Using formula to 'beef up' baby whilst breastfeeding

[bronwynmc]

I'm not sure I've heard of anything quite like this before...but, a first time mum I know has a 3mnth old girl who was born several weeks premmie and tiny tiny. The mum breastfeeds her and recently developed mastitis.

Bubs still looks tiny but is apparently putting weight on. Funny thing is the mum has recently opted to giving her one bottle of formula a day to 'beef her up' (her words). I'm not sure if that was recommended to her or not.

Would formula do such a thing at one bottle a day? I would have thought that bf would be far more beneficial and have more fats in it than formula. Perhaps she isn't bf properly or doesn't have good quality milk and so she feels pressure to supplement feed to put weight on bub.

An odd theory I would have thought...
What do others think?

[Tam-I-Am]

Its one of the things that people who are misinformed about breastfeeding and all its many varied benefits often recommend.

The fact of the matter is that breastfed babies are usually slower to put on weight than formula fed babies, and all the charts for normal growth and development that are used by the healthcare professionals for babies in the country are based on formula fed babies - who tend to put weight on more rapidly and in a more uniform fashion. Its quite possible that your friend has been advised to give the bottle of formula by some well meaning (but ill-informed) paed or CHN or GP etc.

You're right though, unless there's actually a problem with her breastmilk (which is really rare), its THE best thing she could give her baby - ESPECIALLY as the baby is prem.

[Chickadee]

I agree with Tami, but will just add that my MCHN actually told me to do exactly what your friend is doing - to give supplement bottles of formula to help DD put on weight faster. End result was complete breast refusal after only 24 hours.

so it certainly has hazards, but some mums are still given that advice and may not know to get a 2nd opinion elsewhere.

[Freya]

Its one of the things that people who are misinformed about breastfeeding and all its many varied benefits often recommend.

The fact of the matter is that breastfed babies are usually slower to put on weight than formula fed babies, and all the charts for normal growth and development that are used by the healthcare professionals for babies in the country are based on formula fed babies - who tend to put weight on more rapidly and in a more uniform fashion. Its quite possible that your friend has been advised to give the bottle of formula by some well meaning (but ill-informed) paed or CHN or GP etc.

You're right though, unless there's actually a problem with her breastmilk (which is really rare), its THE best thing she could give her baby - ESPECIALLY as the baby is prem.

:iagree:

The fat in formula is different to breastmilk, breastmilk has all the good fats because it isn't artificial. Like Tam said unless there is something wrong with her supply breastmilk is best.

[pennylane]

Yes it is recommended.well it was to me (my dd was 2 pound 8 and 7 weeks prem) whilst I was BF.By her neonatalologist (sp?),her paed and nurses.Sometimes its reccomended for weight gain reasons,and sometimes because its a bit more dense than BM so if bubs has a bit of reflux its harder to get up,so ensures bubs is at least keeping some mls down a day.thats what my daughters team of doctors told me anyway.

All prem babies are completely different though,just like all babies.Im sure she has her reasons.

[Lillynix]

This was recommended to me by the CHN when DS was just 2weeks old. He lost weight for the first 2weeks but I was determined to breastfeed, at 6weeks he was finally back to his birth weight, but even now at 3.5months, he's only around 4.5kgs. He averages 50-70grams weight gain a week, but other signs tell me he is healthy despite STILL being told to comp with formula, no way, no how, not in this life time!

[Tam-I-Am]

It disturbs me that so much emphasis is put on weight gain as THE indicator of health in infants. I never had to go through what the OP's friend and you, DF, are going through - at one point, DD put on something like 90g a DAY (I always used to joke that I made cream, not milk! :p), so obviously I was never advised to comp feed formula.

I don't think that enough people understand the bell curve of normality - of statistical normality that is - and it seems that CHN are amongst the worst offenders at not understanding that anywhere within the 5th to 95th percentile of growth is NORMAL - so any amount of weight gain is probably normal! There are a certain number of babies/mothers for whom breastfeeding is NOT best, but its exceedingly rare and I think that the real problem is not that mothers don't try hard enough, not even that they are uneducated (although this is true in some cases!) but that there's just not enough understanding, and more to the point SUPPORT of breastfeeding mothers, and understanding of the range of NORMAL that comes with a breastfed infant!

Sorry....I went a bit off track there didn't I? :o Bit of a passion of mine...

[pennylane]

I agree with all of that,But, The OP was talking about a premmie baby not a normal 'term' baby.

Emphasis is put on weight gain with premmie babies because it generally determines how they are thriving.If they are coping with their surroundings,climate etc' as premmie babies can drop vast amounts of weight if they arent maintaining body temp. (up to 1kg a day in serious cases).which may also be a factor in the OP's friend being told to supplement with feeds.I know that was a factor in DD being given formula as well as BM in hospy.It was the middle of July and freezing and they knew that she needed a bit more fat on her so that if by chance it took her a bit of energy to adjust her body temp,which would cause her to drop weight. She would have a bit to spare.

[Tam-I-Am]

I do understand that - but BM become MORE important with premmies, not less so. It has so many immunity and health benefits that a prem baby requires, not to mention that its actually designed for them and their little tummies, whereas formula is harder to digest, and therefore takes up more of their energy in just eating rather than growing...

Again, I think its just poor understanding of the many many benefits of breastmilk and feeding.

[punkbaby]

My third child was born 2.2kgs although full term. I was told to subsitute formula but i never did as a lovely midwife told me to try make sure bubs got the hind milk. She gave me a few tips, such as feeding bubs, then disturbing the feed to change bubs and popping her back onto that same breast. DD was slow in gaining weight but she was happy, she was thriving and i knew that she was going fine, her CHN was also very supportive and gave me the reassurance there was no need for top ups. Mind you when there was a substitute CHN there i was told her gain wasnt good enough and to top her up.

My fourth bubs is similar, shes not a huge weight gainer either but all shes had is the breast and shes thriving as well, shes just petite but shes happy she sleeps she has plenty of wet nappies and shes gaining not losing. I was always told as long as bubs is gaining wether it be 50 grams a week to 100 a week or 200g all babies are different and to look at the baby not the chart.

Totally agree with what the others have said and Tam-I-Am is spot on.

[pennylane]

I didnt say BM was less important,As the mother of a premmie baby I understand how important it is,we make special premmie milk that is incredibly important in their first few days of life.My DD was only slightly over 1000 grams at birth. I actually think my understanding of BF is fairly good,as well as my understanding of why prems need it as I have one.:yes:

I was just saying that there are reasons they encourage suplementing as the OP asked if it was something they recommend.I wasnt agreeing with it.Trust me,I would have rather not supplemented.It was done by the nurses without my consent whilst DD was in hospy and then my milk dried up and I had no choice but to bottlefeed.I would LOVE to be breastfeeding.hopefully next time.

[Lastcenturymum]

I agree with TamIam too. Another point I don't think I have seen made here (speed reading!) is that giving formula WILL decrease your supply, hence you get into a cycle that often means you will end up weaning them cos the supply drops and they get more faster and more easily from a bottle as you aren't making enough milk.

I had a 6 week prem and wasn't even in hospital with her for 10 days and we didn't establish breastfeed till she was 3 weeks old (she was in two different hospitals without me) I was then put in a 'mothers & babies' home where they did stupid test weighs. If she didn't get enough they topped her up :hair: I spent my life on the phone to ABA. In the end I discharged myself, took her home and gave her frequent short feeds and she put on half a kg in the first week cos my supply was meeting her demand!

Edit to say my second was always tiny and only gain about 50-100g a week, but that was just her. Successfully fed her for 15 months

[Sheer Bliss]

DS was 4weeks premmie, and lost weight while in hospy and on formula tube feeds (my milk didn't come in until day 8). On discharge on day 7 (so DS was still 3weeks before his due date) the paed reccomended we limit the time at the breast (so as not to use excess energy) and for me to express after each feed to make-up for the stimulation the breasts were not getting. He also recomended top-up feeds once of an evening. Either the EBM from that day or formula - my choice. So that statement says to me that it was not more beneficial to DS's weigth gain to have formula. I bought some formula, giving it one week for DS to put on weight (he was all skin & bones) and he put on 400g in one week on breastmilk alone (including hte EBM top-ups), so IMO formula is not always needed to help increase weight in a premmie. It would have been easier for me NOT to express & given him formula, but I knew it was important enough to establish a good supply, so kept going. He only needed it for 2.5weeks, when we stopped he still gained 300-400g per week with no top-ups.

Instructions are often given differently for premmie babies, and weight gain is VERY omportant for small babies, as it can affect their ability to maintain temperature etc. There are ways to maintain the breastfeeding relationship, but in most cases it is easier to offer a top-up of formula, rather than extra expressing etc to help. A premmie baby is different to a full-term baby, even though both mine were just classed as premmies, their bodies are sooo scary, it almost makes me cry when i see the early baths from DS & DD, they look like skeletons with horrid red skin (still gorgeous to me, but ugly to anyone else) you want to do anything you can to help them gain weight FAST, and often formula does that, so is the choice used by many. I still agree that BF is best, and we managed to get DS to have HUGE weight gains, but it's hard to understand the situation of those with a premmie without having been there. More education on how great breastmilk is would be fantastic, but in a scary situation it's often too hard to see that.

[Freya]

It disturbs me that so much emphasis is put on weight gain as THE indicator of health in infants. I never had to go through what the OP's friend and you, DF, are going through - at one point, Claire put on something like 90g a DAY (I always used to joke that I made cream, not milk! :p), so obviously I was never advised to comp feed formula.

I don't think that enough people understand the bell curve of normality - of statistical normality that is - and it seems that CHN are amongst the worst offenders at not understanding that anywhere within the 5th to 95th percentile of growth is NORMAL - so any amount of weight gain is probably normal! There are a certain number of babies/mothers for whom breastfeeding is NOT best, but its exceedingly rare and I think that the real problem is not that mothers don't try hard enough, not even that they are uneducated (although this is true in some cases!) but that there's just not enough understanding, and more to the point SUPPORT of breastfeeding mothers, and understanding of the range of NORMAL that comes with a breastfed infant!

Sorry....I went a bit off track there didn't I? :o Bit of a passion of mine...

:iagree:

Also a passionof mine...

My DS has never been up to the charts he is now one. Still BF and very healthy.:D

[Nowhere]

I know that breast is best, but in answer to the OPs question yes this is often recomended by the peads when it comes to prem bubs or FTT babies, Yes breast is best and yes prems and sick bubs also need EBM as much as or more then typical babies ( IV fed babies the exception off course), The reason they recomend formula sometimes in these circumstatnces as a top up (right or wrong im not going there) is because they can monitor the aount of caloires that they are getting, and also fortyfy them if need be. That being said ther are also fortifiers you can add to EBM also to make it up to 30 cal per ounce, so that might also be something they have sugested

Yes there is alot of enphasis put on weight gain in premies but its not just for the sake of it prems and sick bubs are not only smal but also fragile internaly and needs to get as much nuorishment as posible to develope as well as they can

Congrats to you friend and he bubs hope bubs is doing well aside from the weight issues

[our little treasures]

Its one of the things that people who are misinformed about breastfeeding and all its many varied benefits often recommend.

The fact of the matter is that breastfed babies are usually slower to put on weight than formula fed babies, and all the charts for normal growth and development that are used by the healthcare professionals for babies in the country are based on formula fed babies - who tend to put weight on more rapidly and in a more uniform fashion. Its quite possible that your friend has been advised to give the bottle of formula by some well meaning (but ill-informed) paed or CHN or GP etc.

You're right though, unless there's actually a problem with her breastmilk (which is really rare), its THE best thing she could give her baby - ESPECIALLY as the baby is prem.

:iagree:

My mchn actually did the same after dd2 was very sick. She hadn't lost weight just not gained much.. I refused too bottle feed and dd2 is perfectly healthy..

Your friend has probably got the wrong advice.

[pennylane]

I dont think its for anyone to say that the OP's friend has got 'Wrong' advice,Unless any of us are paeds or Gp's here.

No offence.

All premmie babies are cared for differently and require different treatment.Im sure this mum is doing the best for her baby that she knows and I'd hate to think The OP will now tell the mum shes doing the 'wrong' thing because of what she's read here.(although im sure you wont,you never know).Its hard enough having a premmie baby.

[kiwibird27]

I did this cause I couldn't express enough...Took me an hour to get 10 mls. I was desperate so just gave her formula. I was desperate to get her to gain weight. My midwife said that was fine, and I could finally see that my baby never actually drank, just slow suckled. When she did drink, she would throw up 2 mls. She had a severe medical problem though.

Don't think doctors really care how babies are fed as long as they thrive.

[naiwen]

If a premmie baby was failing to thive on breastfeeds then the best thing to do may be to use formula, the reason for this is they can boost the calories in formula. However Edward was 10 weeks prem and had fortified EBM which is the ideal comprmise IMO but not all mothers can express.

I do not think it is right for non paediatricians to give advice that contradicts their reccomendations and may in fact be dangerous.

[pennylane]

:iagree:with everything naiwen said.

[MummaBear03]

It disturbs me that so much emphasis is put on weight gain as THE indicator of health in infants. I never had to go through what the OP's friend and you, DF, are going through - at one point, Claire put on something like 90g a DAY (I always used to joke that I made cream, not milk! :p), so obviously I was never advised to comp feed formula.

I don't think that enough people understand the bell curve of normality - of statistical normality that is - and it seems that CHN are amongst the worst offenders at not understanding that anywhere within the 5th to 95th percentile of growth is NORMAL - so any amount of weight gain is probably normal! There are a certain number of babies/mothers for whom breastfeeding is NOT best, but its exceedingly rare and I think that the real problem is not that mothers don't try hard enough, not even that they are uneducated (although this is true in some cases!) but that there's just not enough understanding, and more to the point SUPPORT of breastfeeding mothers, and understanding of the range of NORMAL that comes with a breastfed infant!

Sorry....I went a bit off track there didn't I? :o Bit of a passion of mine...
Makes me mad that so many people are told incorrect advice, then they really don't have a choice but to formula feed in the end a lot of the time, believing their child was unhealthy from breastfeeding :hair:

[MilkOnTap]

I'm with Tam on this one. I was also advised several times by CHN's to give Jedd a bottle to help him gain weight faster.

But y'know once I did - he gained weight at the SAME RATE as he did WITHOUT the bottle!

If I knew then what I know now, I would have never given him the bottle to begin with. Cant turn back time unfortunately, but we can learn from our mistakes.

OP - Tell your friend to trust in herself and to trust in her bodies ability to nourish her baby naturally :hugs:

[Tam-I-Am]

If a premmie baby was failing to thive on breastfeeds then the best thing to do may be to use formula, the reason for this is they can boost the calories in formula. However Edward was 10 weeks prem and had fortified EBM which is the ideal comprmise IMO but not all mothers can express.

I do not think it is right for non paediatricians to give advice that contradicts their reccomendations and may in fact be dangerous.


:iagree:with everything naiwen said.

I agree, its not right for non-medical personnel to be giving medical advice - but nobody here is doing that. We're having a discussion about the misunderstanding of breastfeeding that is rife in our culture and society ;)

Besides anything else, nowhere did the OP mention that the formula was being given on medical advice, OR that she was going to tell her friend to do something other than what she was doing - she was simply asking a question about formula and the reasons why it might be given :)

I would hope that everybody who uses these boards has an understanding that the opinions expressed are that only - opinions - and should in no way replace medical advice.

[pennylane]

Your friend has probably got the wrong advice.


It was comments like this,that were a bit concerning not all the comments in their entirety.