Pumping and Formula...

[@llli*cassakane]

Hi. I know that a breastfeeding site is a weird place to ask a question about formula, but I don't know where else to ask. I don't think there are forums devoted to formula feeders.

I am exclusively express feeding my eight week old son (due to weak suck issues). I will be returning to work this Friday. Because I work out of town, I will be away from home Friday night through Monday evening each week. I had built up a supply of breast milk, but last week my deep freezer somehow got unplugged. I lost my entire supply. I have frozen some milk since then, but this occurrence sent me into a panic. I do not want my baby to have nothing to eat when I am away from home - for whatever reason (not enough frozen breastmilk, power outage...).

So, I want to get my baby used to formula. Sothat he will have food in an emergency...and I can also cut his breastmilk with a little formula in order to rebuild my supply of frozen breastmilk.

The problem is that my son is not responding well to formula. I first tried Gerber Good Start - 1 oz formula mixed with 4 oz breastmilk - and it made him cry. I assumed that it made his stomach hurt. He would drink some milk and then start crying. Starting today I then tried Gentlease...same thing, drinking some of the breastmilk/formula and then starting to cry. I then tried Similac Alimentum. It is supposed to be hypoallergenic...so shouldn't that mean that there is no way it should make him cry? I mixed 1/2 ounce alimentum with 2 1/2 ounces of breastmilk. He drinks for awhile and then cries, drinks a little more and cries. I am starting to think that this is not caused by stomach pain because of this --> When I feed my son I sit him up against my legs. When he starts crying while drinking the breastmilk/formula mix I pick him up and cradle him in my arms. He stops crying immediately. If his stomach were hurting, wouldn't he continue to cry and be harder to calm down? Maybe he wouldn't stop crying until the pain went away?

Is it possible that when I first start feeding him he is drinking really fast and not noticing the taste of the formula in the breastmilk...then when his stomach is a little full he notices it, doesn't like it, and cries?

This is making me sick with worry. It will kill me to be hours from home worrying if my son will have enough to eat. I need to get him used to formula. I don't see how it would be possible for him to not be able to tolerate hypoallergenic formula. Am I doing something wrong with how I am introducing formula?

I know a lot of you are anti-formula, so I really appreciate any advice that you can give. Also, please don't be mean to me about using formula. I am doing my best and taking supplements to increase my milk production. I tried pumping every two hours to maximize my milk production, but since it takes me an hour to pump (one breast at a time so I can continue taking care of baby), half an hour to bottlefeed and then change the baby....that's basically two hours and time to pump again. It turned me into a nervous wreck.

[@llli*esthervegan]

Greetings cassakane,
I am glad you feel comfortable turning to La leche League to answer your infant feeding questions.
Your pediatrician can help you choose the formula that is appropriate for your baby.
I can understand how uneasy you must be feeling knowing that you will be apart from your precious child for an entire weekend.
That is enough to send any mother into a mild panic, irrespective of how she chooses to feed her baby.
But I will cast my my vote for getting your hands on a top quality, hospital grade double pump to kick up your breastmilk supply.
It's the method most recommended for protecting a mother's ability to produce ample quantities of the biologically normal, nutritionally correct good old fashioned breastmilk.
You only have to pump and store 2 to 3 ounces for every missed feed. aim for a total of 24-30 ounces of pumped breastmilk per day, fed in 2 ounce increments 10 to 12 times a day.
Your LO might be crying b/c his belly is being forced to hold more milk than needed if you are feeding him 5-6 ounces of mixed breastmilk and formula.
.

[@llli*mommal]

We're not anti-formula- we're anti-unnecessary-formula. In your case, it sounds like using some formula may be inevitable, due to the loss of your freezer stash. Which I am so sorry about- how awful! I once cried over spilling a 5 oz bottle, so I can't imagine how you felt when you discovered that the freezer had come unplugged. Just FYI, if something like that ever happens again, you can keep the milk as long as it is still frozen. A freezer that is closed will often keep a good amount of milk frozen for 24 hours, maybe even more, as long as the door is closed.

Since your baby is reacting to the formula while he's drinking the bottle, my guess is that he isn't in pain from the formula so much as unhappy with the taste. I think you are going about this the exact right way- trying different brands, mixing small quantities of formula with his milk. All you can do is keep trying to get him to adjust to the taste. Ideally, you will someday be able to get to the point where he will take plain formula, and you can start offering separate breastmilk and formula bottles. The storage guidelines for breastmilk and formula are very different. Unfinished breastmilk bottles can go back in the fridge, but unfinished formula must go down the sink. Since getting the milk is such a challenge, you don't want to have to pour it down the sink!

Tips on reducing your pumping workload:
- Re-use your pump setup. Just leave the pump screwed onto the bottle of milk and pop the whole assembly in the fridge. When it's time to pump again, simply pump new milk on top of the old. My LC said it was safe to do this one time before washing everything again- but that can still reduce your wash load a lot!
- Try to get your baby used to cold milk, if he isn't already. Warming bottles takes a lot of time, and it's not a necessary step.
- Leave a big basin of soapy water set up by the sink, and toss used pump parts and bottles in as necessary. They can sit and soak until you have time to do a washing- and I found that one or two big wash-ups per day was less time consuming than doing a hundred little wash-ups per day.
- See a LC, preferably an IBCLC. It may not be too late to get your baby to nurse, and that would decrease your workload a lot!

[@llli*cassakane]

I do have a hospital grade double pump. A Medela Lactina Select. It works great, but I can generally only use one pump because I need one hand free to take care of my baby. Also, I have it set on the highest suction and the fastest setting...still takes about half an hour to finish pumping one breast.

I am not overfeeding him...5 ounces is just how much formula + breastmilk I put in the bottle. He stops eating when he wants to...generally 3-4 ounces, but sometimes 5.

[@llli*phi]

It works great, but I can generally only use one pump because I need one hand free to take care of my baby.

If you're going to EP, you'll probably want to invest in a hands free pumping bra (I jerry-rigged something for myself). Pumping will go a lot faster if you can find a way to double pump.

Also, I have it set on the highest suction and the fastest setting...still takes about half an hour to finish pumping one breast.

The highest and fastest settings on your pump are not necessarily the best settings. Perhaps try adjusting the settings during the pumping session. Sometimes my milk would letdown more quickly if I pumped on a slower setting for awhile then increased it to a quicker setting, or vice versa. Pumping for awhile on a lower suction setting and increasing the suction later in the pumping session also helped sometimes. Sucking patterns change during a feed when a baby nurses, and sometimes trying to mimic that can help bring on a letdown. Make sure to do breast compressions while you pump. And, as always, Mommal has given really great suggestions on helping reduce the pumping workload.

As for introducing the formula, I think Mommal is right that your current approach, mixing it with breastmilk in order to try to get your baby to accept the taste (maybe try an even higher breastmilk to formula ratio to start ) is the best approach. That's how my SIL got her kids to drink cow's milk. It probably won't be easy, but just keep offering a small mixed bottle periodically and try not to stress out too much about it - your baby picks up on your stress which only makes things worse.

I also agree that we're not anti-formula here. We just want to support successful breastfeeding and unnecessary formula tends to sabotage breastfeeding efforts. When it is necessary, formula can be a lifesaver - quite literally - and no one is opposed to that.

[@llli*mommal]

I am not overfeeding him...5 ounces is just how much formula + breastmilk I put in the bottle. He stops eating when he wants to...generally 3-4 ounces, but sometimes 5.

Since you're now mixing milk and formula, how about breaking the bottles down a bit more? Make one 3 oz bottle and be ready to make an additional 2 oz if baby is still hungry afterwards. That way you're less likely to need to dump your milk down the drain.

Have you tried your LO on plain formula?

[@llli*goldentoes]

Since you're now mixing milk and formula, how about breaking the bottles down a bit more? Make one 3 oz bottle and be ready to make an additional 2 oz if baby is still hungry afterwards. That way you're less likely to need to dump your milk down the drain.

I think that's a good idea. Formula tends to be slower to digest, sits in the tummy longer, and may be more filling. So baby may be sucking down the volume he's used to but then having some discomfort because it doesn't digest the same way. Maybe smaller bottles starting out will help you rule that out

Don't have much more to add since I don't know much about formula, but hats off to you, exclusive pumping just seems incredibly hard and I don't know how you guys do it.

[@llli*aprilsmagic]

You need a hands free bra. I would suggest the Simple Wishes one. I liked it so much I got two!

I know you said your baby had weak suck issues, but have you thought about trying to get him back to the breast now that he is older? It is much easier than EPing long term. It actually becomes much more difficult, and the loss of power was a constant fear of mine...I made DH go buy a generator to run the fridge and freezer when my cleft bab was 9 days old and we lost power!