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  1. #1
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    Default Formula Top up for BF bub?

    Hello, my LO is nearly 4 months and is BF, but paed suggested a top up of formula as he is a little underweight for his height (he has reflux, not on any meds, was using Losec but I don't want him on it anymore after reading conflicting information). He is seriously 'chucky' I have to mop my floors every night! I have given him formula previously (S26 Gold) Can I switch to another formula? Should I use AR or soy or lactose free?

    I'm chasing advice or your experiences, but don't worry I will chat to my GP also.

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    I don't know anything about reflux, but how often do you breast feed? Can you offer him feeds more often to try to 'fatten' him up.

    Also how underweight is he? And does he seem content, or does he seem like he's hungry after feeds?

    What's your & your partners build like? Being a 'little' under weight - or tall for his weight could be genetic?

    I personally would avoid messing with what I assume is a good breast feeding relationship topping up with formula unless I absolutely had to. I wouldn't want to 'accidentally' wean him onto a bottle before I was ready.

    I'd definitely get a second opinion.

    Also I'd have a look on the Australian breast feeding association website for info & maybe call their help line?

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    My bub has reflux. We were topping up from birth as he was prem and very underweight. We had BF issues, so moved to full FF after 6 weeks.

    I agree with boobycino - if he's only a tiny bit underweight I'd be reluctant to introduce a bottle.

    With reflux - I remember my paed talking about some thickener (can't remember what it was called sorry) that you squirt into bub's mouth after a BF. It apparently acts as a bit of a thickened weight on the feed and can reduce the refluxing.

    We tried Nan AR, but found it gave DS too much wind and then he had discomfort associated with that in addition to his reflux. The Novalac AR is supposed to be good as it's fairly thin and thickens after it hits the gut. I'd avoid trialling soy or lactose free formulas until something has actually been diagnosed.

    Is your DS sleeping and feeding well otherwise? And is he generally putting on weight along the same trend line? If so, I'd be reluctant to move to formula. Solids really helped DS' reflux - we started at around 4.5 months. You might find that your DS puts on more weight then.
    Last edited by RastaMouse; 18-12-2011 at 23:52.

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    Thanks for your replies. Boobycino-I'm feeding 3 hourly, he throws up majority of his feeds thus I don't actually know how much he is keeping down. He is only slightly underweight, so I wasn't too worried, I was more upset at the paed when she asked if my supply was good (silly I know). My partner and I aren't tall or underweight so I dont think its genetic. He is very unsettled after a feed (from me), I have given him formula previously and he is so much more content. Tonight I gave him 180mls of AR formula in a Dr Browns bottle to see if it made a difference and its like he is a different baby, so happy gurgling and went down to bed so easily. Do you think it would be possible to wean him onto a bottle with just one feed a day? Maybe I could just express all day and give him top ups of my milk? Is there anything I can do to up my supply? Will check out the ABA website, thank you.

    Salsamama, he isn't a great sleeper, he is all over the place even though I'm staying home most days to try and work a routine. Last two nights he woke up 4 times! I'm going to the Health Nurse Friday morning to weigh him and have a chat with her. Its hard as I have a toddler at home too, but he is an amazing kid and I'm very lucky that he understands he can't have my full attention.

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    Given that reflux is almost always caused by ill gut-health, and given that the base cause of that can be a milk protein allergy (very common) or other food allergy (ie wheat and/or gluten), I'd be extremely hesitant to add formula into the mix.

    Would you consider getting a referral to see a paed gastroenterologist? Most paed GIs will support continued breastfeeding if that's what you want to do - reflux doesn't contraindicate breastfeeding - but will work with you on strategies to improve your bub's gut health, growth and development.

    Breastmilk is the normal food for babies - but it's even more that just 'normal', it's optimal, some would even argue essential, for those bubs who are sick and where it isn't contraindicated (ie by a metabolic issue or complete protein allergy).

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    My DD was a refluxer from 4 weeks. After seeing a paed, he recommended Zantac and also a thickener done by Karicare.

    It worked wonders. Within hours of her first ml of Zantac and thickener she was so much happier. She was much less spewy with the thickener as well which was fantastic (so it was doing it's job well)

    Have you also tried keeping bubs upright for about 20-30 mins after a feed? Getting a wedge for the bassinet or cot so that bub sleeps with their head higher than stomach etc?

    I got SO much conflicting information about how often to feed. Paed said less often, CHN said more often. I kept demand feeding her and also introduced a dummy as the sucking/swallowing helps ease the acid "burn" in the oesophagus.

    Hope your bub gets some relief soon. Good luck!



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    I'm not going to stop breastfeeding, I have no intention of doing so. Thanks for your suggestions Tam-I-Am, perhaps seeing a gastro-ent would be a good idea. Bub is on long term antibiotics for a bladder infection he had from 6 weeks old, I asked a GP if I should take Inner Health Plus and he wasn't very helpful/supportive. Do you think a pro-biotic would help and should I take one or is do you know if there is one that bubs can have (he's 4 months).

    tasha1984- Thanks for your adice. I always keep him upright for at least half an hour. He will still chuck and hour or so after a feed. I've lifted his bassinet. I was told about the thickener but wasn't keen on expressing all the time and adding it to the bottle every feed, I have a toddler also and I have no spare time as it is I will ask my GP about Zantac. I've been told to not feed as often so bub has time to digest his milk and doesn't get 'lactose overload'. He will only take a dummy when I'm trying to get him to sleep.

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    Quote Originally Posted by ChasesMummy View Post
    .
    I was told about the thickener but wasn't keen on expressing all the time and adding it to the bottle every feed, I have a toddler also and I have no spare time as it is .
    You can actually mix the thickener with cooled boiled water, or some EBM and feed it via a syringe each feed if easier. I'm breastfeeding too and have just started doing this and it works fine. The Karicare one is tasteless too.

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    Quote Originally Posted by Pesca77 View Post
    You can actually mix the thickener with cooled boiled water, or some EBM and feed it via a syringe each feed if easier. I'm breastfeeding too and have just started doing this and it works fine. The Karicare one is tasteless too.
    Let me know how you go with this- I'd be interested to see if it helps

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