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2 Q's about supplementing with formula

post #1 of 8
Thread Starter 
I honestly know quite a lot about breastfeeding at this point, and may even become an LC soon - but I know next to nothing about formula.

I need to ask a couple of things on behalf of my friend, who is supplementing due to low supply stemming from a prior breast reduction. She is getting some donor milk, but not enough to go without formula. I noticed that she was mixing the formula INTO the donor milk - and that totally struck me as not good, but I didn't say anything at the time.

It seems to me that this is wrong on a number of levels: it's wasteful, because that way he doesn't drink as much of the donor milk as he would have if it were given straight donor milk first and then topped off with formula only if needed, and also because whatever is leftover has to get tossed! (Right? Don't you have to get rid of whatever's left in a bottle of formula? I think breastmilk is different because of the antibodies.) I also think I heard something about the different types of iron binding together and thus becoming inabsorbable.

Is there any legitimate reason to combine formula with breastmilk?

Second question, or more accurately, set of questions: I am, again, pretty familiar with breastfed poo and its variations. I have no idea what's okay or normal (relatively speaking) with formula/combo poo. I know it's supposed to be more peanut buttery, but is it okay to also be green? With EBF babies, that indicates a foremilk/hindmilk imbalance, but what does it mean with formula?

He also is going 2-3 days without pooing, and this worries me for a 2 week old baby. Breastfed babies might start skipping days when they're older, but at the beginning they're usually pooing a few times a day, right? Sometimes with every feeding.

Thanks in advance - I'm totally out of my depth here.
post #2 of 8
Thread Starter 
Oh, also, I noticed that sometimes her husband feeds the baby with formula before she nurses him. That also sent up a red question mark for me. I would think in this case, it's important for baby to nurse as much as possible FIRST, especially because of hindmilk. We want to get as much hindmilk into him as possible, right? And if he's getting partly full on formula first, then he might not get to the best stuff, right?

I don't know where they got the idea to do that, or if they just aren't thinking . . . Some of their decisions are hard to support, honestly, but I want them to get good, fact-based info and help her and the BABY get as much breastmilk as possible.
post #3 of 8
I would advise you friend to go to the www.bfar.org website (breastfeeding after reduction) where she'll get lots of help and it is only open to mothers who have had reduction surgery, first of all, i would agree that it is highly inadvisable (and wasteful) for the mixing of breastmilk with formula - don't know what's been recommended by the drs - but I would be surprised if they even recommended this, she can put the donated milk in a Lactaid or SNS to keep the baby at the breast and stimulate the breast function at the same time, then only if required add in the formula, also maybe try to pump on the other breast while nursing on one or after each feed for a while to stimulate more and signal to the body that she needs to make more milk - good electric pumps are Medela Symphony and Ameda Lactaline. She can take oatmeal, blessed thistle, fenugrec, beer etc to augment her supply and of course domperidone, there are lots of options out there for her it seems to me that she may just need a little pointer in the right direction. She can also get lots of support from a local LLL group which will also help her seeing other mothers breastfeed and talk about their experiences.

Forgot to mention breast compression as well so that he gets the hindmilk too, see www.drjacknewman.com and click on videos
post #4 of 8
Quote:
Originally Posted by RoseDuperre View Post
Oh, also, I noticed that sometimes her husband feeds the baby with formula before she nurses him. That also sent up a red question mark for me. I would think in this case, it's important for baby to nurse as much as possible FIRST, especially because of hindmilk. We want to get as much hindmilk into him as possible, right? And if he's getting partly full on formula first, then he might not get to the best stuff, right?

I don't know where they got the idea to do that, or if they just aren't thinking . . . Some of their decisions are hard to support, honestly, but I want them to get good, fact-based info and help her and the BABY get as much breastmilk as possible.
Yeah, it's probably good to nurse before supplementing. I'm no expert but I do have a friend who breastfed after reduction--at first her baby was having failure to thrive (it was scary to compare her 2 month old with mine...visibly, scarily, different), but then her doctor put her on a "bulk up the baby" campaign. Baby was given Xanax (to stop reflux) and she mixed formula powder in with her pumped breastmilk to make it even more fatty. It wasn't PREPARED formula (I don't think), but just the powder--to get maximum calories in. Anyway, that's the case I've heard of where mixing formula with breastmilk seemed like a good idea (her kiddo and mine are almost 3 now!!! Both healthy )
post #5 of 8
2 thoughts come to mind for me... I'm having similar issues as your friend with low supply and having to supp.

Feeding formula first - if baby gets upset at the breast because he's not getting enough quick enough, feeding formula first so he's not "starving" is pretty much the only option. I can give my LO about half a feed of formula to take the edge off, and then put him to the breast to nurse as long as he's willing before going back to the formula to top him off. If I were to start at the breast, he'd get a lot less BM out of me because he'd get hysterical pretty quickly.

Mixing with formula - for me, I'm not producing hind milk, so I cannot give my LO straight BM in a bottle, it's too lean and he won't thrive on it. I have to mix it with formula for the fat content. I just make a small bottle, and mix it roughly 50/50 so that he eats the entire bottle in one sitting.

And I'd say green probably still isn't a great color for poo to be... even on 95% formula, my LO's is that lovely yellowy brown, as I was told to expect by my MW.
post #6 of 8
Just wanted to add a ditto to what's been said above. I had a breast reduction (was lucky enough to drop all supp. at 10 weeks just using fenugreek, and that's rare).

Is she taking herbs to increase her supply? Herbs like alfalfa, which several moms I know use, can make baby's poo look green. Of course green can also indicate an allergy of some sort

I have heard of mixing prepared formula with breastmilk, but never mixing the powder in the breastmilk itself, which I gather is what your friend is doing.

Please, please direct her to www.bfar.org and encourage her to join the forum That site has saved and informed many breastfeeding-after-reduction relationships, including mine.
post #7 of 8
Good Start formula produces 'healthy' green poos (we used it to supplement with two of our babies). It's the whey protein.
post #8 of 8
Some people do advocate giving the supplement first:

http://www.lowmilksupply.org/finishatthebreast.shtml
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