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

 

Special Ticket Offer, Save $8!

The Essential Baby & Toddler Show is back this April! Save $8 off the door price for a limited time only!

Why I breastfed my son until he was three

The fact that I not only breastfed my son, but breastfed him for three and a half years, seems pretty incredible in retrospect.

Do babies and young children see ghosts?

Do babies and young children see ghosts? If you’ve pondered the question, you’re not alone.

15 years with Essential Baby: meet Therese

"Life has a funny way of giving you what you need when you need it the most."

Mum causes a stir by taking a stand against leggings

A mum has found herself the subject of debate after claiming tight bottoms cause lustful thoughts in men.

Don't set a parenting goal for 2015 - do this instead

The problem with goal setting as a parent is the measure. How do we really know if we’re succeeding?

5 pregnancy myths that just won't go away

When you're expecting, it often seems like everyone is keen to offer advice about what you should and shouldn't do in the interests of your health and wellbeing.

RPA hospital contacting mums after discovering vaccine storage fault

Sydney's Royal Prince Alfred Hospital (RPA) is trying to contact women who had babies at the facility after discovering a fault in a refrigerator containing vaccines.

'Nutella' not a baby name, French court says

A French court has blocked parents from naming their baby girl after the hazelnut spread Nutella, arguing it would make her the target of mockery.

Why I'm never calling myself 'just a mum' again

I’ve grown three human beings. I feed them, dress them, teach them, care for them and love them 24 hours a day. Yet for eight years, when I meet new people and they’ve asked me what I do, I tell them: “I’m just a mum”.

Rosie Batty named 2015 Australian of the Year

One year ago, Rosie Batty could not have imagined she'd be where she is. Tonight the grieving mum who put domestic violence on the national agenda was named Australian of the Year.

Five reasons to hug more

Hugging – some of us thrive on it, even depend on it – and then there are those who don't care for it really. So, are they missing out?

Help - my three-year-old has started throwing tantrums

My daughter never went through the "terrible twos" but began throwing wild tantrums shortly after her third birthday.

That's commitment

First peek at Sonia Kruger's daughter Maggie

"She smells so good, I could eat her," Kruger tells co-host David Campbell.

Mum assists in own caesarean surgery

A mum who partly delivered her own twins during a caesarean has encouraged other women to take control of their birthing experience.

How to handle common childhood regressions

Regression can be a natural and common part of development prompted by a variety of factors, but that doesn't make it less frustrating.

Disgruntled dad's pram ad goes viral

When buying a second hand pram, there are lots of things to take into consideration. 

Man discovers he's a dad after finding 55-year-old letter

Discovering you are about to father a baby is startling enough - never mind finding out you have a 61-year-old son.

15 thoughts mums have during a tantrum

Ranging from mild to feral and triggered by events both minor and major, tantrums certainly keep life interesting.

Natural pain relief in the early stages of labour

While managing labour pains on your own can be daunting, there are a number of natural pain relief options to help you cope until you are admitted to hospital.

Win an Octonauts prize pack

To celebrate the launch of Octonauts Live! Operation Reef Shield, a spectacular underwater adventure live on stage, we are giving away an amazing Octonauts prize pack to one lucky fan.

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

Forgotten Baby Syndrome claims the life of toddler

One baby dies every eight days in the back of a car in the US, victims of 'forgotten baby syndrome'.

For a brief time, I was touched by an angel

For a brief time, I was touched by an angel. You stole my heart, and changed me into the women I am today.

Chinese woman gives birth to quintuplets

After six years of trying for a baby, a couple’s dreams have come true many times over after the mum gave birth to quintuplets this week.

Chrissie Swan has reached her "sex quota"

Chrissie Swan says she and her partner have sex once a year due to her fear of falling pregnant.

Stars help save choking babies

It's an important lesson to learn, but one that busy new mums and dads might overlook until it's too late.

New Girl star Zooey Deschanel pregnant

Actress Zooey Deschanel is expecting her first child with her producer boyfriend Jacob Pechenik.

16 times 'dad reflexes' saved the day

Of course, in some cases they may be the ones who actually got their child into a precarious position in the first place, but we'll ignore that for now.

Couple's 'non-traditional' pregnancy announcement goes viral

Knowing you are not the father of your pregnant wife's baby would usually indicate a rocky relationship ahead for traditional parents.

The trials and tribulations of identical triplet newborns

Pip Donnelly is still playing spot the difference with her newborn identical triplets, Isabelle, Georgina and Frankie.

Win an Octonauts prize pack

To celebrate the launch of Octonauts Live! Operation Reef Shield, a spectacular underwater adventure live on stage, we are giving away an amazing Octonauts prize pack to one lucky fan.

Earthquake baby thriving five years on

Jenny Alexis is lucky to be alive after spending four days buried in the rubble of the 2010 Haitian earthquake, but now she's a thriving five year old.

Please don't say I'm lucky because I was adopted

On the one hand I was having a regular life with friends and sports and sleepovers and school. But I was also always wondering: Did my mother love me? What was wrong with me?

An open letter to non-parents who offer advice on child-rearing

Kitty, when you’re the parent of my child you’re welcome to wade in with an opinion – but until then, I’d prefer you to have a supportive ear and a glass of wine ready.

Couple arrested over baby gun video

A US couple faces charges after investigators say they found mobile phone videos showing the woman's 12-month-old daughter putting a handgun in her mouth.

NSW Health dumps 10-year limit on frozen embryos

A 10-year time limit on storing frozen embryos that were created with donor sperm has been dropped by the NSW government.

How my happy-go-lucky husband became a monster

Sharan Nicholson-Rogers watched her husband change from a happy-go-lucky police officer into an unpredictable man prone to violent and emotional outbursts.

Dads-to-be experience hormonal changes, too

Dads-to-be experience hormonal changes in line with their pregnant partners, a new study shows.

'They were just doing their job': mum of toddler killed in police chase gone wrong

"They were just doing their job. I feel so sorry for them. It is all just too sad."

Miscarriages to be formally recognised by NSW government

Women who miscarry will be able to obtain an optional "recognition of loss" certificate as a formal recognition of their often heartbreaking loss.

Cafe cubby house 'too noisy' for neighbours

Teenage parties, domestic disputes, or raucous late night pubs are the things that usually come to mind when you think neighbourhood noise complaints.

Dad films baby playing with snake

Most parents would not consider a snake an appropriate playmate for their baby, but a US dad who filmed his daughter playing with a python has defended himself against criticism.

Clever breastfeeding products

Check out this range of products designed to help make your breastfeeding journey more enjoyable, manageable and convenient.

 

Back to School Offer

Findababysitter.com.au

We've got you covered for this school year. Use www.findababysitter.com.au to meet local nannies now.

 
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.