Struggling with breastfeeding and supplementing with formula

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  1. Sorry this is so long! Here is my story and I need some good advice... my little girl is 3 weeks old today, and when she was born, I couldn't get her to breastfeed in the hospital no matter what I, the nurses, and lactation consultants tried. First, I am told that I have small nipples, and she is tiny and can't latch on to my breast. So the lactation consultants had me use a nipple shield, which she could latch onto, but she wouldn't suck and would just fall asleep on me every time. Finally they did a blood test and determined that she had elevated levels of bilirubin, some hormone that causes jaundiced skin and made her too sleepy to eat. We ended up staying an extra day in the hospital so she could be incubated, which apparently helps metabolize bilirubin. And they had us start giving her formula so she would eat, and she was able to drink it and started waking up a little bit.

    When I got home, she would only breastfeed lying down, so we did that for a few days. I remembered I had a Boppy pillow, and when I tried it, she learned to breastfeed with me sitting in a chair, which was a relief. The nurses told me to pump for 15 minutes after every feeding to increase my supply, which I tried to do when my husband was home with me. But now since he is back at work, DD has been waking up a lot during the day, and there are days I can't pump at all, because she won't sleep or entertain herself without bawling for 15 minutes to let me do it. She pretty much needs me or someone to hold her most of the day or she screams and cries bloody murder.

    When I nurse her, I know I am producing milk, because I can see it in the nipple shield, and I hear her sucking and swallowing. However, I can let her nurse for an hour, and she still does not get full from my breastmilk alone. My doctor told me not to let her nurse that long, and to give her 15 minutes on each side, which definitely doesn't fill her up. I nurse her at least 3 times before noon every day, and one or two of those times in early morning, she goes back to sleep and seems full. But the rest of the day we have to supplement with formula. My best friend/sister-in-law has started coming over a couple afternoons a week to take care of her so I can sleep, because DD doesn't sleep much at night at all. That's a whole other story, but we had some success last night after I discovered the Slumber Bear which has a recording of womb sounds, and knock on wood, she slept most of the night last night! Please let that not be a fluke!!

    Anyway, I want to breastfeed her, and I will continue to do it as much as I can. The problem is that it takes SO much time, and she doesn't get full from it. I can't see the day where we won't be supplementing with formula just to fill her up. On top of that, I am a vastly underpaid lawyer for a small law firm that does not pay maternity leave, so I started a wedding cupcake business when I found out I was pregnant so I could have some income and be able to take a decent maternity leave. Little could I have predicted that the cupcake business would absolutely take off! My SIL became my business partner a while back, and we are now "this" close to opening a retail bakery, which will enable me not to have to go back to a job I hate, and be able to bring DD with me and not send her to daycare and her mother and aunt take care of her, which is HUGE for me:smile:

    Unfortunately, that also means that I am super busy baking now in the middle of wedding season, so when my SIL comes over in the afternoons, she takes care of DD so I can catch a nap and then bake. So in the afternoons, I simply don't have time to breastfeed, and she has formula all afternoon. I nurse again when my husband gets home from work, bake some more, nurse before bed and during the night, but all of those times require supplementing with formula.

    So here is my emotional/moral dilemma: I feel so bad that I am either not making enough milk to feed my daughter, or the quality of it isn't enough to fill her up. I feel like there's something wrong with me. And I feel bad that my schedule doesn't allow me to nurse her in the afternoons. And I feel bad that I don't have time to pump, which would probably increase my supply and give her more breastmilk to drink rather than formula. But pumping is really frustrating too, because even when I can do it several times a day, I barely get anything. The most I have ever gotten is about an ounce and a half. Am I doing something wrong?? I just feel like I'm not good at it. I enjoy the time with DD when we nurse, and I'm going to keep trying as long as I can. I even feel inadequate with the stupid nipple shield, because I can't even nurse her with my breasts alone, and milk inevitably spills all over my shirt every time because she gets fussy and knocks the shield off with her flailing limbs. I have tried to wean her off it, but she just gets super frustrated and cries because she can't latch onto me. So the whole experience is just frustrating me and making me feel like a bad mom:sad:

    I know I'm not the only one who has experienced something like this, and I know lots of people use formula. I just feel like it's not the best nutrition for her, and I don't know what to do. I would appreciate any advice or experiences you guys want to share with me, if you have any ideas or maybe just want to make me feel better...:sad: Are there really people out there who breastfeed and pump and never need formula? How in the world do you have time to do it all?? I want DD to have all the benefits of breastmilk, and I feel awful that I'm probably making it worse just because of my schedule, which is necessitated because I hate my job and it doesn't pay me a dime for maternity leave. Is everyone else supermom but me??:sad:
  2. Your daughter is beautiful. Congratulations!

    I couldn't bf but know a little and want to respond so you feel quickly supported. Is she getting to the hind-milk? (Is that the right name for the richer, fattier milk?) My doula said that expressing for a time gets to that heavier milk. Also, if you express, you could have that for her to be bottle fed. Not bfing but still your milk and and you can feel good about that.
  3. Congrats on your baby girl.

    BF is hard!! I do wonder if your DD is getting the hind milk too - this milk is the richer fatter milk that will keep them more full. You might want to talk to a lactation consultant from the hospital - I'm not sure why your Dr told you to only nurse for 15 mins at a time on each breast. Your DD would stop on her own when she's full.

    My first baby, I couldn't BF, but pumped instead as I felt guilty for not giving him breast milk. My second baby however latches on quite easily and I've been able to BF. I originally did 30 mins each breast, but than read that you should just have the baby finish one side, and the next feeding have the baby on the other side and that's what I've decided to do instead now because I wasnt to make sure my DS gets the hind milk.

    You shouldn't feel guilty in anyway - formula is just as good as breast milk, so if you need to use formula, it's ok.

    I wish you lots of luck!! :hugs:
  4. Oh hon, don't beat yourself up! First off, any BM is better anything ^_^

    Secondly, the fact that you're FF is what's killing your supply. Forumla takes longer to digest, therefore letting your LO seem fuller longer. And BFing is a supply and demand sort of thing. If the demand is smaller because the formula's occupying space in the stomach, well of course when you're BFing, she won't eat as much.

    You can try taking suppliments (Fenugreek, Mother's Milk, etc.) to try and increase your supply. Pumping that much is actually kind of average if you're not consistent with it. A pump is not very sufficient at all in extracting milk. Pump when you can, but try to find time to pump and at normal intervals.

    Nipple shields were the only way that I was able to BF my kiddo, otherwise I probably would have given up. And honestly, 15 minutes on each side isn't enough probably if she's a lazy nurser. There were times that I was BFing DS every hour, on the hour (again, demand is what increases your BM) and most often, I was BFing him for 40-60 minutes. I just went with it. LOL DS used to fall asleep ALL the time at my boobs (he could stay there for hours if I let him). I used to switch sides, but then I started block feeding because he kept falling asleep on one side and then that way, he could get the hind milk. It meant that it took longer for him to feed, but so be it.

    Also, it takes WEEKS for a kiddo to settle into a lengthier sleeping pattern (including sleeping at night). The first half of her life is filled with growth spurts, which is why she seems like she's hungry all the time LOL.

    I was able to EBF DS for almost 6 months and then had to switch to supplimenting with formula because my supply wasn't increasing (I was only able to pump 2x's a day at work) and his demand WAS increasing. I then still BF'd when I could (morning wake up, and nursed on demand when I got home from work and then all day on weekends) for a couple more months until my supply dropped so much that I was barely getting 2 ounces between both breasts when I was pumping. I was SO sad because BFing such hard work! FInally we weaned down to just one nursing session at night and then DS self-weaned at around 8.5 months.

    Okay, if you've gotten this far, my message in a nutshell is nurse as much as you can and don't feel guilty that you have to use formula. And if it gets to the point where you just can't nurse, then just know that you gave as much as you could :biggrin:! :hugs:
  5. Okay, first of all, I need to strongly encourage you to IGNORE whatever you are getting via the breast pump. It is in NO WAY any reliable indicator of how much milk you are making. the beginning, babies want to nurse all the time. This is normal, and does not mean that there is anything wrong. Some of it is nutritive, and some of it is non-nutritive, but it's all perfectly normal. Yeah, it can be super frustrating, especially when you have other things you really need to do. Have you tried introducing a paci? Neither one of my boys ever took one (they both preferred me, lol) and normally I wouldn't recommend introducing one this early on, but if you can get her to take one, it might give you a little break.

    Third...15 minutes per side is not a good recommendation, and I would think that based on what you are saying, she's not getting the good hind milk. I would suggest allowing her to nurse on one side only per feeding, and see if that makes a difference.

    Fourth...I would encourage you to trust in your body's ability to nourish your baby. It's hard, I know, because you can't SEE what they are taking it. Also, I know you have probably heard countless women tell you how they were not able to breastfeed for whatever reason, but the real truth is that most women who 'can't' breastfeed were not successful because of lack of proper (and knowledgeable) support around them, NOT because there is something wrong with their bodies. Unfortunately, finding someone that actually knows what they are talking about and can teach you how to get over the hurdles is NOT easy, and to be perfectly honest, MOST pediatricians don't have a clue what they are talking about when it comes to this subject. So, trust that your body CAN do what it needs to do. You just need to find some support is all. Maybe look into your local La Leche League? They can be a wealth of information and support as well!

    In the end, though, you need to do whatever is going to work for you. While I can't in good faith sit here and tell you that formula is 'as good as' breastmilk (because, well, quite frankly, no, it really isn't), there's nothing wrong with it. I was raised on it and I turned out just fine, lol! So if you feel you need to supplement with it, DON'T feel guilty. The fact is that you are doing great, and you should feel good about that!

    Feel free to PM me if you want. I successfully nursed both of my boys exclusively, and I'll be happy to help you in any way I can. :flowers:
  6. :goodpost: Hopefully no one is filling you with stories of why they couldn't when what your need is encouragement. You want to do this, your body is doing it, and it sounds like what you need is figure out how best to bf this particular child. And it is different with every baby from what I've read and watched.

    And as Christy says, "can't" means different things, not always supply or latching issues that cannot be resolved. Sometimes schedules/jobs or medications for illness make bf impractical/risky. But most often, not having kind encouragement and information leads to struggles.

    Sending lots of kind encouragement your way. :hugs:
  7. I just want to say that I didn't have enoigh suppy with DS, called La Leche League, hired a BF-ing expert to come and what ended up happening is that I would BF every time DS was hungry for 20 min each side, supplement 1-2 oz with formula, and then pump for 15 min right after. It was exhausting but I stuck with it and then BOOM, at 7 months, I was EBF DS! It took me 7 months! And I was a SAHM and I was so exhausted, I can't imagine working and trying that schedule.

    I guess I just want to say that sometimes, even with all the help in the world, it might not happen and do not beat yourself up over it. I used to cry myself to sleep thinking I was a failure as a mother because ppl kept telling me the only reason it wasn't happening was because I was doing something wrong.

    Every bit of BM helps and whether you end up FF or not, DD will be just fine. Just do your best and take it easy on yourself! It will all work out :smile:
  8. I totally agree with what christy said.
    Also to add on, u need to be very clear of what u wanna acheive at the end of the day. There's only 24 hrs in a day n if u wanna Breastfeed as long as possible then u really gotta sacrifice ur baking time n get ur other partners to do it. I had like only 15ml in the beginning n pumping is really a
    lousy gauge of how much u have. Eventually I had even up to 300ml after allowing her to breastfeed on demand as long as she wanted. It's tiring but it's worthwhile. I'm still Breastfeeding now. As long as u r determined, u can do it! Most importantly both mum n child r comfortable!
  9. #9 Jul 18, 2010
    Last edited: Jul 18, 2010
    Give yourself time, 3 weeks is a little early to really establish your flow. It's great that you want to give your daughter the best and breastfeeding is hard work. I was only able to pump 3 to 4 oz both breast throughout, with a 3-4 hour gap. When it was good, perhaps I can get 6 or 7oz but it's like once in a blue moon. I started working after 8 weeks, I pumped twice in the office and drove home during lunch to nurse my son. Well, after all the ups and downs of breastfeeding, I managed to feed my son till he was 9 months and boy I am proud of myself. Although I started supplementing 1 formula feed from 2 months onwards until 6 months, then it was 2 feeds and until DS was 8 months, he just prefer to be nursed before his sleeps, then he refused to be nursed when he was 9 and I had to mentally prepare myself, telling myself it's enough. Anyway, I still have the last bottle of breastmilk in the freezer, with a date, that was 5 months ago, HAHA!

    So here's my tips:
    1. Ensure you have a balanced diet and you have to eat more than your pre-pregnancy diet
    2. Relax when you pump, this is a challenge especially when you are super busy
    3. Get a hospital grade pump, it makes a whole lot of difference
    4, Drink lots of fluid, water, juice, soup

    If you have the heart and will to breastfeed, you can do it. It's just to adapt to your schedule and if you can't breastfeed, you are still the best mother, it doesn't make you any worse in any way. We all survived on formula when we were babies.
  10. Thank you everyone for your support and encouragement:smile: I'm up after DD woke up at 2am after sleeping for 4 hours! I have to say this Slumber Bear thing really seems to be working, as is our nightly bath schedule and trying not to let her sleep as much during the day. She was sleeping like a rock from late afternoon through the evening, and then she would be wide awake all night. I'm just trying to get her to switch her nights and days around, and I understand that of course she will wake up during the night and I'll feed her. It's just so stressful to be up all night long unable to console her! Tonight, when she woke up and we tried to nurse, she was screaming with the nipple shield in her mouth like she was super frustrated, and I didn't know why. She would suck a bit, then scream, then try again, so after about 40 minutes I gave up and gave her a bottle of less than an ounce of pumped breastmilk (my last attempt at pumping), which she drank happily and wanted more. Then DH woke up and offered to continue feeding her formula so I could pump, and then of course she spit up all over herself and the comforter, so he got frustrated, and then I thought I was in for another restless night. That explains why she was so upset trying to nurse, that she had to burp and I didn't realize it because she hadn't even drank anything yet! After feeding her a little more, she is back sleeping with the womb noises calming her down, and here I am. I pumped for about 20 minutes and got less than an ounce again. My doctor told me that babies are much more efficient at getting the milk than pumps are, but it's still disheartening to get so little. I would like to think that the times she is calm and content to nurse for a good block of time, that she is getting more than an ounce!

    I didn't know there was such a thing as hind-milk! Four days with three different lactation consultants and several nurses in the hospital, and nobody told me that! That makes sense to let her nurse just on one side each time, because I always feel bad having to pry her away from one breast to switch to the other, and then watch her get frustrated that she has to work all over again to get the milk to come down from the second breast. Even though my doctor said to only allow 15 minutes per side, I often let her go much longer if she seems to be getting sleepy. That's why I feel like it takes so much time out of my day. I'll try letting her go the whole time on one side to see if that helps, thanks so much for the suggestion!

    I'll try not to beat myself up so much:sad: I know I've only been doing this whole mom thing for 3 weeks and I have SO much more to learn and experience. I wasn't prepared for how hard it is to be a mom. I guess no one is. It doesn't help that my boss is very anti-baby, even though he has two grown daughters himself. He did not participate in their upbringing at all (all his SAHM ex-wife's "responsibility", which I'm sure is why she's his ex!). He is making me feel super guilty for even being at home now. I've been off work for 5 weeks because my doctor put me on bedrest, so that made him mad too. He has already asked me to come back to work and makes my assistant lie to my clients that I'm not even out of the office. I can't come back to work already after only knowing DD for 3 weeks!! No daycare would even take a 3 week old baby, and I could never do that to her and to me!! I went in to work the other day to pick up my last check from my leftover vacation, and my boss called her "that thing", as in "you brought that thing with you?". Yes, idiot, if I leave the house during the day, I can't leave the baby at home! Plus the other 8 people in my office are mostly women and parents and they really wanted to meet DD! I seriously hate my boss, which is why it's SO important to me start this business and be able to take care of my daughter myself. I do not want to pay someone else to take care of this precious little baby while I slave away at work making half of what I should so my ******* boss can buy a million dollar vacation condo. Anyway:smile:

    So I guess I need to come to terms that I'm doing the best I can, and DD will benefit far more in the long run if I am able make this business successful, because she'll have me to take care of her every day. And I won't be nearly as stressed working for an idiot boss. Breathe...:smile: Thanks for letting me vent, I really appreciate it!!:smile:
  11. I think we were writing at the same time, so now that I see your post I have another question. I have been renting a Medela Symphony pump from the hospital, but I was planning on buying a regular Medela pump at the end of the month. Is the hospital one really more efficient, and would you suggest I keep renting it rather than buying one? It will be much cheaper in the long run to buy one, but I want to make sure I'm getting the most out of it that I can. Thanks!
  12. Ok, so this morning I let DD nurse on one side for about half an hour, and she fell asleep. After a few minutes I took her off, and there was still milk in the shield, but she was peaceful and sleeping and not looking hungry. Then I pumped for 15 minutes and barely got anything out of the breast she had nursed on. Does that mean she got the hind milk, and that's why she was satisfied? If it took 30 minutes to get to that point on one breast, should I expect it to usually take about that long, or just let her keep sucking until she quits? And one more question- when I pump, should I be pumping longer to try to get the hind milk out of the other breast so she can drink it in a bottle later, or is 15 minutes sufficient? Thanks for all your help!:smile:
  13. This sounds like nipple confusion. I had the same problem. It happens when you don't establish BFing before you start giving bottles and their little brains forget how to extract milk from a breast and they get frustrated. A trick I do is giving her my finger to suck on, which takes a minutes and when she has a good suck on it I pull it out and then give her my breast and she latches. The finger is more like the breast so it helps them remember.

    I had similar problems as you, my LO was jaundiced and she had a hard time BFing at first, we could only do the laydown position, but we have worked through all our problems ourselves and are doing great, but it took 6 weeks! A few things that worked for me...swaddling her at feedings so those flailing arms didn't get in the way, feeding her before she started to cry, and I also would pump in between feeds to build a supply to freeze. The more you extract the more your body will make. I eventually could pump 4+ ounces at a time.

    Just don't give up. I read a lot and tried different things until I found what worked for us and now I am much more confident and I no longer have to give her bottles of BM.
  14. I'm not sure about the hind milk thing. I always fed my LO on one breast per feeding so she got more hind milk and she eats about 20-30 mins and then she is done.

    A trick to increase supply is to pump another 5 minutes after your breasts are empty so yes, I would continue to pump. I never really paid attention to the 15 min thing, I always went by how much milk I pumped, but thats just me.
  15. #15 Jul 18, 2010
    Last edited: Jul 18, 2010
    We had similar issues with our first baby. A month or so into breastfeeding, a lactation consultant told us that we needed to supplement with formula. I wasn't thrilled with the idea, but we knew that it was best for our daughter. I continued to nurse her for 6 months and we also gave her formula. My daughter just wasn't good at nursing and latching on, but once we supplemented her breastfeedings with formula, she began to thrive. Life got easier for everyone because our daughter was finally getting enough food and the pressure was off of me to be her sole provider. My daughter still got the benefits of 6 months of breast milk and supplementing with formula didn't take that away from us.
    My advice to you is to continue with breastfeeding and don't feel bad about supplementing with formula. Your little one still gets all of the benefits of breast milk, even if she's not exclusively breastfed. A lot of women fall into the trap of feeling like it is somehow their fault that they can't breastfeed exclusively. After my second baby was born (my son), I instantly knew that it was my daughter that had the problem with feeding and latching on and had nothing to do with me and/or my milk supply. My second baby latched on immediately and knew exactly how to feed. I was able to breastfeed him with ease exclusively for 6 months:smile: Sometimes, it's the baby who has difficulty and not the mom or her milk supply. All of the advice in the world in regards to increasing your milk supply (drinking lots of fluids, eating a well-balanced diet, etc.) won't make a bit of difference if your baby is not a good feeder.