Long term comp feeding

Not sure if this is the right forum, but I'm hoping to hear from mums who have comp fed their bubs. I've struggled with breastfeeding for nearly nine weeks for various reasons, and have seen a private LC, breastfeeding counsellor, midwife and GP to fix things but it's causing me so much stress, not least because I have a very unsettled bub who won't sleep during the day no matter what I do. On paper he gets enough milk - wet nappies and weight gain, though he is a small baby. I don't know if he's normal or just constantly hungry - he will often doze off only to wake up crying and hungry. And it's been like this for many weeks. He's on medicine for reflux, so we're taking care of that but I'm beginning to wonder if it's been a hunger issue as well?

Anyway, what I'm really asking is has anyone supplemented with formula long term? Do you top up feeds or give full bottles at some feeds and not others? I hate to give up BF altogether especially, that bonding time, but part of me wants to trial combining the two to see if that really is the issue. But then, will a week or so of that impact my supply too much? I would express every three hours to give him EBM in a bottle, and still do night feeds because he seems to get plenty of milk then... I know babies fuss and cry, but I feel I need to do this to rule out hunger as a cause of his unhappiness. I'm so stressed and exhausted that I don't feel I'm being a very good mum. But giving up on breastfeeding makes me feel just as miserable.

What a rough time! :hug:
How long has he been on the reflux meds? Sometimes it takes a while for them to work. Do you have allergies in teh family at all? Sometimes sensitivities to components in your milk from your diet can cause this sort of unsettledness too (although, somtimes it's also just the way the baby is).
It really does sound like you're doing a good job feeding your baby, but he's perhaps a bit more challenging for you. Some babies do require a whole lot more effort than others - you're doing extra work so, in fact, that makes you super mummy! Do you have lots of help at home? Do you get any time to yourself?

If you replace feeds with formula, your supply will be affected. However, some women do comp feed long term, so it's possible if that's what you want. In saying that, sometiems the bottles and supply issues can be a challenge and, on average, you're more likely to wean early, so it's good to keep possible issues in mind. If it's a small amount, over a short term, you can easily lift your supply again, however, so trialling something like this shouldn't end breastfeeding for you.

I don't comp feed per se and I certainly don't do it for weight or lack of supply issues. More sanity issues, but I do give dd 1 and sometimes 2 bottles a day. I have since she was about 2 months old. I haven't noticed any real affect on my supply at all. I make enough milk to suit all her other feeds so it works for us. But it won't work for everyone I know. The only way I can get through breastfeeding is to offer a bottle or 2 a day. Otherwise I wouldn't be doing it at all. We're 7 months in and going strong with boobie and formula and this way she remains my longest breastfeeding bubba. DD goes between both easily without any drama and see's both boob and bottle as food. It works for us. That being said it doesn't work for everyone. As MadB said you can always trial it and you can always rebuild up your supply if it doesn't go to plan.

There's some other threads on here - I'm not sure which topic they're under.

I did it for nearly 3 months. I had a lot of physical and mental stress so my supply never really fully came in. In the end comp feeding became too stressful as it was taking up too much time on the breastfeeding side of things for me.

your bub sounds just like my dd was, i seen a lc who told me it probably was a supply issue, but it turned out to be reflux. we got zantac and the doses were adjusted as she gained weight to make sure she got enough to stop the burn. for a while, after she was diagnosed she also had mylanta prescribed by the peadiatrician 4 times a day (1ml just before a feed) as the zantac can take a while to kick in and it can take a while for bub to stop associating feeding with pain, the mylanta is just something to give them a quick hit of relief to be able to feed better and to learn feeding doesnt have to mean pain.
because of the advice i initially received that it was a supply issue i comp fed every feed till around 11 weeks, it really was unnecessary though, she gained ridiculous amounts of weight doing this. i did pump after every feed to help my supply and to use as comp. around 11 weeks i realised i couldnt keep it up and instead just bf her without comping at every feed. i would pump after her morning feed and at night when she went down and she would have these bottles of ebm at the dinner time feed and as a dream feed late at night. at 7 months i gave up pumping and instantly my supply took a nose dive, so i used formula for her dinner time bottle and bf her every other feed, she is 23months now and is still bf except for the dinner time feed which is a bottle. So yes it's definately do-able long term. i think it will depend on whether your LO is happy to go between breast and bottle for an extended time, and whether your supply keeps up.
My advice would be to pick a feed or 2 to comp feed entirely and bf every other feed with no comps as the more you comp the more it will affect your supply, so comping every feed will really affect your supply unless you pump. offer both breasts at each feed and make sure the first is empty before swapping. if you have the time and the inclination, i would also recommend a pump to express even just a little if you can when your LO has the bottle feeds, or at night when they are in bed asleep.
once the reflux was sorted out she settled a lot, she wasnt hungry, she was in pain and she thought if she continued to feed it would stop the pain, but it just made it worse.
i hope my rambling has made some sense and is of some help to you.
goodluck. You are doing a great job.

Thank you everyone for your thoughts so far.

MadB - he has only been on his meds for five days. I forgot to give him his dose tonight - I feel awful. I will have to give it to him when he wakes for his next feed. Already I feel like he's crying less, but he's still unsettled and doesn't want to lay down. I very much hope there's more improvement to come. There are no allergies in my family or DH's, but I have thought of that. I wanted to see the results of the reflux meds (and possibly comping) before eliminating food groups from my diet. If it were an allergy, fussiness would be his only symptom. Is that usual? I am beginning to suspect he may be a "high maintenance" baby - which I can handle as long as I'm sure I'm not starving him! I'm very lucky in that DH is home a lot because he works shifts, and he does a lot around the house. He leaves all the baby stuff to me, which sounds like a good trade off, but sometimes I feel like saying, "Just take the screaming baby and let me do the dishes!" I know that comping can be the beginning of the end for breastfeeding, but because it's been so challenging, stressful and for a big part, not very enjoyable, I kind of see it as prolonging my breastfeeding journey - a middle ground instead of giving it up altogether.

Mumof2 - your post really struck a chord with me. I really respect your approach to breastfeeding, and perhaps that's how I feel too - a bottle a day may just help me enjoy breastfeeding more, as well as take some of that pressure off about whether or not he's hungry. Breastfeeding is important to me, but it's not as I imagined it would be.

Jen82 - I also really like your approach - I feel that it would suit us if I could maintain it. As for going between breast and bottle, DS has been on the breast, on nipple shields and on bottles since day one, and so far he goes from one to the other with no problem. I've actually been offering both breasts twice at every feed! I don't know if it's necessary but I've been paranoid about him getting enough milk. He empties both at every feed, except overnight when my supply picks up and he may only take some of the second. It's the day feeds that worry me - is that silly? That makes sense about your DD wanting to feed to ease the pain and not hunger - perhaps that's what DS is doing? How long until the meds worked for your DD?

It's the weight gains and the nappies that are the real indicator as to whether he is a 'high maintenance' bub or whether he actually is hungry. Given his weight gains and napppies are consistent with his size, then I'm thinking he's just a normal baby with reflux.

If I were in your shoes, I'd give the reflux meds at least a week to kick in and check that the dosage is correct. Introducing formula when reflux is in play can make things worse and you might be creating yourself another set of issues.

Is this your first baby? My first was a very unsettled baby. He would cry and cry and cry. Like you I searched for everything that could be wrong and only time made me realise that nothing was wrong, but being a baby was pretty overwhelming for him. I've just had my second and he is a completely different kettle of fish. He doesn't cry much at all - after my first experience I'm finding this very unnerving!

Hang in there - it gets easier and you get better at being a mummy.

lee, I totally understand. We must all do what we must. That said, formula may make things easier... or it may not. If you're baby is high maintenance, then he will be so regardless of how you feed him (and fiona's advice re reflux is good). When babies are little, it's all about feeding. And when things are tough and we're breastfeeding, that's often the first 'problem' we identify and try to change. But it isn't always the answer.
Try the meds first. And maybe try a different one too if that doesn't seem to do the trick.

It's great your DH is helping out at home. Try to get some baby-free time too though! Even if you do have to do the dishes (though getting out somewhere for 30 minutes by yourself would probably be even nicer)

For what it's worth, my first was also like this. He had silent reflux but luckily he grew out of it by around 12 weeks.
I know you probably don't feel it, but you are doing a good job in very trying circumstances.

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I'm thinking he's just a normal baby with reflux.

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FabFiona - thank you. All I've heard is "he's hungry, give him a bottle", "top him up", "it's time to sleep train him" and "he's manipulating you". It makes my head spin. How happier I feel thinking he's "normal". Thanks for the tip about the formula - I hadn't thought of that. And yes, he is my first baby - can't you tell? :)

Lee - yes I can tell. I posted very similar things to you with my first. It's hard when there is so much stuff being put into your head by mostly well meaning family, friends, strangers in supermarket aisles (yes, that happened to me), maternal nurses, doctors, the interweb, everything.

He's manipulating you? That's a good one! Pfffft to that.

I found a sling very useful for my first. He tended to cry less when I held him so the sling was great as it meant he could be held and I could do stuff - like hang on on bellybelly posting about how I was going bonkers. My little one would only sleep in the sling during the day for the first 3 months. I love my Close Baby Carrier for the first few months but an Ergo with an infant insert is also a good choice (and a longer term investment).

For what it's worth, I comp fed for the first 7 weeks due to low supply. At 7 weeks I stopped breastfeeding and moved to full formula feeding. It didn't make him more settled in any way. In hindsight I realised that the comp feeding was in part causing my supply problems and I didn't have the information I needed at the time to build my supply up to exclusively breast feed. If you don't have any supply issues (and the weight gain and nappies tells you all is good in that department) I'd stick with the breastfeeding.

If you want to 'give a bottle' for a break, perhaps look at expressing breast milk. I'm not an expert on that so if you are interested I'd pop over to that part of the forum and ask the lovely ladies there.

Feel free to come back with any thing else you need.

Fiona

oh yeah, I was just coming back to suggest a sling or wrap-style carrier, if you don't have one. Also have you tried a dummy at all? Sometimes comfort sucking without milk is helpful with reflux. They come back to the breast so much for comfort they can actually end up getting too much milk.

i was given all the same 'advice' and told the same things, it made me wonder what i had done wrong to get such a 'bad' baby. but she was normal, just like yours is.
the meds took a week to 10 days to start to work, and she also had the mylanta till about 4.5months. so it could be so far that your ds hasnt received any relief. id give it another week or so and if you dont think it's helping take him back to discuss it as there are a fdew different types they can have and its really trial and error as to which works for your baby.
things that helped me were making sure she stayed upright for at least 20 mins after each feed, propping one end of the cot up, letting her sleep in the bouncer, swing or sling during the day as they are in a more upright position in these than in the cot or bassinette and lots of burping throughout feeds, it helped to get wind and any fluid up, so i knew she had had a decent feed without feeling like she'd brought it all back up afterwards as she brought little bits up and then continued to feed and she wasnt all full of wind and not taking as much milk as she needed due to wind.

you should be proud of the effort and commitment you have to this, i know its not easy, your doing great.
if bubs gets too much during the day, get hubby to take him for a walk or you go outside even just 15mins without the screaming can ease your tension and freshen you up to think strait

Hi,

It can be very tough with a high needs baby. it takes all the resources you and your partner have, and unfortunately there is very little understanding for parents in this situation.
I would just want to make sure you are looking for and addressing the underlying causes. Now, that may not be easy - sometimes it's like tipping a 5000 piece jigswa puzzle on the floor and trying to put it together without ever having seen the picture. Often formula can make things worse in the longterm rather than better. And, unfortunately it can be a lot easier to down-regulate your milk supply than to increase it. If your baby is getting plenty of milk, as demonstrated by good weightgain I would be doubting that he is hungry (and don't forget, babies can be hungry for more than food - for his mother, for touch, for being held)
MadB has come up with some good ideas. I would be wondering, is there any asthma or eczema in either side of the family? Anyone have it as a child and grew out of it? Mothers are under such huge pressure these days to give their baby formula. But what happens when that doesn't work? Your milk supply may be damaged and those who urged you to formula feed will be *very quiet*.

I comp fed for different reasons, we tried really hard to breastfeed, making breastfeeding a priority and followed all the advice, but in the end - possibly unless I took high amounts of Motilium, my supply just wasn't enough for him.

I have to add that he was an emergency caesarean under general anaesthetic, I was on antibiotics for ages due to a bladder infection, and I had to deal with separating from my partner as well.

It has been really disheartening that I couldn't breastfeed exclusively but we did well to do it for as long as we could.

It really does depend on your circumstances.