breast milk to formula transition

I posted this question a while ago in the Breastfeeding forum, but didn't receive ant responses, so I'll try here.

I've mostly stopped pumping. I only pump at 6 a.m. and 9 p.m. now for a total of about 14-16 ounces a day. My freezer stash is going fast. I'd guess I have another week to week and a half left and then it will be gone. :cray: Anyway, we will then be moving to formula. I was asking the question just to see if others had trouble transitioning so I could be prepared. I assumed it was a non issue since I received no responses. Well, it is definitely an issue for us now.

We had a test run yesterday and it did not go well. We were traveling and needed to use formula because we had no way to warm bottles and I just didn't want to deal with a cooler. So the girls got 4 bottles each of formula yesterday. They drank it fine. The problem is that they were so gassy and just screamed in their car seats. We stopped about 12 times in a 5 hour car trip (which should have been a 3 hour trip) to try to burp them and make them more comfortable. It was awful. Nothing worked. Additionally, Karina threw up at least half of each bottle. I don't know if it was just a bad reflux day for her or if it was caused by the formula itself. We are using Enfamil EnfaCare Lipil as prescribed by the Pedi. They have always received some formula in their EBM for extra calories, but this is the first time they received straight formula. I did shake the formula when mixing it (I have to do this anyway to mix in the thickener for the reflux) and I put Mylicon in their bottles to help with bubbles. What else can I do? Has anyone else had these issues? I guess I could make the formula ahead of time and let the bubbles settle out, but I was really looking forward to the freedom of not having to haul a cooler and warm bottles any more.

I called the Pedi and he said to go back to breast milk now that we are home and to call again when we run out if we have the same problems with the formula.

This is so frustrating. I thought formula was going to be easier.

 

I don't have any advice, other than I think with time it will get better, and you can try other brands (Nestle, or soy formulas...).

I was never able to produce enough for both twins to get 100% EBM (after the first 6 weeks or so), so they always got some formula... we've switched formula's pretty regularly from the beginning (whatever coupons we had), so I think they got used to the differences (or maybe there's not much difference between formulas). DD had reflux, so we tried different formulas, restricted my diet and nothing helped so we're back to the regular "nothing special" formula (we use enfamil, good start, and similac)

Great job on pumping for so long and producing so much!

 

Beth,

I'm also pumping for my boys, but I only pump 4x's/day and have been since they were 3.5 months when I stopped BFing b/c of their latch problems resulting in nipple trauma and repeated bouts of mastitis - so I get about 32oz/day so they get about 16oz EBM/day and the rest is formula.

We've recently switched from Similac Sensitive to the Soy version due to an increase in fussiness, gas, etc. and we've seen a big improvement using the Soy. My guys don't have reflux, so we haven't had to deal with that - but they are happy spitters and the soy seems to improve that a bit.

I've also noticed that I have to give them 5oz or less per feeding to keep them from having huge spit-up issues. So, even though they are 6.5 months (5.5 adj), they still get 6 bottles/day and they seem much happier with smaller, more frequent feedings. I'm not sure how often your girls are eating, but it might be something to consider.

Way to go on pumping for this long, it is such a time committment and a gift to your girls. I'm sure they will get used to the formula in no time - its just a change for their systems.

I hope that it gets easier!!

 

Have you tried RTF formula? IOur pedi says its better for reflux and digestion. It's more money but we've found woprth it. I pump about 35-40 oz a day then give some Similac Senstive RS (rice starch already added). My boys have horrible reflux too and it seems to help. Also it takes a week to get adjusted to any new formula. Good luck!

 

What bottles are you using? That could make a difference as well. The Dr. Browns have always worked best for us.

 

The only formula that worked for us was Nestle Good Start. You may have to try other formulas to see what their tummies can tolerate. We found Similac and Enfamil to be too harsh.

 

We're using the same bottles we've always used since coming home from the NICU (Playtex Drop Ins), so I don't think that's the issue.

Do those other formulas come in high calorie versions for Preemies?

Also, we've been using this formula because that what the NICU and our Pedi prescribed for them. It's also covered by WIC. I'm pretty sure WIC won't cover RTF formula. They may give us a different brand if we need it, but I'm not familiar enough with the brands to know what to ask for. They need a 22-cal formula until their height and weight percentiles are equal and I'm guessing that is going to be a long time yet since we've been mixing EBM with formula to make it 24-cal and they don't seem to be making progress super fast.

 

We transitioned to formula over a few weeks and had no problems. I hope it is figured out soon :hug99: .

 

I stopped pumping about a month ago and mine have been on straight formula for a few weeks. I transitioned slowly and made bottles half formula half ebm and just slowly made it less and less ebm. They did fine. I guess my advice would be to just introduce it very slowly. Also, some babies dont do well on certain formula and you may have to try different ones to see what works best for them.
It sounds like you are doing everything right, it may just take some adjusting.
Good job pumping for so long!

 

Hi Beth,
I can only help you out with one of your questions. Instead of preparing the formula before hand, just bring an extra bottle. Then after you mix the bottle up, pour it into the second bottle, stopping before all the bubbles get poured in also. That is what I did years ago for my son. That way you don't have to prep it and refrigerate it, but they don't get all the bubbles.

 

hi beth,

sorry to hear about the transition trouble, Liana is now a 100% formula baby, she eats good start natural cultures, no problems at all, but she seems to have a stomach like a horse anyway...

Kaden is used to EBM 100%, at our last pedi appt, he suggested to introduce him slowly into formula, he gave us the enfamil hypoallergenic nutramigen, because of his reflux. so far, I only have given him about 1oz formula each feeding, and I have to trick him. I have to do a couple oz EBM, then switch in the formula bottle, by the time he realizes it's formula, he already finished. I plan on pumping for him for longer, but you never now, we are also going on a one week trip without babies in oct, I started already stocking up freezer with EBM, but you never know.

have you tried to give them your EBM chilled? ours love it, not freezing cold, but cool....especially when it's hot....and that eliminates the warming bottles problem.

I can't help with what formula would be good for your babes, sorry. definetely try to give them the formula slowly, not from 100% EBM to 100% formula, I don't blame Kaden for not liking it, they all really smell terrible

GL
alexa

 

Didn't have time to read all the replies but we made a gradual swith off of breast milk to formula and started with 4oz breast milk 1 oz formula for a few days then then 3oz BM and 2 oz Formula then half and half till they were drinking only formula!

Good luck I hope your next attempt goes more smoothly

 

QUOTE(alexafaeh @ Jul 22 2008, 08:07 PM) [snapback]890314[/snapback]
they all really smell terrible


You aren't kidding. It's awful. It makes me sad to have to give them something that smells so bad.

 

QUOTE(Mellizos @ Jul 22 2008, 12:38 PM) [snapback]889504[/snapback]
The only formula that worked for us was Nestle Good Start. You may have to try other formulas to see what their tummies can tolerate. We found Similac and Enfamil to be too harsh.


This is what we are using too (it is also the only thing that our older DD could take (who had terrible reflux))...when I started the babies on it they had no difficulty in taking this vs. EBM.

 

I would try mixing the EBM with formula, and see if that helps them transition. Or, at least do it with the bottles they're most likely to finish, so you don't waste any amount of EBM.

We did this from the beginning -- my two were on Similac NeoSure (also a high-cal preemie formula) for six months, and then I switched to Nestle Good Start.

I had a really good experience with the Good Start -- people claim less gas, less spit-up, etc. -- and that was true for us. If you want to try it, maybe you can ask the ped if it's okay to mix this one to be 22- or 24-cal, whatever your munchkins need?

K&K always got about 50/50 EBM and formula in each bottle through 9 months, and then I slowly weaned back the EBM to straight formula by 10 months. No issues, although we also never dealt with reflux, so I know that must be a huge factor.

I hope you get it figured out!

 

We ended up putting Ellie on Nutramigen and Zantac and she is finally doing better. We aren't sure if it is silent reflux or just gas, but she was miserable when I transitioned her over to formula. Abby is still on Similac Advance and has no problems at all. It's amazing how different their bellies can be. We tried switching to soy, but Ellie was still miserable. The good thing is that our insurance covers the Nutramigen, so we are only paying for 1 baby now. I gradually weaned them off of breastmilk. Starting with 1oz of formula and every week adding another oz. They had been getting some formula from the beginning at night and that never bothered them. It was when I started giving them more and more that Ellie had tummy issues. I've heard people say they tried 5 different formulas before they found one that worked. It did take a over a week before we saw a change, though. That's the worst part. You have to watch them suffer for a week before you can try something else. Good luck.