Supplementing and diaper output

[@llli*mamaasher]

My son is 6 weeks old and due to a number of complications, is being fed a combination of formula and pumped breast milk from a bottle. I'm pumping 10-12 times a day to increase my supply, in hopes that we can get him back on breast milk only and with the goal of getting him back to the breast without the bottles. Right now he's getting maybe 1/3 of his milk in formula and is gaining weight like he should be. He has lots of very wet diapers, so I know he isn't dehydrated, but he hasn't had a poopy diaper in 2 days.

I know diaper output slows when babies get older, but I wasn't sure if now was about the time that should happen or if it might be a problem. He's had this happen before, he'll go a day without one, then have a major dirty diaper, then he'll have 4-6 more dirty diapers that day, then skip another day or two. His poops are all the yellow, seedy looking stuff I was told to watch for. He seems more squirmy than normal, but doesn't seem to be in pain or upset. Should I be worried? I've heard that formula can constipated babies and I just really hoped that with so much breast milk in combination would prevent that. Any thoughts would be appreciated!

[@llli*auderey]

sorry, i don't quite understand what proportion he's getting milk vs formula - can you clarify?

[@llli*mamaasher]

Out of the 32 oz that he ate yesterday, approximately a 1/3 of it - 10 oz or so - was formula. My milk production is slow, but rising steadily, so hoping that ratio will drop soon.

[@llli*lllmeg]

At this age (6weeks +) it would be perfectly normal for an ebf baby to go several days without a poop. Some go to this pattern earlier. (and some keep pooping up a storm.) When moms are worried about the less frequent poops, I suggest looking at pees and weight gain to be reassured.

I have looked high and low for good info on how moms who are combo feeding (breastfeeding and formula bottles) can tell baby is getting enough, with little result. The best I can come up with is that sometimes formula causes constipation or less frequent poops and sometimes it makes baby poop more. Not helpful, I know.

It may be helpful to know that a ebf baby would need about 25 oz of breastmilk a day (some a bit more, some a bit less.) This amount does not need to increase as baby gets older. So if you are feeding baby 32 oz per day total, that seems like plenty. But again, I have no idea how much formula is needed vs. breastmilk.

Are you trying to get yourself up to a full supply by pumping before trying to reintroduce baby to the breast? That is one way to do it, but usually the most effective way is to be bringing baby to the breast all along-if baby will latch & nurse, that is more effective at building supply than pumping. You could still pump as needed but you might be able to pump less if baby will nurse more.

[@llli*aprilsmagic]

I worry when I see moms pumping to bring up supply. Why?

A) pumping is a HORRIBLE way to measure your production. Many women make plenty of milk if they nurse. But the pump does not stimulate milk production nearly as well. So, these same moms who may have an oversupply actually struggle to feed a baby via exclusive pumping. I am one of them, actually. Once I started dropping sessions, I started struggling...but it is unrealistic to pump like this long term.

B) babies only get better at breastfeeding with practice at breastfeeding. Thus, bottlefeeding often undermines the ability of mom to breastfeed. The longer you wait, the harder it is to go back. The baby often will prefer bottles, and this makes it really hard to get baby to breastfeed, which is work. I have exclusive pumped for a baby who was unable to breastfeed from birth, and it has been such a difficult road that I strongly urge moms to get off of it as soon as they can.

If you can, try breastfeeding first, then supplement with any needed formula.

It's very normal for a baby at that age to stop having bowel movements every day.

[@llli*laurenc]

If you can, try breastfeeding first, then supplement with any needed formula.

I agree - I am one of those people who was EPing with my newborn and I ended up with a horrible case of Mastitis when I accidentally skipped a session. It has taken over a month to heal and I'm still not even at 100%! Breastfeeding should come first, then you can try pumping gently for an additional 5-10 minutes after you've breastfed, to stimulate your nipples. But don't overdo it and end up with overproduction (like me). I always try to breastfeed if the baby is around me and only resort to pumping when she's not available.