with formula some, but I want to use formula as little as possible.  I plan to keep up with what I'm doing in hopes that something will click.  I am hoping she will start consuming more at the breast as she gets stronger/ less lazy (??)  But in the meantime, if I can't pump enough to keep up with what she needs, I am looking for advice on the best way to go about supplementing. 
Would it be better to:
a. pick one feeding per day and do all formula for that feeding, then pump?   
b. when supplementing is necessary, mix formula and breast milk in same bottle?
c. weigh/nurse/weigh, then supplement the difference with formula?

I know there isn't one correct answer, but I am looking for suggestions on the best way to supplement with formula and keep my supply up as much as possible.  Also, how to be more efficient so we aren't spending the entire day feeding.  I know this is really long so if you read all this, thanks.  And thanks in advance for any help!!!   
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Re: XP: Help with formula supplementing

  • I supplement with 2-4oz a day of Similac supplement formula for nursing mothers (green bottles - not the organic stuff). I give it to her during the day if I am out and didn't pump ahead if time or can't bf. if I don't give her the formula then, I give it to her at her bedtime feeding around 9:30-10pm. She has been doing great as far as nutrition and health/weight gain. It is also nice to know I don't have to stress if I haven't pumped or can't bf when she is screaming, if we are out. They are liquid 2oz bottles and they come in packs of 8 for about $7-$9 a box. I use coupons so I usually pay $2 a box. These have saved my life!
  • When I was supplementing I believe I was doing 10-15 mins per side then using a 2 oz Similac bottle. I am now EFF so I'm no help with supply. Perhaps @AmyG* has some words of wisdom?

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  • I supplement for the last feeding when DS wants 4-5 oz and is not getting enough. I use enfamil AR and it really helps with his reflux right before bed time. I would supplement at night if you are going to do it, because they tend to sleep longer:)
  • I don't have any answers for your questions but I wanted to tell you GREAT JOB MOMMA for nursing this long and making the time and extra effort to pump. I know it's very stressful to be feeding all day long and to worry if your baby is getting enough to eat. Good luck finding the right balance of BF and FF for your family.
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  • Big props to you for pumping and breastfeeding all day. I was doing that for LO's first weeks and it drove me nuts.

    I dont have answers for all your questions but there is a porridge you can make from millet that increased my supply. I use a lot of sugar bc it doesnt taste great but my supply shot up. If you are interested I can pass on recipe.
  • I supplement with 2-4oz a day of Similac supplement formula for nursing mothers (green bottles - not the organic stuff). I give it to her during the day if I am out and didn't pump ahead if time or can't bf. if I don't give her the formula then, I give it to her at her bedtime feeding around 9:30-10pm. She has been doing great as far as nutrition and health/weight gain. It is also nice to know I don't have to stress if I haven't pumped or can't bf when she is screaming, if we are out. They are liquid 2oz bottles and they come in packs of 8 for about $7-$9 a box. I use coupons so I usually pay $2 a box. These have saved my life!
    This is exactly what I do too. Those bottles are great. I also sometimes give him Enfimil formula for fussiness at bedtime to help him sleep better. It has taken so much stress off me by doing this.
  • @Albertsgirl1982, I'm interested in the millet porridge recipe if you can share it. I'm curious... Why millet?
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  • I didn't read all the responses, so forgive me if I'm repetitive!  First, I could have written your post.  Seriously.  2.5 weeks ago I went to see a LC for nipple pain and found out LO had not been gaining weight so we had to start supplementing.  Checked me for retained placenta and thyroid, all normal.

    Ok, so we did the weighing each feeding up until Wednesday (so 2 weeks for us) and then supplementing after each one.  I have been using pumped milk and I was able to get donor milk.  This system is NOT sustainable, as you said.  It's so consuming and exhausting.

    So here are a few thoughts for you and what is working for us:

    - DD has started sleeping really long stretches at night too, so we're also struggling to get enough feeds in during the day.  I've started offering to nurse much more often, even if she doesn't show signs.  Yesterday, I tried to nurse her to sleep for a nap and instead of her usual 2-3 minutes, she nursed for a full 25 minutes!  So I would say, try just nursing her like crazy and see what happens with her weight.

    -  I stopped weighing feeds and instead give one big bottle a day now, as her feeding at bedtime.  I pump during that time, as well as in the middle of the night (the other night I got 5 ounces) and in the am.  It sucks to get up to pump but it's only temporary.  For me, it's worth it to not use formula. I am just weighing her once a day now to ensure she is still going up.

    - Speaking of, is there a way for you to get donor milk?  I know if I had formula in the house, I would have given up BFing by now...

    -  I am taking domperidone.  If nothing else is helping, it would be worth it to look into.  You can get it online.

    -  A LC showed me to do massage while nursing/pumping and I also think this had made a big difference for us.  When LO slows down or stops sucking, I can use massage and get her to nurse for another 5 minutes.  There are some videos online that are helpful.  

    -  When pumping, are you hand expressing afterwards?  When I started this, I was able to get an extra .5 to 1 ounce each time!

    - I just reread your post and realized you didn't mention your pediatrician - are they worried? I've been slowly coming to terms with the fact that my baby is petite and will not follow the growth charts. She was bigger when she was born but, except for those 2 weeks when her weight gain was very slow, she's averaged a half ounce gain per day, which is normal!  So if that means she slowly goes down on the chart, it's ok.  My ed said she would only be worried if her length and head circumference weren't going up at a steady rate also.

    Sorry for the novel! I hope you are doing well - please PM me if you want to...we're very much in the same boat!  It's tough work and you are doing an amazing job feeding your LO.
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