Anyone supplement with bottles successfully?

I've posted before about my sons' weight gain issues... they are still struggling. At their 5 month weigh-in one was 11 lbs 12oz and 12 lbs, 2 oz. which is pretty low. They seem happy, healthy and reaching all their milestones but I'm getting concerned. My doctor has put me on Domperidone (not sure if it's helping yet, only day 2) and suggested we start solids. We've tried rice cereal the last few days which basically just went all over their bibs so not sure it's going to be a big help in gaining weight for awhile.

My doctor suggested formula as well and thinks it's great I've gotten this far with breast feeding. I am concerned about their weight and want to get it up, just not sure I have any other options. I've seen an LC twice this past month and she thinks they're fine, but I know they are small. My big fear with using bottles is that they'll start to wean. They do get one bottle a day of pumped milk (so my DH can help) with a few extra ounces of formula, but I'm scared about adding more as I know it can be a slippery slope. We tried a lactation tube yesterday (they used it during the early weeks)... one took it and the other refused but it's a ton of work, takes forever and hard to do on my own.

So I guess my question is, are their others out there who supplement with bottles after feeds and are still successfully nursing? Any tips? How often a day do you do it? Part of me still wants to give up on BF altogether but I know even some BM is better than none and we've made it this far. As much as I'd like to continue exclusively breastfeeding, I feel like their health is in jeopardy. Any advice or help is appreciated!!!

 

Or anyone who has started supplementing and it's affected your breast feeding in a negative way or ended it altogether... I want to hear from you too!

 

We started supplement since second month. My girl got back to nicu due to sucking breathing problem at feeding. I was so stressed and couldnt produce enough milk. Plus my twins came too early (32w1d). And the doc told us they were allowed to have 2 neosure bottles/day to help weight gain. I was so disappointed but i thought about my kids first. If its good for them, then Id do it. So we have been doing supplement since then. But I limit it at 1 bottle/day. Sometimes, we do 2 bottles/day because im so busy with work or too tired. It took a lot of stress of my shoulders. And I never thought i could still pumpping until now. I thought I would be done by 6 months. But here we are still going strong. I dont see I/d stop pumping anytime soon. My current goal is 1 year, but no whos I might go for 18 months after the twins are 1.BUt its so easy now. I pump first thing in the morning, lunch, after work, before bed.Thats it. Its tough when I got my P back. But it gets back to normal after P. I know how you feel about supplement. BUt you should consider about your kids' best interest first. I remember read your post about milk supply before. But anyway, its up to you. good luck!!!

 

Is your Dr going on charts for formula babies? This could be different. As long as they are growing and healthy it seems to me that their weight based on a chart is not as important. However, I do agree w the PP if you are concerned then you should do what you feel is right for you and the babies. Remember BM is the best for baby... if it straight from the "tap" or pumped and in a bottle! Good luck! I will soon be entering the world of Bfing twins. I am sure I will be here a lot for advice too!

 

The question is not what their weight is, but are they following their curve. Every baby has their own spot on the growth curve and we can't expect every baby to be 50th percentile or higher. It is the same as looking at adults...some are average size and others will be 110 lbs even if they eat a ton. If your babies are following their curve, then I would not worry at all and I wouldn't supplement. My DS is a small guy and at 6 month was only about 12 lbs. At 17 months he eats more food than kids twice his age but is still only about 22 lbs.

If they are falling off their curve, then it might be worrysome, but have you tried adding in a nursing session? The pp posted about supplementing, but she exclusively pumps so it doesn't apply to your situation. How often do they nurse? Do they STTN or wake to feed?

As far as supplementing with formula, I would NOT recommend giving formula after a nursing session because it is a very slippery slope. Babies learn that they can be lazy at the breast and still get what they need. My advice would be to replace a feed or two and continue to nurse the rest of the time. Your supply is naturally lower as the day goes on, so maybe skip an afternoon or evening feed. Another option if they are STTN is to do a formula dream feed before you go to bed. Mine got both formula and BM because I worked and could never pump enough at work for both. They went well between bottle and breast but when they nursed I did not supplement afterward. We had some rocky days but it got easier and they are still nursing twice a day at 17 months!

 

I agree with most of this . As to the timing of WHEN you should supplement, well that's up to you. But I think a feed in place of a nursing session would be better than supplementing right after. Yes your supply is lower as the day goes on BUT lower milk volume also = higher fat contect. The emptier the breast the fattier the milk. I would either practice a bit more with the lactation tube or figure out which feed would be the most convenient for you to offer formula while you PUMP. Anytime they get a feed anywhere other than you, you want to pump to continue to stimulate your supply.
I can tell you I supplemented my daughter with a bottle (for 1-2 feeds of formula) starting around 5 months. She weaned by 8 months of age. I went onto breastfeed her brother till 14 months and continued to pump for her while I nursed him. PITA!!!
My pedi thought she was small, and looking back at her growth chart (now that shes almost 3) you can see the 6 months that she was supplemented with Formula. She had a spike in weight from the 3% to the 10% and then as soon as the formula stopped at a year she went back down to her 3% growth curve. Shes perfectly happy and healthy, shes just petite.

 

If you're starting to feed solids soon you could always make their rice cereal with formula to "supplement" them.

I think it also depends on if you have healthy eaters. I had supply problems after having really serious mastitis and I supplemented my kids with 1 bottle a day while I recovered. They would have a large 8 oz bottle in the early afternoon when I found that my supply was usually lowest. They were always ready to eat several hours later. By the time they were 9-10 months and eating 3 solid meals a day their intake started to go down and I cut the bottle out. We bf'ed until about 15 months.

And any BM is good.. so if you do choose to supplement for a bottle a day, don't feel guilty about it because you're doing GREAT! You are just making a parenting choice based on what you're seeing with your LO's.

 

i agree with PPs who have suggested completely replacing a nursing sessions with a bottle, rather than offering a bottle after a nursing session, for the reasons mentioned.

as for starting solids to get more into them, i call bunk. Tbsp to Tbsp, breastmilk will trump any babyfood for total calories, every time. so if you want to get more calories in them, i would offer more breastmilk.

i also agree with PPs who have said that being small isn't an issue as long as they're following their own growth curve.

last, but not least, we gave our girls a bottle every night for their dreamfeed & nursed the rest of the time, and we nursed until just before their 2nd birthday, so it's definitely possible to do. i also know there are moms on here who did about 50/50 bottles & nursing & nursed till past a year. do what works for you! :good:

 

My girls had BM and formula from birth. I breastfed one for 10 minutes then they got a bottle while I breast fed the other for 10 minutes then that one got a bottle. While the second was having her bottle I pumped for 20 minutes. Some days/feedings their bottles had formula, some days/feedings they had only BM. I breastfed the girls for 6 months and then continued to pump for another 6-7 months. I would say that it was a 75/25 split with the 75% being the breast milk over the course of the year.

Giving the girls formula didn't cause any problems for us. They did not prefer either one and it didn't have an effect on me - at my peak I was pumping full bottles in a 20 minute session.

 

Thanks for the great advice... good to know most recommend supplementing for one session instead of following nursing with a bottle. Since I tandem feed, maybe one could get a bottle while the other fed on both sides. Since they usually only get one side each, even the nurser would get more as they get two sides instead of one and it would only be an extra bottle every other day since the nurser would get the bottle the next night. Does that make sense? They do get one bottle a day in the morning of pumped milk with some extra formula which they've basically been doing since birth.

They do STTN and we already wake them at 10pm for a dream feed... don't really want to wake them again unless I have to. I've looked at the WHO charts for BF babies and they basically aren't on them either and not really following a curve. They do gain a bit each month but not enough.

 

We supplemented our twins from birth and I was able to bfeed for 15 months. I never offered them a bottle after a feed, but rather the bottle feeds were scheduled at set times. We started off with 5 bottles a day at birth with bfeeding on demand around than. By 5 months they were only on three bottles a day with breastfeeding on demand all day.

I also agree that you could try to start solids as the supplement at this age. I went back to work with my singleton at 7 months. He doesn't like formula and will only ever drink 2 oz at a time from a cup (he won't take a bottle) So he gets solids when I'm at work as his supplement.

 

I am currently having to supplement about 2 feeds a day with formula as my supply just won't cooperate. There are days that I feel that just going straight to formula would be so easy, but I have made that commitment to my babies to give them the best and that is BM, so I pump right after feeding them their bottles (which is never easy thing but it has to be done) in the afternoon and then they get 1 bottle before bed. I have had no problems so far, but they are still young, but definitely not little!! My DS is 9 pounds and my DD is 10.5 and they are only 8 weeks old today!!

 

Do you have some numbers handy? What did they weigh at their last weigh-in, and how long ago was that? Here is a chart from Kellymom with average weight gain for BF babies.

In general, if they are gaining, healthy, alert (ie not sleeping all day), and meeting developmental milestones, they are probably ok. I've met some moms on here whose babies were just slow growers, and everything turned out fine.

Agree with pps that solids are not going to do much for you. If anything, starting solids early (and 5 mo is early, AAP and WHO recommend waiting until at least 6 mo) might hurt instead of helping, since it will just displace high-calorie food (breastmilk or formula) with low-calorie (and possibly more filling) food (ie cereal or whatever else you give them). Also agree about NOT offering a bottle right after nursing.

If you do replace a nursing session with a bottle, you could try mixing it to be 22 or 24 calories (there are "recipes" out there on how much extra formula to use) to get a bit extra into them. Also agree with pps about trying to add another nursing session or two.

Good luck, and please keep us posted on how things are going! :youcandoit:

 

At their 5 month weigh-in one was 11 lbs 12oz and 12 lbs, 2 oz....that was last Friday. Any links to these recipes? I've never heard of that!

 

Oh, sorry, I should have been clearer! What were the stats from the weigh-in before that one - ie how much have they gained between weigh-ins?

 

Gotcha. Here are some weights....they haven't gained a ton in the past 2 months.

DS1
Birth - 6,5
3 months - 10,15
4 months - 11, 5
5 months - 11, 12

DS2
Birth - 6,11
3 months - 11,2
4 months - 11,9
5 months - 12,2