Jump to content

Comp feeding with formula, how much to give?


  • Please log in to reply
11 replies to this topic

#1 indigo~

Posted 21 December 2012 - 04:07 PM

Hi, I have had ongoing supply issues despite all efforts with expressing, motilium, fenugreek, nursing tea etc. I have also seen 3 different lactation consultants. With bubs now almost 15w old, the last LC said that my supply is probably as good as it's going to get.

I have given bub EBM (when available) and formula top ups in the past but phased them out and went a fortnight of no formula. Unfortunately bub did not put on sufficient weight at her fortnightly weigh. The MCHN recommended that I give her some formula top ups for the extra calories.

Just wondering how people know how much to give? She weighs 4.6kg (premmie so 8.5w corrected age). I usually only give one or two top ups a day; one in the afternoon when my supply drops and one in the evening if needed.

I base my decision on when it's needed when bub is sucking madly at my boob for ages but gets very frustrated and pulls off frequently and scrambles with her hands trying to drag the boob into her mouth, then cries and angles her head in for more. It appears to me that she's hungry and cranky she's not getting enough/any.

I usually make up just 60ml, mainly because it's a top up only after a BF and it's a multiple of 30ml (1 scoop to 30ml water) and she'll almost always take the lot.

My question is that i'm never sure if I'm either not giving her enough or giving her too much, making her uncomfortably full. She cries after the bottle whether I take it away early or let her finish the lot. I just can't seem to read her signs. And I would rather not over-stuff her as she has quite bad reflux (on maximum dose of losec).

Any suggestions? Thanks!

#2 neev

Posted 21 December 2012 - 04:30 PM

I think it's 150mls per kilogram of body weight, per day for full bottle feeding but you should check this with MCHN.

I did combined feeding for the first month on all 3 babies due to supply problems. I only ever got 50mls combined per express (with motillium & fenugreek) so assumed that breastfeeding was supplying at least that amount (more efficient than expressing). I saw a lactation consultant for the 16 days that DD1 spent in special care nursery (6 weeks prem).

I used to add an extra scoop for the formula top-ups if they were finishing. DD2 had silent reflux and was on Losec and I gave 1/3 of a bottle, then a winding break etc. Bottle-feeding her sitting up (and for 20 mins afterwards) helped with reflux too.

DS had a formula top-up after every single breast feed (or EBM when there was some) as he was losing weight for nearly 2 weeks.

You're doing really well original.gif

#3 Tarantara

Posted 21 December 2012 - 04:47 PM

My son is not a terribly helpful example, as I don't think he was ever very effective at breast feeding, and he was very slow to gain weight.

He was born on his due date. 2 months later he was about 4.5kg (3.6 at birth). At that stage, I was breastfeeding him 4 times a day, 20 minutes each side, and 'topping up' with 120ml formula, with an additional bottle of 150ml formula in the early evening, sometimes one or even 2 other 120ml bottles.

I could never express properly, and had no idea what he was getting in breast milk, but at least he sat there placidly for 40 minutes.

I then spent 20 minutes wrestling with a screwing baby to get that much bottle into him. He needed it; his weight only just started picking up at that point ( he is a tall baby, looked like a skinned rabbit, ribs everywhere).

Anyway, I think he is unusual in how much formula he needed, but all the motillium, fenugreek, blessed thistle and lactation cookies in the world couldnt make him interested in eating.

#4 Futureself

Posted 21 December 2012 - 04:51 PM

Hi OP,
I've been giving top-ups for 5 weeks now and DS is nearly 14 weeks. The advice by the Paediatrician was the same regardless of whether I was going to use EBM or formula and was due to DS not putting on sufficient weight. Basically it was: 150ml per 1 kg of weight to get the total amount needed in 24 hours (720ml). Divide that by the number of BFs DS was having per day (8)and we got the 'average feed amount' (90ml). Half that was what the top-up should be (45ml). These 45ml Top ups had to happen after every feed except the middle of the night one which I know seems a lot (it did to me!) but the Paed said 1 or 2 a day wouldn't make a difference.
It worked  and we're slowly dropping the number of top-ups per 24 hours now - down to 5 atm - but each is now 55 ml in line with his new weight.
Hope that helps

#5 kay11

Posted 21 December 2012 - 04:59 PM

I combo fed for 6 months. I offered breast first and then topped up with formula until my baby was settled and happy. By 6 months, my baby was only feeding on the breast for a morning feed and was eating a good amount of solids. From memory the top ups were 60ml and became 90ml after a bit.

My baby got pretty chubby though so maybe it was a bit much (I topped her up after every feed so probably shouldn't have done as many). That said she's within normal height and weight as a preschooler and nobody gave me any grief for over feeding because my husband and I aren't overweight (and I stopped taking her to the MCHN and switched to my GP instead).

#6 Lucygoosey1

Posted 21 December 2012 - 07:19 PM

I don't think I had supply issues, but early on with my DD1 I'd top up after a breastfeed,  just of an evening.  She'd take 30-60ml initially,  but after a short time would completely refuse the top up,  being full after the BF.

#7 axiomae

Posted 22 December 2012 - 06:44 PM

Wow I came here looking for similar info! DD doesn't take much milk (I comp feed too) at night after her solids and I was a bit worried. Some quick calculations and she's probably alright, thanks to that maths, cheers ladies!

#8 AliC05

Posted 22 December 2012 - 06:57 PM

Hi OP
Good on you for persevering with the breast feeding and comp feeding. I had to comp feed until DS was about 6 mo (when he was happy just with expressed breast milk, breast feeds and solids). I also had tried with motilium and fenugreek.

I also went with the 150mL of milk per kg per day (as per the local child and family health nurse) and would top up, up to 1/2 of his total feeds needs.
I, like you, went up in 30mL increments, I found that when he was finishing bottles of 30 and then 60 mL I would go up to the next amount, but would also try and balance it out with his weight gains.

I also tried weeks with only expressed breast milk but like your little one he wouldnt put on enought weight.

Its hard work - but I must say it was great once he was a bit older and we weren't having to worry about the comp feeding!!! original.gif

Robin Barkers baby love book also had amounts for formula feeding etc.

Edited due to my inability to type!!

Edited by AliC05, 22 December 2012 - 06:58 PM.


#9 Feral_Pooks

Posted 22 December 2012 - 07:42 PM

OP, I had a similar issue in terms of supply, comp feeding, reflux and wondering what the hell to do.

I'll just tell you what helped me.

Firstly, the reflux. Great you're on the Losec, has it been for long? Have you tried a formula thickener? Might be worth talking over with a MCHN. I found it helped, although others have told me they saw no difference. I found with his reflux it made it so hard to know what was fussing from hunger, and what was fussing from pain. I found that giving DS a dummy after a bit, gave him a chance to have some "sucking" time, calm down and the saliva production is meant to be very soothing for reflux. Otherwise, I found he would pretty much demolish whatever amount I was giving him! He was (and is) one of the relux babies who find feeding very soothing on their tummies, and would take in as much as I offered, so the dummy was an important tool for us. Sometimes, in those early days, he would actually just fall asleep, so that was great. So can you ask about the dummies? While he was doing this, I'd hold him up on a tilt and gently stroke his back, and sing, and generally try to calm him (and get wind up). If I found he was getting antsy or sucking it very hungrily, I'd offer him a little more and depending on how he responded, allow him to finish. Have you looked at reflux.org? Some great tips there.

Secondly, and I am really not trying to put you off here because you are doing a stellar job, but I found that when I was comp feeding (he was younger, only 4 weeks, so not sure if it's relevant for you) DS developed a strong preference for the bottle. I believe that it was simply easier for him to get the milk in that was soothing his reflux. It's something to consider and I wonder if it would be worth seeing your LC to discuss. I actually got to the point where I was convinced he faffed around on the breast because he knew it would get him his EBM/formula. I would be wondering how the heck he was asking for more frim the bottle, and I think part of the answer was that he wasn't effectively feeding from my breast and was awaiting the top up as his "main meal". I was advised by an LC to express full time which was not something I felt able to do long term, so that was the end of it for us. However my DS was a lot younger (I think about 4 weeks at that stage) so I have no idea if that could be totally irrelevant for you. But as I say, might be worth asking.

Can I just say I know it's tough with reflux babies, you're doing a fantabulous job and I wish you all the best.

#10 chickenpants

Posted 22 December 2012 - 09:15 PM

I am comp feeding my little dude too, and had problems with crying after feeds and reflux-type behaviour. It turned out that it was the formula we were using, once we changed that then he was absolutely fine and the issues went away.

He was on that S26 which left him grizzly and windy and sad - we found the Karicare regular formula works well with him, a lot of EBers swear by Bellamy's too.

#11 antsy

Posted 22 December 2012 - 09:49 PM

I also comp fed until 3 months, and would only top up the afternoon and evening feeds. I would give 30mls at the beginning, and then 60ml as baby got older. You can kind of tell if it is too much because baby will not be acting hungry or enthusiatic at the next feed, or they will gain more than the average amount. By the time my son was 3 months he started refusing the top ups, so I knew then that he was probably getting enought from me. Good luck with it all. Once your baby begins solids you may be able to eliminate the top ups altogether too.

#12 lucky 2

Posted 22 December 2012 - 10:58 PM

I thought I'd let you know that you can supplement your baby during a breast feed rather than using a bottle with a device called a Supply Line or Supplemental Nursing System.
It might be an option for you if you are only giving a top up twice a day.
You could put whatever volume in the bottle of the supply line and baby can take whatever is needed.
A LC can help you with this device if you are interested.
All the best.
https://www.breastfeeding.asn.au/bf-info/us...ng-supplementer




1 user(s) are reading this topic

0 members, 1 guests, 0 anonymous users

 

Clever panda fakes pregnancy

News that a giant panda was pregnant prompted much excitement, but it appears there were never any cubs on the way.

'I survived placenta percreta'

When writing her birth plan, Simone Pavil included an item most women wouldn?t even think about: what should happen if she was put on life support. The mum had the potentially fatal condition placenta accreta.

Managing personal space as a mum

In the midst of the early parenting years, our bodies and minds can seemingly be overtaken by our offspring. How can we balance our need for personal space with the needs of our children?

'If love could have saved you, you'd have never left'

The words "spontaneous abortion" on the hospital paperwork really got to me. My baby died; I didn't spontaneously decide to abort him.

15 classic Aussie ads

Watch some of the classic Australian ads of the 80s, 90s and 00s, and remember the catchphrases and jingles we all used to know so well ...

For and against

Should Blue Ivy have been at the VMAs?

Many were quick to condemn Beyonce and Jay Z after appearing on stage at the MTV Video Music Awards with their two-year-old daughter, but others thought it was a sweet family moment. What do you think?

Toddler attacked at gym creche

Two-year-old girl Eva Ness was left with a black eye and bite marks on her face and body after an altercation with an older child at a health club's child-minding facilities. Now her parents are calling for the centre to be closed.

Pregnancy a tricky matter of timing for FIFO couples

Manipulating rosters, coordinating 'conjugal' visits, working on site with your partner; getting pregnant can prove stressful for FIFO workers.

WIN a $100 RedBalloon for Dad

Enter now for your chance to win 1 of 5 $100 RedBalloon experience vouchers. Helping you make Dad's Day EXTRA HAPPY.

Carseats have twice as many germs as a toilet

Most parents know their child's carseat is not always squeaky clean, but they might not realise just how dirty it really is.

Doctors remove foetus from 'medical marvel' after 36 years

Doctors in India have removed the skeleton of a foetus that had been inside a woman for 36 years.

Nine months in six seconds: new parents' Vine clip a hit

We?ve seen some memorable time-lapse pregnancy and birth announcement videos before. Now one new couple has taken it to the extreme, capturing it all in just a six-second Vine video.

Sonia Kruger speaks of baby joy

Celebrity mum-to-be Sonia Kruger has spoken candidly about using donor eggs and IVF to fall pregnant at age 48.

Dressing to not impress: life through the eyes of a three-year-old

When it comes to getting dressed, my three-year-old has only one criterion: ?I don?t want to look beautiful.? And now I've worked out why.

Special nappies made with love for angel babies

Angel Baby Nappies make and provide tiny bereavement cloth nappies for pre-term stillborn babies and premature babies who pass away in the NICU.

Inside the brain of a tantruming toddler

What's going on in your child's mind in the lead-up to a tantrum? And what?s the best way to respond?

5 secrets to a long-lasting relationship

When it comes to keeping your relationship strong, it?s what you do - and not what you want - that really matters.

When 'furbabies' meet real babies

I am obsessed with my dogs, and can't imagine loving them any less once my baby arrives. But that doesn't stop everyone from telling me I will.

The least popular baby names of 2013

Looking for a baby name that?s nowhere near the top 10 ? or even the top 1000? Try the bottom five.

'I was so sleep deprived I crashed my car'

There are no laws regulating driving while tired, but statistics show that driver fatigue is one of the top three contributors to the road toll.

Win back some precious time and get FREE coupons

Membership to eBay's Bubs? Corner is free and includes a $10 coupon to spend on nappies each month - a win for multitasking mums!

Download now: Essential Kids Activity Finder app

Got bored kids? Quickly find the best activities for kids wherever you are in Australia with the Essential Kids app.

 
Advertisement
 
Advertisement
 
 
 

What's hot on EB

WIN a $100 RedBalloon for Dad

Enter now for your chance to win 1 of 5 $100 RedBalloon experience vouchers. Helping you make Dad's Day EXTRA HAPPY.

Win back some precious time and get FREE coupons

Membership to eBay's Bubs? Corner is free and includes a $10 coupon to spend on nappies each month - a win for multitasking mums!

Do you suffer from Precious Firstborn Syndrome?

Testing ?no more tears? shampoo in your own eyes, warming cucumber sticks so they're not cold straight from the fridge, waking a sleeping baby to check they?re still breathing: these are all symptoms of Precious Firstborn Syndrome.

Ezra's tragic death not in vain, mum says

Little Ezra was a "Harry Houdini" who loved trying to escape the family home. Now, after his tragic death, his parents are doing what they can to help others.

7 mistakes old hands make with new babies

As I sat across the table from my friend ? me, a seasoned mother of three; her, a brand new mum ? I thought of all the mistakes an old-hand parent can make when visiting a newborn baby.

Video: When adults act like children

Ever wondered what would happen if adults were allowed to act like children? This dad's hilarious video clip will give you an idea of what life would be like.

Mums hit hardest as flu cases skyrocket

The number of confirmed cases of influenza in Australia has doubled the number for the same time last year - and women are 25 per cent more likely to get it.

The mum who had four babies in nine months

Feeling exhausted due to the demands of caring for a baby? Imagine the life of this mum, who gave birth to three boys and one girl in just nine months.

Everything baby at Big W

Lowest prices on everything baby, only at Big W. Sale starts August 4 and ends August 20 2014.

Going viral

Weirdest pregnancy products

From pee stick keepers to stylish sick bags, there are some very strange inventions out there for pregnant women.

Personalised baby gifts

We've scoured the internet to find gorgeous personalised keepsakes and nursery decor to record baby name and dates. They make great gifts for christenings, name days and birthdays! (All prices in AU.)

 

Mind, body, beauty, life

Making time for me

We look at your wellbeing, covering health, relationships, beauty and fashion, mind and body.

 
Advertisement
 
 
Essential Baby and Essential Kids is the place to find parenting information and parenting support relating to conception, pregnancy, birth, babies, toddlers, kids, maternity, family budgeting, family travel, nutrition and wellbeing, family entertainment, kids entertainment, tips for the family home, child-friendly recipes and parenting. Try our pregnancy due date calculator to determine your due date, or our ovulation calculator to predict ovulation and your fertile period. Our pregnancy week by week guide shows your baby's stages of development. Access our very active mum's discussion groups in the Essential Baby forums or the Essential Kids forums to talk to mums about conception, pregnancy, birth, babies, toddlers, kids and parenting lifestyle. Essential Baby also offers a baby names database of more than 22,000 baby names, popular baby names, boys' names, girls' names and baby names advice in our baby names forum. Essential Kids features a range of free printable worksheets for kids from preschool years through to primary school years. For the latest baby clothes, maternity clothes, maternity accessories, toddler products, kids toys and kids clothing, breastfeeding and other parenting resources, check out Essential Baby and Essential Kids.