Talk to me about "Top Ups"

Please forgive my ramble- I'm not sure which section to really put this is- i am breast feeding and considering using formula to "top up" my four month old DD- i dont want lectures, just advice please..... :)

I breast fed DS for close to 16 months, never ever had any problems other than a bit of thrush.. DS was constantly on my boob, morning noon and night, i never had any problems with supply and i leaked and needed to use breast pads until he was about 6 months old- even longer.

With DD (four months old) it is alot different, it feels different, i feel different- physically. I dont feel "full" at all ever. I feel my let down when it happens, and it only seems to last a short time. I have not needed breast pads since she was about a month old- no leaking what so ever. DD does not spend 24/7 on my boobs- she seems to be a very efficient feeder, but lately i am getting the feeling that she wants more than i have, and even her sucking away (and getting very frustrated) doesnt seem to be increasing any kind of supply.

I have noticed in the last month or so that when she feeds she is getting really frustrated, she pulls off and latches back on time and time again- which i know is a babies way of trying to create a let down, but it just doesn happen- we struggle for up to an hour sometimes and she is crying and gets worked up and eventually after some rocking she will got o sleep- but then wakes again after half an hour or so wanting more- so we try again and this continues.. she uses a dummy and for a while i was thining ok- maybe she doesnt want me she wants the dummy ( i was used to my son using me as a human dummy) and occassionally she will be ok with the dummy, but this last week, she has just been VERY unsettled- which is extreamly unusual for her....

I have been thinking for a while that im just not making enough milk for her- i have tried expressing and trying to feed her as often as possible to see if that helps boost a supply- but nothing seems to be helping. I tried to get some Fenurgreek (i know thats not how you spell it) a herbal tablet to help boost supply- but every health food shop i tried had had it all recalled or they had stopped making it or it was "under review" and might be available again in a few months.... and my poor baby is getting sadder and sadder....

Now i KNOW enough to know that dipping into the "dreaded" FF area will not in any way boost my supply... BUT i also know enough to think that maybe if I am not "doing it for her" so to speak, that i may need to look at this option. so today i bit the bullet... i bought two pre-made formula popper things....

We had been out most of the day and DD had fed at about 11 :30 and again at about 2:30, we got home at 4 ish and i sat down to feed her and she fed and i felt my let down and then mintues later she was fussing about again, screaming and get frustrated pulling on and off and working herself up.. so i thought what they hey i will give it a go and see if she is still hungry or just fussing, so i poured half the popper into a bottle (about 150mils) and within minutes she scoffed almost the whole lot. She gulped it down like it was the first food she had had for weeks.

part of me was releived and part of me is very very sad. I was happy that she was happy and satisfied, but i was sad that she had been hungry for so long and that i hadnt been enough for her.... :(

So after that feed she slept for a good two hours- woke up happy as larry and now again tonight i breastfed her until she started fussing.... used the rest of the popper (100 mils) which she again lapped up and is now sleeping soundly- where as until tonight she would have been awake again by now trying to get more milk...

So after this ramble i guess i am asking for advice from fellow breast feeders who have "topped up" - am i doing the right thing by feeding until she fusses and then going for the bottle?? And i am asking for a little reassurance that i am not completely ending my breast feeding journey by doing this, tell me i am not going to loose what little milk i have!!!!!!!

Thank you In Advance for any support and advice :)

It's tricky to know what to do isn't it. For us the decision to top up was made when Ds was only putting on an average of 60 grams a week and his pead was concerned. He also has reflux so it was hard to know when he was hungry, but I do the same as you, offer a bf on both sides then if I have it ebm or formula. I can't keep up with him, he wants about 240ml some feeds and I have never been to good at producing milk. Unfortunately I have been sick and my supply dropped so now he seems more interested in having a bottle but I am still offering the boob and expressing so we can try to get him back to bfing.

First of all :hug: for you!

I'm sorry I don't really have any advice because I don't have any experience with top-ups but I just wanted to reassure you that what she is doing might be normal. My DD did the same thing around that age. She would fuss all the time, on and off constantly. I felt like I had no idea what she wanted. But I could tell I had a lot of milk so it wasn't that for us. It was just a stage and she eventually got over it and we went back to normal feeding. So JIC you find the top-ups don't help it might just be a phase she's going through no matter how frustrating it is :hug: How are her weight gains?

Your post rang so true with how DD2 used to feed. I feel for you :hug: DD2 was fussy from birth and we topped up from birth so my supply really didn't establish properly. DD2 used to get so frustrated at the breast after 5 mins and after hours of on/off feeding and screaming I would give in and give her a ff. She totally refused the breast at 4 months and was fully ff from that moment on. At the time I was so relieved and even today I feel I did the right thing at the time.

DD3 breastfeed beautifully from birth, but she was a very frequent feeder. She was my only baby that I feed past 12 months. I never ever got that full breast feeling and I never leaked!!! I had to feed her 2 hourly around the clock to keep my supply going. I reached breaking point at around the 4/5 month mark when DD went through a really fussy stage. At this point we tried to give her formula but she rejected it so it was tough cookies for me, I had to persisit. I ended up starting her on solids at 5.5 months and things got easier from there.

If you really want to continue bfing I would call the ABA to get some strategies on how to cope with her fussing. GL hun I have lived this scenario and it is tough

FTA I had to do a similar thing with dd1, but she was always topped up. Dd2 was meant to be topped up but like Bek said with her dd, she refused a bottle.

First thing I notice is the age - it's very, very common for babies to behave this way at this age (3-5 months) and it often has nothing to do with your supply.
Give a baby a bottle, and (assuming they don't reject it outright) they will often gulp it all down liek they're starving, but it doesn't necessarily mean they are.
What else is going on - how many wet nappies? Weight gains?
The fussing could be due to slow letdown or supply, butit could also be because your baby wants to look around while feeding and is very distracted by whatever else may be going on around her. Maybe she's been feedign a lot quicker, or less often during the day and more at night...?

It's up to you how you proceed from here. Why not call the ABA and see what they say? A few bottles of formula are not the end of the world, but it can be a slippery slope and I think it's good to nut out exactly what is necessary and what you're happy with beforehand. Does that make sense?

At around 4 months DS started doing very similar things. He had been a very looooong (and frequent) feeder and suddenly started feeding much quicker and fussing at the breast. I thought he wasn't getting enough and tried to force him to have more - he got very upset with me and ended up refusing outright at times. I tried to give him some bottles of EBM (because I was stressing - never mind the copious wet nappies ) but he wouldn't take them anyway.

Anyway, I don't have experience with topping up, just thought I'd add a different perspective.
Hope you can figure things out :hug:

Thanks girls :)

Her weight gain seems to be really good- although i havent had her weighed since she was about 11 weeks, and the problems hadnt really started then yet...

I guess its just adjusting too to a different baby who feeds differently... after having DD i am convinced that DS actually had reflux as he cried ALOT and fed constantly and spewed ALOT too- where as while DD doesnt feed as much- she never spews and her weight gain has been better. She has gorgeous chubby cheeks!! She is a really happy baby too- and she doesnt use the breast for comfort (she never seems to need comfort lol she is always happy until she feeds!!)- only for feeding (again TOTALLY DIFFERENT to DS) so its really unusual for her to be unsettled. She is only just four months old and she has been showing interest in food- I started shane on farex a bit after five months- and i dont think it will be long til i give it a go with DD, maybe i should be heading down that road instead of top up's..

i just dont know- its so hard, but i must say after this afternoon and tonight - i really honestly do think my poor girl has been hungry.. she is sound asleep- where as she would normally have been up and down three or four times in this amount of time. She did half wake up once, (thanks to DS jumping and yelling right next to her bassinette) and i put her right on the boob- she sucked for about a minute and went back to sleep without really waking up.

So i think i will limit it to nights.. or when she is really obviously frustrated and unhappy while feeding- and then fingers crossed starting tomorrow i might have a bit of a build up of milk- which she can drink in the morning - and there will be enough to satify her and that might even boost things a bit... maybe... ???????? its all sooo hard!!!! I wont have the car tomorrow- and i only have one popper left- so at least i havent got an abundance of it sitting there to be tempted to use- i will persevere!!!

Thanks again for all the support- i have my ABA playgroup meeting next monday- i will ask our leader for some advice if things havent settled by then!

SB - couple of things hun. First of all hugs :hug:

DS is also being really fussy ATM!!!! I really think it's an age thing. He sucks, pulls off, laughs or grizzles at me, sucks, pulls off, I drip everywhere (lol), then he may or may not continue to feed!

I can't contemplate top ups tho as he won't take a bottle.

Also, like you I never really feel full, nor do I leak much (except when he pulls off after let down lol), but I know i've still got milk.

Can I just add that I think they can gulp at bottles because they let the liquid flow without any real effort from baby, whereas the breast makes them work for it!!

Also... Isn't there sometimes an element in formula that can make them feel fuller or something? A thickener? Whereas BM is more easily disgested... Hence the more frequent wake ups? Not sure on that one.

Anyway, there are other things you can do to help boost supply, give the ABA a call and they will give you some info.

It's not the end of your breast feeding journey hun :hug:

hi marcellus.. you snuck a post in while i was posting :)

You have sort of summed up my fears.. i have heard two different sides to the "top up" some people say that one bottle ruined the whole thing and others who swear by it and have no problems.. i dont want to stop breast feeding... i just want DD to be happy :)

I do vaugley remember DS going through a similar thing at this age- but he would never take a bottle be it EBM or formula (which DH tried with him once) i knew DD was ok with the bottle as about a month ago while trying to express (to try and boost supply) i got a whole 30 mls and she drank it happily.

I forget how many wet nappies they should have, but i dont have to change her during the night.. i change her in the morning when we get up (9am), and then she will go down for a sleep from about 10-12ish and she usually doesnt need changing til she poo's (not too long after she wakes up- some times she wakes up TO poo and then goes back to sleep)she is awake usually for a few hours then has an afternoon sleep and then i will change her again once or twice in the afternoon - depending if she has done another poo- but honestly if she hasnt poo's i will only change her once and often there isnt alot of wee in the nappy- and then she gets ready for bed - fresh nappy and pj's at about 7-7:30 then we start the feeding/sleeping cycle and she is in that nappy til morning, and its never full....

It will be interesting to see how it is in the morning....

I think the fussing may have to do with letdown at the least, she isnt distracted, it happens at night when tis just the two of us and its all quiet- and it happens during the day when DS is running around- and she isnt interested in him, i do sometimes stop and hold her up and that just makes her scream all the more- and she wants back to the nipple to keep trying....

Thank you though- i do know what your saying- and it is my fear that heading down this road will possibly lead where i dont neccessarliy want to go, so i will give the ABA a call tomorrow and not wait til monday.. thank you xo

Get some advice and take it from there. It must be confusing when they're so different. Your DS sounds so much like mine - I'm not sure what I'd do with a baby like your DD - probably get worried.
Just one thing - you don't need to fill up between feeds. Your breasts make milk as demanded and skipping feeds will reduce your supply (even if you initially feel fuller, after a few days your breasts readjust and you won't any more, does that make sense?).
Sounds like she's doing very well :) - Hope you can figure out a way that works for you.

Thanks OP.. that used to happen with Shane constantly.. i would spray all over the room lol, but now i think about it, i havent sprayed at all with DD... but i know i had an "over" supply with him as DS fed sooooo much lol

i wish these gorgeous creatures came with instruction manuals.........

SB - it is too late for me to do a proper post ;) but tell me that she was 17 weeks and I'll show you the wonder week (and the 2-3 weeks stormy period on either side) DS2 did exactly the same thing and has been snuffing and snorting and fussing at the breast with feeds and it is driving me nuts!!! But things have settled.

My suggestion - if you want to breastfeed, avoid the FF top ups. The less they feed, the less you produce and you KNOW you did a fantastic job with DS so your boobies know what they are doing :)

Yep Michelle- she is 18 weeks now and she started really fussing about 2-3 weeks ago (making her 15-16 weeks)- so i would love it if you could forward on the info about the wonder week that would be great!!

I will say though- she slept alot better last night- she still woke up at about 3-(but not 10, 11, 12 and then 3) and came into bed and bfeed- but didnt fuss, went back to sleep til about 6:30am, more breast and went back to sleep till DS woke us up at 8:30. She had a full wet nappy this morning, her hour of awake time, more boobie (no fussing) and back to sleep by 10am... now we wait for her to wake up and poo!!! lol

I am going to up my water intake too as i notice that helps too, and i will try the health food shops again for the fenurgreek.

Thanks again everyone for the support!!!

Hopefully things settle down for you Starbright.
I have to say again - it sounds to me like your DD is doing just fine :hug:

hi SB :)

i'm prob a bit late to join in here but one of the mum's in my MG pretty much gave her DS one bottle (at bedtime) from about 3 months & BF the rest of the time. her DS was still a regular BFer & she fed successfully until her DS was 13 months & she weaned him. i'm not saying it will end so happily for everyone, but just wanted to let you know that it can work.

the other thing you could try, if you're worried about supply, is lactation cookies. there's a recipe around somewhere & they're very tasty! (and they have choc chips - yum!).

i do recall DS going through some very fussy patches & pulling on & off. he nearly drove me crazy for a while! i've never felt full since the first couple of weeks either but my DS is still happily feeding at almost 16.5 months so i figure even if there is no sign of heaps of supply, it's still there!