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Thread: If I could just drop the bottles...

  1. #1
    Join Date
    Nov 2006
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    17

    Question If I could just drop the bottles...

    Hi there,

    I am in the middle of a transition from one lactation consultant to another and would like some advice if you can offer it in the meantime.

    First the history:

    My son was born September 10 (that makes him +/- 7 weeks old). He was premature (born at 35.3 weeks) and had trouble latching and sucking at the beginning. He has since learned to do so, between offering him the breast at every feeding and topping off with the bottle/formula. Between the breast and bottle, he is gaining well and is very healthy. His latch has improved although he tends not to open his mouth very wide and his tongue doesn't always go or stay down.

    I have thyroid disease and polycystic ovarian disease. All these factors have probably contributed to the low milk supply. I am taking Domperidone, 20mg X4 a day and have gone from 15ml a breast to 30 ml a breast since then.

    I currently feed at the breast at every feeding (approx. 7 times a day) and pump for 15 minutes right after. I have tried the SNS and when it works it is great, but I find it to be a hit and miss and it has become too frustrating (for me and baby) to continue. It is a good idea in theory though if I could make it work.

    So this is my situation. Now I would like to breastfeed exclusively and ween off the bottles if I can. Anything else I could be doing??

    Does anyone know how to slowly reduce the formula to encourage milk supply to increase, without putting my baby at risk?

    Thanks in advance
    Renee

  2. #2
    Join Date
    Jun 2006
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    4,893

    Default Re: If I could just drop the bottles...

    Hello Renee, and welcome to the forum. I do not know about using formula, however I did wean my 33 week preemie off of the bottle (EBM) after 2 months. I know you are fearful about putting your baby at risk, but as long as he is a healthy weight at this point, I would say pick a day and try to only breast feed. This is what I did with my daughter. I continued to pump to keep my supply up though at first. And if you decide you just can't stop supplementing, then you need to make sure that you pump whatever you are giving with formula - so if you top off with 4 ounces, then you need to pump 4 ounces. You need to tell your body how much milk it needs to make for your son. Don't worry if you are unable to pump that much in the beginning, but the stimulation should tell your body to make more. I hope this helps! Good Luck!
    If you obey all the rules, you miss all the fun. - Katharine Hepburn

  3. #3
    Join Date
    Apr 2006
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    869

    Default Re: If I could just drop the bottles...

    If you are trying to increase your supply, you should be trying to nurse 8-12 times a day. 10-12 is ideal.

    I was in a similiar situation to you, and ended up cutting out the formula because my son would not nurse frequently enough with it. Formula can take longer to digest.

    Have you considered renting a scale? You could weigh the baby before and after a feeding. I'd bet he's getting more than 2 ounces. Babies are more efficient at emptying the breast than the pump. Also, you could monitor his overall weight gain.
    Last edited by jentut; November 5th, 2006 at 12:16 AM.

  4. #4
    Join Date
    Nov 2006
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    6

    Default Re: If I could just drop the bottles...

    I have always been told that breastfeeding works with supply and demand. If you just go to breastfeeding than you will produce enough milk. At first you may be having several more feedings to keep up but your body will begin to produce more, just like if the baby is having a growth spurt. I agree that the sns is good in theory but doesn't work that well. It caused some major latching issues for me when I first started breastfeeding and my daughter would try to just latch onto the tube.

  5. #5
    Join Date
    Oct 2006
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    627

    Default Re: If I could just drop the bottles...

    kellymom.com has a great article on weaning from supplements

    http://www.kellymom.com/bf/supply/decrease-formula.html

    What I'm finding most helpful is keeping a log of when I fed, how I fed, how many oz. or how long she nursed (and which side), and then wet/messy diapers. Then, as you're decreasing the formula, you'll know that you're nursing more and that the wet diapers are still coming. I've got a notebook going. The first thing you do is track how much formula you're giving in a day so you know where to start. We started out giving her about 18 oz. of formula a day and now we're down to 5. It's taken several weeks, but it's working.

  6. #6
    Join Date
    Nov 2006
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    17

    Default Re: If I could just drop the bottles...

    Wow, thank you so much! All your suggestions are very helpful! I have taken note of all of them and will implement them right away! I will have a new consultant so I will get her to keep an eye on it all.

    KST7399 -- original name! Does it mean anything? Thanks for suggesting to breastfeed only for a day. I have discussed it with my husband and we will do that next Saturday, where he is around to offer any help he can.

    Laura/Nicole's Mom -- Yes, my son would either not have a good latch on the SNS or like your baby, would want to latch onto the tube. It's good to know I am not alone. It's too bad it doesn't work because it seemed like the ideal solution.

    Jentut -- Renting a scale is an excellant idea. That way I'll know right away if he starts to lose weight, and also I can know for sure how much I give him from the breast at every feed. Sure, I will nurse more often. I started right away today to see if I can go from 7-8 times to at least 10. One question though, once I breastfeed exclusively, do I still need to keep going 10 times a day?

    Zoewmu -- Thanks for the article and logs. I have been keeping my own logs for the last few days but didn't include the diapers. This should complete the information I already have and help guide me through the rest. I will slowly decrease until Saturday and then give a try to a day with no formula, see what happens.

    Thank you again, you have all been very helpful. I think I will come back to these boards!! Have a good week, Renee

  7. #7
    Join Date
    Jan 2006
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    1,437

    Default Re: If I could just drop the bottles...

    Hi,

    It sounds like you've already been given a lot of great ideas.

    I would just like to add that, when cutting back on formula suppliments, it is critical that you keep an eye on the number of wet/poopy diapers baby is having. Baby should be having 6-8 wet cloth diapers per day (5-6 really wet disposables) and 2-3 bowel movements. If baby is not having that kind of diaper output, you will need to cut back on the suppliements more slowly. Rule #1: Feed the Baby!

    Are you having a doctor keep close tabs on your thyroid levels and your PCOS? Thyroid disease can usually be regulated to the point that it does not cause low milk supply. Sometimes, however, even when fully treated, PCOS can continue to cause milk supply problems. Here is a link to a recent article from our Leader Publication on the subject. I would recommend printing a copy and sharing it with your healthcare provider. http://www.llli.org/llleaderweb/LV/LVAprMay05p27.html

    HTH,

    Tiana

  8. #8
    Join Date
    Apr 2006
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    869

    Default Re: If I could just drop the bottles...

    Quote Originally Posted by rambec View Post
    Jentut -- Renting a scale is an excellant idea. That way I'll know right away if he starts to lose weight, and also I can know for sure how much I give him from the breast at every feed. Sure, I will nurse more often. I started right away today to see if I can go from 7-8 times to at least 10. One question though, once I breastfeed exclusively, do I still need to keep going 10 times a day?
    I have always been a low supply momma. My son is now nearly 10 months old. I still offer to nurse him on average 8 times a day. The good news is he's gotten much more efficient at emptying the breast. What used to take 45-60 minutes now usually takes 10-20 minutes. When he's hit growth spurts, we've been back up to 10-12 times a day for a few days.

    When he was an infant, I didn't rent a scale as I was already broke from LC's and renting a pump. I have an electronic kitchen scale that I used to weigh his wet diapers. At the time we were using disposible diapers, and I had a tough time telling if they were wet.

    http://www.kellymom.com/bf/supply/enoughmilk-older.html

    Looking for (4*2) 8 to (5*3) 15 ounces each day.

  9. #9
    Join Date
    Nov 2006
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    17

    Default Re: If I could just drop the bottles...

    Hi LLLTiana,

    Thanks for the advice on the diaper. I had forgotten just how important it is to keep track of the diapers, I remember the nurses at the hospital explaining how this could represent dehydration. I have added an area for diapers on my homemade logs (printer is broken, couldn't print the above suggested logs for now).

    As for my PCOS, it's actually not clear that I even have it since I don't seem to have very pronounced symptoms. At this point my milk supply seems to have gone up again in the last few days and of course, I had managed to get pregnant so it seems I'm not too affected by it. Either way, I will keep it in mind and tell my doctor to do so as well as we continue the breastfeeding journey. Thanks for the input!

    Hi again JenTut,

    I just want to make sure that I understand your suggestion of weighing diapers. I do have a kitchen scale I could use for this purpose. So if my baby pees 7 times a day, each wet diaper shoud be approx. 1.5-2 oz. (to make 8 to 15 oz. of pee a day)?

    He poops 2-3 times a day, but sometimes skips a day, and my doctor thinks that is fine.

    I think a clean diaper is 20g so of course I will keep that in mind.

    Thanks again,
    Renee

  10. #10
    Join Date
    Apr 2006
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    869

    Default Re: If I could just drop the bottles...

    Quote Originally Posted by rambec View Post
    Hi again JenTut,

    I just want to make sure that I understand your suggestion of weighing diapers. I do have a kitchen scale I could use for this purpose. So if my baby pees 7 times a day, each wet diaper shoud be approx. 1.5-2 oz. (to make 8 to 15 oz. of pee a day)?

    He poops 2-3 times a day, but sometimes skips a day, and my doctor thinks that is fine.

    I think a clean diaper is 20g so of course I will keep that in mind.

    Thanks again,
    Renee
    Well, I would just weight each one and subtract the weight of a dry disposible and log it. Over a few days, I'd look for an average of 8-15 ounces a day. If you try it, you'll see that not all diapers weigh alike! The morning diapers are much heavier.

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