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Thread: EBF 4.5 months old - drying up? Formula?

  1. #1

    Default EBF 4.5 months old - drying up? Formula?

    I have been reading so many posts and forums about this that I am completely unsure what to do. My LO is now 20 weeks old and I am still EBF. Tried a formula feed once but felt so bad that I wasn’t giving her my milk that I decided to not do that again. I would really like to keep EBF until she is 6 months old and then slowly start her on solids and maybe formula feeds (not thought that last bit through yet). Unfortunately, she is not sleeping through. I put her to bed after a bath and a feed between 6-7pm, she often wakes up as I go to bed around 10/11pm (she sleeps in her cot in our room) and then again at about 2am. The last few days she even woke up at 4am for a feed. Last week I tried to get her to fall asleep again rather than feed, but she often refused. I have to admit I often am also too shattered and just let her feed instead. Since birth she has been a very fast feeder, spending not more than 5-6 minutes feeding. Her dayfeeds are 3h apart and she is a happy, healthy and growing/gaining weight proper little girl. I have started work again about a month ago and am expressing (taking Prolak and drinking lots of jungle juice to keep the supply up). My nanny lets me know when and how much she feeds, but lately I am extracting much less than she actually drinks. I have had times where I get 150ml out of it but also where it has only been 100ml, while LO drinks more than that. It worries me that I might just not have enough milk for her or am drying up. I have a very small stash of breastmilk in the freezer but certainly not enough, but I don’t know when I could add more to it. Expressing in the evenings is depressing as I often don’t get more than 20ml out of it and I wouldn’t know when to do it at night. I really don’t want to go onto formula just yet, but I have to admit that having to extract at work is quite onerous and feeding three times at night is quite exhausting, even if just for 6 minutes. I really am at the end of my means, don’t know what to do anymore and feel like I am failing my LO if I am not feeding her my milk. I also just cherish that intimacy so much especially since I don’t see her that much during the day anymore. Everyone asking and expecting that she is sleeping through is also stressing me a bit. I have tried to fill her up after a bath with an extra feed but it just makes no difference. It's a bit all over the place but please HELP!

  2. #2
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    May 2006
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    Default Re: EBF 4.5 months old - drying up? Formula?

    Welcome to the forum and congratulations on making it to 4.5 months of nursing your baby!

    The first thing I have to say about your baby's sleeping pattern is that it is absolutely normal and not in any way an indication of supply problems. Breastfed babies nurse at night because they need the calories, because night nursing helps keep mom's daytime supply going strong, because they want to reconnect with mom after she has been away, because they are teething, and most of all because infants normally have shorter sleep cycles and when they wake, they require help getting back to sleep and nothing does that as well as nursing. The 4-5 month window is often the absolute worst for night-waking, because the baby has almost certainly begin to teethe by that point and because she's starting to master new motor milestones like rolling, squirming, or pre-crawling, all of which she will practice in her sleep, resulting in a wake-up.

    So what can you do about it? If you want to continue to EBF, the best thing to do is to find a way to make nighttime feedings easier on you. Your baby is in a cot in your room, but if you can take her to bed with you, you may be able to nurse her in the side-lying position without having to wake all the way up. I'd also suggest checking out Elizabeth Pantley's excellent book "The No-Cry Seep Solution" for a realistic look at infant sleep and some gentle techniques which may encourage longer stretches of more independent sleep.

    Don't let other people and their expectations get to you. People love to prey on suffering new parents! And they often don't realize that for an infant, sleeping through the night is defined as a single stretch of 5-6 hours, not 8 hours!

    Your pump output is excellent. You're getting 100-150 ml (3.5-5 oz) at a time when average output is more like 60-100 ml (2-3 oz) at a time. But your nanny is overfeeding your baby. A breastfed baby should never be getting anything more than a 120 ml (4 oz) bottle, and most take something more like 60-120 ml (2-4 oz) at a time. This is because most babies take only 60-120 ml when they nurse at the breast, and because babies have tiny tummies. I suggest reducing the size of the bottles you are leaving to around 60-100 ml, with a separate 60 ml "chaser" bottle. That way the nanny will have to pause the feeding in order to get the chaser, giving your baby an opportunity to decide if she's full or just wants to suck. The nanny should also be informed about how to bottle-feed a breastfed baby: http://kellymom.com/bf/pumpingmoms/f...ottle-feeding/
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
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    Default Re: EBF 4.5 months old - drying up? Formula?

    Hi. What you are experience is totally normal. Most 4 month old don't sleep thru the nigh. Even if they were fleetingly before. Babies sleep patterns change every 4-6 weeks and at 4months old they are beginning to bat and swing at toys and developmentally it's like someone just turned on the whole world. And whenever they are making huge leaps like that they wake more. Also I am not sure what is going on with your breastmilk and pumping during the day, but unless you are now pumping LESS than you always have there should be no issue. Meaning if your child is drinking MORE during the day than she used to your DCP is overfeeding her. And that would be because there is an assumption that as children get older they need MORE. Which is true for formula fed kids but NOT breastfed kids. Because your milk is the exact perfect food for you child and it's composition grows and changes with her. SO don't let your DCP dictate to you how much you need to feed your baby. You tell her and be firm. I don't know how to convert to the metric system but the rule of thumb is your baby needs 1-1.5 oz of milk for every hour that you are way. That's it. Forever. Even if you are still pumping at a year. The amount needed never changes. So making sure that your child is never being fed more than 3oz increments at a time would really help.
    And yeah Mama it's hard. No one here will tell you that it's not. But we will all tell you that this 1st year of your childs life (which is the MINIMUM recommendation for breastmilk by EVERY organization involved with childrens health) is SOOO SHORT. And that your short term investment in her long term health will never be something you are sorry you put the time into. Did you eat healthy and not smoke and drink while pregnant? So that you could have a healthy baby? Well I would encourage you to think about breastfeeding in much the same way. And I would encourage you to NOT give up on giving her your perfect milk for substandard nutrition at the 6 month point. There is such a short short window of time when you are all your baby needs and that you KNOW FOR SURE that what you are feeding her is PERFECT. Because feeding healthy well rounded nutritious meals all the time with 6-7 servings of fruit and veggies and whole grains and not processed crap out of boxes and not too much sugar is a LIFE LONG challenge. ( and involves label reading forever) That you will be at for 17 years at least. Don't rush it and don't start it by giving up on your milk when she is so very young and it's still so very important. Your baby deserves your milk. Even if it costs you a little sleep. And believe me, we have ALL been there. And from the other side I can tell you, you will never be sorry you stuck it out.

    Way too lazy for formula

  4. #4

    Default Re: EBF 4.5 months old - drying up? Formula?

    Thanks a million for your reply. It really is such a relief and gives me peace of mind!
    I had no idea that I was feeding my baby too much expressed milk when I am away. I always thought that baby would indicate when it's enough. Hopefully I will be able to reduce the amount again.
    The link you sent states that one should not feed on a schedule but only on demand. I had been feeding her every three hours if she was crying for it or not. This morning her feed before I left for work was rather short and when my nanny feed her about three hours later she gulped down 150ml (5oz). When finished she was crying for more according to my nanny, so she prepared her another 50ml (2oz) which she also happily finished. Normally I express twice at work which is used for the two feeds the next day and I go home for lunch for one feed. Thinking that I have to replace a 200ml feed maybe even twice with what express at work....no chance Relieved to hear that it should be less than that per feed.
    But how do I work around non-scheduled feeding and going home for a feed during lunch?
    My LO actually used to sleep in our bed which worked fine, but gave us not much privacy and again everyone around me advised that I at least get her into her own cot in our room also to forecome her from rolling over onto her stomach on a mattress that is not suited for babies. A friend of ine told me a freak story of a 4months old rolling over and suffocating.

  5. #5
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    Default Re: EBF 4.5 months old - drying up? Formula?

    You leave smaller bottles. So she should NEVER feed her 5oz at once because your feeds are supposed to mimic breast feeding and she would never get 5oz from you at one time. Much less 7!! So you have your nanny feed her 3 oz bottles. And if she is still fussy give her one more oz. After that if she is fussy, PICK HER UP. A bottle fed baby learns to drink until the bottle is gone. She can't not drink it. Because milk is dripping into her mouth and if she doesn't swallow she chokes. So YOU or your Care provider must regulate for her. Just because she drinks that much doesn't mean she needs it.

    Way too lazy for formula

  6. #6
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    Default Re: EBF 4.5 months old - drying up? Formula?

    The link you sent states that one should not feed on a schedule but only on demand. I had been feeding her every three hours if she was crying for it or not.
    You can't overfeed a breastfed baby from the breast, so if you happen to have a baby who is content to nurse less often than every 3 hours during the day, there is no harm in offering to nurse more often than that! For most babies, feeding on demand results in the baby eating much more frequently than every 3 hours. Nursing more during the daytime hours might help cut back on nighttime waking- the more calories baby gets during the day, the less she may require at night.

    But how do I work around non-scheduled feeding and going home for a feed during lunch?
    Have the nanny try to hold baby off from feeding for at least an hour before you come home. She can rock her, swing her, take her outside, offer a pacifier- as long as baby is somewhat hungry during your lunchtime visit, she should be willing to nurse.

    My LO actually used to sleep in our bed which worked fine, but gave us not much privacy and again everyone around me advised that I at least get her into her own cot in our room also to forecome her from rolling over onto her stomach on a mattress that is not suited for babies. A friend of ine told me a freak story of a 4months old rolling over and suffocating.
    Sharing a bed with a baby is safe as long as it is done safely. That means:
    - Bed should be free from large gaps between bed and headboard or bed and wall into which baby can fall and become entrapped.
    - Bed should be fairly firm. No waterbeds!
    - Bed should be free of mounds of soft bedding, including pillow-top mattress covers.
    - Baby should not be overdressed.
    - All adults who share the bed should be non-drinking, non-smoking, and non-drug using.
    - Co-sleeping should never occur on upholstered chairs/couches, since those surfaces tend to have gaps which are just right for baby to roll into.

    When it comes to "privacy" in the adult bed, I encourage you to think about ways to have intimate time with your partner that isn't in the bed. When I was co-sleeping with my younger daughter, my husband and I tended to go to the guest bed for fun, non-sleep related activities!
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

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