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Introducing Formula

  1. #1
    Swoon's Avatar
    Swoon is offline Banned
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    Nov 2002
    Hong Kong

    Introducing Formula

    I've been breastfeeding baby for last 2 1/2 months but feel he's not getting enough milk and seems constantly hungry recently. He cries right after a feeding and is always sucking on his hands. I've been doing the every-3-hours-for-10 minutes-on- each-side routine. Although I wanted to solely breastfeed him, I need to top up with formula before he starves!

    What is the best way to introduce formula to a solely breastfed baby? Replace one feed a day with formula for first week and then increase to 2 per day? How much should be given at first and then later on? Also, should I start increasing the time between feeds for longer than 3 hours and give a larger amount of formula during the feed? I yearn for this to happen for the nighttime feeds.

    Any advice or input from your experiences would be appreciated as I have no idea what to do.

  2. #2
    rani's Avatar
    rani is offline Administrator
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    Sep 2002
    Pokfulam, Hong Kong

    Sounds like you may be going through a growth spurt. Why don't you increase your feeding time to 15 mins per side. Or you can even nurse on demand. The increase in demand will signal your body to produce more milk to meet your baby's needs.

    If you decide you'd rather introduce formula, then after breastfeeding you can try giving him an additional 3-4ozs of formula. If you want to continue breastfeeding, than don't replace feeds with formula, otherwise your supply will slowly diminish.

    Here's a good article on Nursing and Growth Spurts
    Last edited by rani; 06-09-2003 at 08:36 PM.
    Founder of GeoBaby.Com

  3. #3
    LLL_Sarah is offline Registered User
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    Feb 2003
    Hong Kong
    Dear Bzee,

    You can be confident your baby is getting enough breast milk if:

    · He has six to eight really wet diapers a day. For babies under six weeks also look for at least two bowel movements. In an older baby, beyond six weeks of age, the number of bowel movements per day may decrease, and baby may have a bowel movement per day or even every three to four days, but the number of wet diapers continues to signify that he is getting enough milk.
    · He is gaining weight at an average of four to seven ounces a week or at least one pound a month (453 grams). Although four to seven ounces per week is an average gain for an average baby, different babies gain at different rates. In addition, some weeks your baby will gain more or less than other weeks, and that’s perfectly normal.
    · He is nursing eight to twelve times in a twenty-four hour period. This is an average and some babies may nurse less frequently while others nurse more often. Less frequent nursing is not a problem unless the baby is not gaining well.
    · He appears healthy with good skin colour and resilient skin; he is ‘filling out” and growing in length, and is alert and active with good muscle tone.

    Sometimes it is easy to think that you don’t have enough milk when actually there is no problem with the supply. If your baby is gaining well and has plenty of wet and soiled diapers there is nothing wrong with your supply even if you baby has the following behaviour patterns:

    · Your baby nurses very often. Many babies have a strong need to suck or a need for frequent contact with their mothers. Remember that frequent nursing assures that your baby is getting enough – not that there is a lack of milk.
    · Your baby seems hungry soon after being fed. Breast milk digests more quickly than formula does and places less of a strain on a baby’s immature digestive system, so that the breastfed baby needs to be fed more frequently than the formula fed infant.
    · Your baby’s nursing habits, weight gain, or sleeping habits don’t compare with other babies you have known. Each baby is an individual, and there is a wide variation within the normal range.
    · Your baby suddenly increases the frequency ad/or length of his nursing. Babies go through occasional growth spurts (usually around two weeks, six weeks and three months). During these times they nurse more often than usual to bring in more milk for their expanding needs.
    · Your baby suddenly decreases his nursing time, perhaps down to five to ten minutes per breast. He may simply be able to extract the milk more quickly now that he is more experienced at nursing.
    · Your baby is fussy. Many babies have a fussy period each day, often at about the same time of the day. Some babies are fussy much of the time. Fussiness can be caused by many things other than hunger, but often there is no discernible reason. If nursing doesn’t seem to help try such things as swaddling the baby in a light blanket, changing the baby’s position, walking him, or rocking him. Keep in mind that whatever the reason for your baby’s fussiness he often needs the comfort of just being held.
    · Your breasts leak only a little or not at all. Leaking had no relationship to the amount of milk you are producing and you will probably find that leaking between feedings is no longer a problem once your supply becomes established and regulated to your baby’s needs.
    · Your breasts suddenly seem softer. This happens as your production adjusts to your baby’s needs and the initial engorgement subsides.
    · Your never feel the let-down sensation or milk-ejection reflex or it does not seem as strong as it did before. This may occur as time goes on. Some mothers do not feel a let-down at all, but they can learn to recognize that it is occurring by watching their baby’s pattern of sucking and swallowing.

    If it seems that your supply is not meeting your baby’s needs then it is important to determine what is interfering with your production of milk. The following factors can cause or contribute to lessening milk supply:

    · Supplements. They fill the baby up and cause him to wait longer for the next feeding, thereby decreasing his sucking at the breast. The more formula he gets one day, the less milk the mother’s body will make the following day. Supplementing causes a mother’s breasts to produce less, not more.
    · Improper positioning of the baby at the breast.
    · Nipple confusion. A baby can become confused by a bottle nipple as it requires a different type of sucking. If your baby is not sucking properly at the breast, he will not be able to stimulate your breasts to produce enough milk.
    · Pacifiers. Some babies are willing to meet their sucking needs with a pacifier, which may significantly reduce their sucking at the breast and interfere with supply and demand.
    · Scheduled feedings. Delaying the baby’s feedings until the clock dictates a certain amount of time has passed can interfere with the supply and demand system of milk production. Feeding when the baby indicates he is hungry usually assures an adequate supply.
    · Length of feedings. Long nursings (twenty to forty-five minutes) can help assure an adequate milk supply as well as assuring that your baby gets plenty of milk high in calories. Cutting feedings too short can prevent your supply from increasing as your baby’s needs increase.
    · One breast per feeding. After the milk is established, some mothers prefer to nurse at only one breast per feeding. But if you are working to increase your supply, use both breasts. The baby who nurses at only one breast will take in less milk per feeding and each breast will receive less sucking stimulation.

    I’m sorry that this information is so long. I tried to cover all possible scenarios. If you are concerned about any of the factors in the last section please contact an IBCLC trained lactation consultant or a La Leche League Leader for help. All these problems can be overcome with the correct information and support.

    The local LLL Leaders’ telephone numbers are:
    Tanja 2259 3081, Judi 2987 5809, Maggie 2817 7475 and Sarah 2548 7636

    Best wishes,
    La Leche League Leader in Hong Kong

  4. #4
    Manfa's Avatar
    Manfa is offline Registered User
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    May 2007
    You know what I would try? Try feeding on ONE side. Only change to the other side if you are sure that he has emptied the first one. There is a possibility that he is not getting to the "hind milk" - the really good rich stuff that will satisfy his hunger and keep him fuller longer. You will notice that the longer he feeds on one breast, the slower he feeds.... That just means he is getting to the good stuff.

    I did this from the word go, against the advice of several people... not because I was convinced it was better but because I was not very good at getting him in the right position and getting him to latch on and wasn't confident that I could get him back on if I interrupted him halfway to change him to the other breast! After doing some reading I found out about the 3 stages of breastmilk and decided to carry on as I had been.

    The 1st stage of breast milk is quite thin, it's basically a drink for your baby. The second stage is richer and higher in protein. The last stage is the really fatty rich stuff. If he is mostly only getting his "drink" on one breast and then you change to the other, he will get more "drink" again and not really get as much "food". It would be like you replacing some of your dinner with a big glass of water. Wouldn't satisfy you for as long would it?

    Anyway, these are just my thoughts, based on a bit of reading and my own limited experience..... There is so much conflicting advice out there what I have read may well be wrong. But this has definately worked for me. My little un goes for 3-4hours between feeds most days. Maybe it's worth a try. I hope that helps a little anyways.

    Edit to add - he's gaining weight like a trooper (didn't even lose hardly any of his birth weight!) and he has LOTS of wet and dirty nappies every day. Midwife and health visitor have said "whatever you are doing - keep doing it!" Happily, the little guy has only ever woken once at night to feed as well... don't know if I'm just lucky or whether the feeding has something to do with it.
    Last edited by Manfa; 05-20-2007 at 09:41 PM.

  5. #5
    joannek is offline Registered User
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    May 2005
    Hong Kong
    i also used to only feed my baby on one side each feed. when i first starting nursing, i listen to other people's advice "20mins on left & 5 mins on right", 10 mins this & 10 mins that, etc. my baby wasn't gaining weight well, so i decided i just let her nurse on one side until she has enough, then the other side for the next feed. it was so much better & my breasts were finally emptied.

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