Want to make a big mistake right.

[@llli*forecastofrain]

Back story: My daughter is almost seven weeks old. About four days ago I feared that I was starving her and began supplementing her with formula. I did have low supply because of stress/exhaustion (I have to really concentrate to letdown), not putting her to the breast enough and reoccurring blocked milk pores in my right breast. I want to take her off formula as soon as possible. I have been taking three fenugreek pills three times a day for more than a week and a half, and have been pumping after all the milk is gone and am getting milk that I can feel through the skin on my breast now. I have been struggling with pumping, feeding her from the breast and, because she drains them, having to give her formula.

Question (Please be gentle, I'm the first in my family to bf and the first in my husband's immediate family to bf): The rut I've been in is that I wake up full after she's slept maybe five hours (she cluster fed to formula and was nursed to sleep at night), feed her, she sleeps, I wake her up after about two hours and feed her. She almost sleeps, but I guess I run out(?) because she fusses at both breasts and wakes herself up. So I give her formula, and try to stop giving her formula when she is obviously trying to comfort nurse herself to sleep. I might not have enough(?), or have a problem with letdown, or she's not sucking hard enough, because she fusses and so the bottle, then the breast, etc. until I finally get her to get on the breast. This just happened after I sterilized a needle a popped a blister on my nipple. She slept after nursing for less than a minute. So in a little bit she'll want to wake up and eat. My in-laws say let her sleep, which I have been doing, but by the time she wakes (or gets to 3 hours), she's so hungry that I have to give her formula because I don't have enough(?) and she fusses. It's a never ending cycle. My fil doesn't believe that cluster feeding exists and thinks I feed her too much and that her hunger signs are "playing." I don't know what to do, because my husband is having a hard time with the same things, I think because his father says it's not true. I know she needs to sleep, but she tries to find the breast at night and falls asleep when her mouth touches the nipple. I should wake her up and feed her, right? Not just let her sleep? I've been having such a hard time because I feel like I have to suppress my instincts and I hate it. I'm not looking for in-law hate conversation, I just need a strategy to feed her and I'll respectfully fight for it. Even if the best suggestion is feeding her every hour, I don't care. I want her off of this formula.

[@llli*mommal]

Welcome to the forum! It's definitely possible to get your baby off of formula, especially since it's been just 4 days since you started the supplements. How much are you using (number of oz per day), how much do you give to baby as a supplement (number of oz in the bottles), and how many times a day do you supplement?

[@llli*esther2013]

So she's only been on formula for four days? How much formula does she get daily? How has her weight gain been? Do you give her the milk you pump?

[@llli*bfwmomof3]

Hi mama, welcome to the forum!

First, a couple questions, so we can better understand your situation: For the first seven weeks, was baby exclusively breastfed? If so, how was her weight gain during that time? If there were no supplements and weight gain was on track, then your supply is fine. Also, how does breastfeeding feel? Any problems with latch? Is latch comfortable? How much are you currently supplementing - how much at one time, and how much total in 24 hours?

Second, a little general information: there are two indicators of supply, diapers and weight gain. If baby is having an appropriate number of wet and poopy diapers, and is gaining weight appropriately, then supply is fine. Things that are NOT good indicators of supply: baby's fussiness (or lack thereof), baby's sleep habits, baby's behavior at the breast, how your breasts feel (full, empty etc), and pump output.

Third, how a breastfed baby feeds, especially a 7 week old: around the clock! In spurts for hours at a time (cluster feeding - yes, very normal, often in the evening hours), every hour or two, maybe with a longer sleep of 3-4 hours once in 24 hours. Normal is 10-12 times in 24 hours, or even more. If baby cues (like when she's looking for the breast at night), nurse! If it's been a while, offer! It sounds like one problem you are having is baby is getting TOO hungry and then gets desperate and fussy. You can prevent this by trying to nurse her before she gets to that stage. You cannot overfeed a breastfed baby - one of the many beauties of breastfeeding. The fact that you are full in the morning and getting milk blisters suggests that you are not emptying the breast enough.

This article explains how to wean off of formula: http://kellymom.com/bf/got-milk/basi...rease-formula/ I think one thing that's really important in your case is, when she is fussy, NURSE, rather than giving formula. Because if you continue with the formula, then your supply will go down.

ETA: A couple other posts popped up since I started writing this, sorry that some of it is redundant!

[@llli*lllmeg]

I am editing becaue I think my post does not sound gentle. OK, just so you know, I am upset at the pressure you have been put under NOT at you for supplementing. Supplementing is not the problem, really. Sometimes formula is needed and sometimes it can give peace of mind, Ok, fine, But it also (over time, not in four days) may causes milk production issues. But what I am upset about is the undermining of your confidence as a mom and in your ability to nourish your child that has been going on.

My fil doesn't believe that cluster feeding exists and thinks I feed her too much and that her hunger signs are "playing." I don't know what to do, because my husband is having a hard time with the same things, I think because his father says it's not true.

I'm sorry, is your father in law a breastfeeding expert? A baby care expert? A doctor, what? I am very confused why his "beliefs" about infant feeding carry so much weight.

Cluster feeding most certainly DOES exist. A newborn baby wanting to nurse frequently is healthy and normal, not NOT necessarily a sign baby is not getting enough or mom has low supply.

You are the mother and your baby’s well being is YOUR responsibility. It sounds as if you know what you are doing but are being undermined by your in-laws. I am sure they are trying to help, but this interference is NOT helpful.

Your baby does need to sleep, of course. Infants sleep around the clock in short, frequent spurts. That is normal. But it is far more important that baby get enough to eat. By nursing frequently. At least 10 times a day usually at UNEVEN intervals. So if you think you should wake baby to nurse baby again, by all means, do so.

I had overproduction in the early weeks wiht my baby daugter, and I set my alarm every two hours so my baby would not sleep so long I got engorged. She got plenty of sleep overall, and I avoided getting engorged.

As pps have said, formula supplements are only POSSIBLY needed if baby is not gaining well. They are a serious medical intervention with consequences, so should only be done if necessary.

Assuming baby is gaining well, baby fussing and all that is just NORMAL. You do not "run out" of milk over the course of the day. Give this to your in-laws to read: http://www.llli.org/docs/00000000000...sbreastfed.pdf

I also suggest the book The Womanly Art of Breastfeeding (8th edition) It will help give you and your husband peace of mind that your baby is healthy and normal.

[@llli*MaeganAlberta]

Let me assure you that a lot of what your baby is doing is normal. Mine have acted and continue to act in similar ways and are very successful nursers. Cluster feeding is very common and my babies continue to cluster feed in the evenings though they are 4 months old. They simply have a preference for drinking at night, especially after missing me all day while I'm at work. And remember, even if cluster feeding is "playing", then there's nothing wrong with that, either. It simply would mean that your baby is playing with you, which is something you want. I love it when my babies pull off, smile at me, suck a bit more, then smile again, etc. They're obviously not super hungry when they do that, but they're having fun, and they feel comforted and close. So there's no harm.

I know she needs to sleep, but she tries to find the breast at night and falls asleep when her mouth touches the nipple. I should wake her up and feed her, right? Not just let her sleep? I've been having such a hard time because I feel like I have to suppress my instincts and I hate it. I'm not looking for in-law hate conversation, I just need a strategy to feed her and I'll respectfully fight for it. Even if the best suggestion is feeding her every hour, I don't care. I want her off of this formula.

When she does that, she's not necessarily hungry at that time. Sometimes a baby is just looking for mom. Putting her mouth on you and falling asleep just means she needs to be close to you. And most babies love nursing to sleep. It actually lowers a baby's heart rate and blood pressure to nurse, making them very relaxed for sleep. It's a well-designed evolutionary tool. And, yes, feeding every hour might be the right solution. Feeding her as often as she asks to be fed is the best way to ween her off formula. Often mine are hungry an hour after eating and when they were younger they wanted to nurse sometimes every 30 minutes. Or every 10 minutes. If you are able to feed her that often, then it might be the answer to getting her exclusively breastfed. Eventually she won't need to eat quite as often or for as long.

[@llli*MaeganAlberta]

Oh, and consider trying dream feeding if you feel your baby isn't eating often enough, but you are wanting her to get her sleep. You can lie down with her in bed and allow her to eat while she's sleeping. If one of my babies is sick or asleep when I get home from work, I sometimes lie next to her to encourage her to eat and she'll stay asleep the whole time, plus continue sleeping afterward.

[@llli*forecastofrain]

How much are you using (number of oz per day), how much do you give to baby as a supplement (number of oz in the bottles), and how many times a day do you supplement?

I would say maybe 3-7 ounces. We put 2 oz at a time and she eats various amounts. And probably max 4-5 times a day.

How has her weight gain been? Do you give her the milk you pump?

She was gaining 4oz a week. What made me feel like I was starving her was because I looked online at her WHO curve and her head circumference is at the 1 percentile (only gained about 1 cm in 5 weeks, but her father and gmother have small heads too). Her height is around 80 (gained 2.5" in 5 weeks), and I don't remember her weight... but she gained 1lb7oz in about 4 weeks from her lowest (lost more than 10% five days after birth). Yes, I give her the milk I pump before I give her the formula. Today I started the feeding tube/syringe from the hospital as an SNS system because it's all I have.

[QUOTE]For the first seven weeks, was baby exclusively breastfed? If so, how was her weight gain during that time? If there were no supplements and weight gain was on track, then your supply is fine. Also, how does breastfeeding feel? Any problems with latch? Is latch comfortable?[QUOTE]
No. We supplemented at the hospital because of circumstances outside of my control (they said I had no milk and I gave birth at night so there was no LC). Then supplemented again for a few days two weeks later. BF is fine, I fixed how I feed her. She has an upper lip tie like I have, which caused me to have a space between my front teeth. I told her pediatrician about it and he said that the top lip doesn't affect latch (I beg to differ because it feels like she's biting me), and that it's the lower lip and the tongue he worries about. He checked her tongue, but because her tongue was able to leave her mouth he said it was fine.

You do not "run out" of milk over the course of the day.

I understand, and thank you for being on my side. A question I had was, why does she get SO fussy at night? She will scream and cry murder at the breast when they seem to be drained. I can't convince my husband that it's normal, and it does seem a bit abnormal to me, too, because she lunges at the bottle with full force...

[@llli*mommal]

Thanks for answering our questions! Since you're supplementing with a relatively small amount of formula, you might be able to simply drop all supplements and go back to nursing on demand. If you choose that route, just keep a careful eye on diaper output- as long as baby continues to have enough wet diapers, you know she's getting enough to eat. (After 6 weeks, poop output becomes a less reliable indicator of intake, since some breastfed babies will poop just 1x per week.)

If you'd like to drop the supplements a little more slowly, you could simply put less in the bottles. Instead of offering 2 oz, put 1 oz in the bottle. And after a few days of that, go to 1/2 an oz. I would be sure to always offer the breast at the conclusion of a feeding, since that will get the baby to associate the feeling of being full and comfortable with being at the breast, rather than with the bottle.

Nighttime fussiness is 100% normal for babies this age- it's just a developmental phase that a lot of them go through. This is a good article about it: http://kellymom.com/parenting/parent...fussy-evening/. And here are some things you can do for it:
- Nurse. Nurse, nurse, nurse, nurse, nurse.
- Calm house- lights,MTV, and stereo turned down or off
- Motion- rock baby in a rocker, put her in a swing, take her for a stroller ride, etc.
- Warm bath
- Closeness- snuggle baby close in a sling
- White noise- radio static, dryer sounds, or even the sound of your breath/heartbeat
- Trip outside into the fresh air
All the things on the list above are about changing the baby's sensory input.

Coping with fussy evenings (a.k.a the witching hour(s) or evenings-only colic) can be really difficult and upsetting. Just be patient- it will pass!

Have you been in to see the LC? And can you post a complete weight history for the baby? (Birth weight, lowest weight, weight at each checkup.)

[@llli*lllmeg]

4 ounces per week is pretty slow gain, although for some babies it would be normal gain. However it possibly an indication of some issue. But it certainly does not indicate baby is starving! A starving baby would be LOSING weight.

but she gained 1lb7oz in about 4 weeks from her lowest

But that would indicate an average of 5 and 3/4th ounces of gain per week-closer to average gain. Was this when baby was ebf or was being supplemented?

Today I started the feeding tube/syringe from the hospital as an SNS system because it's all I have.

Do you mean you are using this like a finger feeder to supplement baby? Or are you using it as an SNS to supplement baby? Has someone showed you how to do this? I'll post some info below but these can be tricky devices.

Are you pumping every time your baby gets supplement milk or formula? Or close to every time? Do you have a good pump?

Here is the deal. Milk production relies on baby taking milk out of the breast frequently and efficiently. If this is not happening, your milk production will suffer and baby possibly will not gain well. In the rare circumstances where a baby really does require supplements, it is very important mom pump in order to attempt to replicate what baby would be doing.

So whenever there is slow gain, the question first has to be answered -WHY? Is it just who this baby is? Is baby not nursing often enough? Is baby having trouble extracting the milk (aka milk transfer trouble) ,or is it low production-or some combination? Or is baby ill or have a physical condition causing slow gain? If you do not know what the problem is, you end up with interventions that have nothing to do with the actual problem.

I strongly suggest seeing a good, well recommended, board certified lactation consultant for a private consultation, The consultation should go something like this: http://cwgenna.com/lconsult.html

IF the issue is related to breastfeeding, She can help you figure out what the problem is (assuming there is a problems) and how to best approach it systematically.

I understand, and thank you for being on my side. A question I had was, why does she get SO fussy at night? She will scream and cry murder at the breast when they seem to be drained. I can't convince my husband that it's normal, and it does seem a bit abnormal to me, too, because she lunges at the bottle with full force...

If I could find the answer to why babies fuss, I could be rich. As far as I can tell, babies fuss because they are babies, it can be really intense in the first 2 to 3 months for some babies, and it often is worse at night. Mommal suggest many great comforting ideas. Keep changing the stimuli is what has worked for me thru 2 colicky babies. My guess is that baby “lunges” for the bottle because you have taught baby to drink from a bottle. it’s a change, something different. My baby daughter who went through about 4 weeks of nightly colic would sometimes “lunge” for my husband (if I were holding her) or “lunge” for me (if my husband was holding her) or just “lunge” toward nothing, just in exasperation- during these episodes, looking for a change. A baby who had never seen a bottle might fuss and refuse to nurse for a time in exactly the same way, but would not “lunge” for a bottle except possibly as curiosity about new stimuli.

Lactation aid info: http://cwgenna.com/smartnothard.html

and http://www.breastfeedinginc.ca/conte...agename=doc-LA

and video: http://www.breastfeedinginc.ca/conte...me=vid-lactaid

and video using a finger feeder: http://www.breastfeedinginc.ca/conte...ame=vid-notyet