I think DCP is overfeeding - opinions please

[neonalee]

I know the topic of overfeeding is talked about a lot, but please will some of you weigh in on my specific situation? When we picked up DS today (his 7th day at daycare) DCP told us she needed bigger bottles. I thought I heard over 4 oz per bottle, and that he was hungry and I interpreted this as she wanted to feed him more/I needed to provide more milk. I've been giving her two 2 or 2.5 oz bottles and a bag of 12 - 14 oz pumped the previous day. If I remember correctly, today I gave her a 12 oz bag plus 2 bottles, though her feeding log today shows 15.5 oz over 6 feedings. The feeding log shows each feeding (for all recorded days) between 2 - 3 oz. DS is there from 7:30 - 4:30 or 5. I have already given her the kellymom handout and asked that she read it.

This is what I'm thinking of replying. We would like DS to receive 5 bottles of 3 oz at a time spaced at least an hour apart. We would like him to be burped after 1 or 2 oz. If he's crying for more we would prefer other comfort be given before more milk (I don't really know if she is already doing this or not). I will include an extra 2 oz in the bag in case he really is hungry for more.

Am I being unreasonable? He is EBF and at home he feeds on demand. I know he comfort nurses, so I wonder how much of that he's "requesting" at daycare during which he is actually fed. He does take a paci, but only for a minute at a time, after which he spits it out. I've gotten him to take it for a total of maybe 5 minutes, but I have to keep giving it back to him. I know he's only sleeping around 3 hours of the 10 he's there, which seems extremely low. He's exhausted and sleeps most of the evening when he gets home. DP gets him for the first hour and then I hold/nurse him. He also cosleeps, but I think he goes longer than 3 hours at a time without waking to eat, though honestly I'm so used to nursing in bed that I barely wake up and it's possible I just don't remember.

[GuildJenn]

I'm not sure I believe it's that possible to overfeed a baby. Might be a growth spurt or a comfort thing, but what do you see as the issue if he eats more at your DCP's and less at home for a while?

[TinyMama]

Well...I didn't deal with pumping and working, but it seems to me that if he's awake for so many hours there, he may be genuinely hungry. He may also be eating in an attempt to fall asleep--why do you think he's not napping much while there? Is your DCP not allowing him to fall asleep while eating (and then, of course, take the bottle away) for some reason?

[motherhendoula]

I think if he were truly hungry at day care - he would be nursing all night long - to make up for it. I think he may need more 'suck time' to soothe himself. Breastfed babies get like unlimited time to suck - but with a bottle - its over way too soon. I would give the DCP different kinds of pacifiers and tell her to push those - after he has eaten - he may take them from her...from YOU he knows he can nurse - so why would he accept a silly piece of plastic? A pacifier may help him settle down and sleep more.
My DD started day care at 6 months old and took maybe one nap from 7:30 AM - 5:30 PM....she fell asleep on the car ride home from day care and didnt wake up until the morning!

[neonalee]

Originally Posted by GuildJenn

I'm not sure I believe it's that possible to overfeed a baby. Might be a growth spurt or a comfort thing, but what do you see as the issue if he eats more at your DCP's and less at home for a while?

Well, I don't want him to grow to prefer the bottle. And, knowing that pumping isn't as efficient as baby, and that milk production often slows when returning to work for that reason, I don't want my supply to diminish if I can help it.

Originally Posted by TinyMama

Well...I didn't deal with pumping and working, but it seems to me that if he's awake for so many hours there, he may be genuinely hungry. He may also be eating in an attempt to fall asleep--why do you think he's not napping much while there? Is your DCP not allowing him to fall asleep while eating (and then, of course, take the bottle away) for some reason?

Good point - I hadn't considered that being awake more he would be hungrier. After all, if I'm up later then usual I will get hungry again too! I think it's just the classic situation of going from a quiet home where he falls asleep on mommy all the time to a noisy environment with multiple children and being expected to fall asleep in a crib.

Originally Posted by motherhendoula

I think if he were truly hungry at day care - he would be nursing all night long - to make up for it. I think he may need more 'suck time' to soothe himself. Breastfed babies get like unlimited time to suck - but with a bottle - its over way too soon. I would give the DCP different kinds of pacifiers and tell her to push those - after he has eaten - he may take them from her...from YOU he knows he can nurse - so why would he accept a silly piece of plastic? A pacifier may help him settle down and sleep more.
My DD started day care at 6 months old and took maybe one nap from 7:30 AM - 5:30 PM....she fell asleep on the car ride home from day care and didnt wake up until the morning!

Thanks, I think this might be more what he's after. He's used to mama always being there, ya know? I will remind her that the paci is in the bag and please give that a try before feeding more. Of course if he wants to eat, feed him, but if it's comfort only and not hunger I'd prefer it not come from the bottle.

Speaking of LOs... need to go!

[Spiralshell]

Even 15 oz over ~9 hours seems like a lot to me. Per kellymom and other sources, about an ounce to an ounce and a half per hour is typical. I pumped 3X a day, but was never able to bring home more than 9-10 ounces -- about an ounce for every hour I was away. Nate made up for it by nursing all night long!
If you're able to pump 15 oz during the 9 hours you're apart, that's awesome! And some of this might just be adjusting to daycare. It's hard and he might be wanting extra sucking and comfort. Hopefully you can get the DCP to follow your direction and not go to bigger bottles. More than 4oz at a shot seems like so much for a BF baby!

[Altair]

Are you pumping as much as he's eating?

I worked slightly less hours, was gone about 8 hours 5 days a week... and I pushed reverse cycling a bit by keeping his bottles 3.5-4oz and leaving 3 per day, but most days he only drank 2 or 2 and a half. That way I was ahead with pumping (pumped 12 oz minimum) and he was hungry for me when I got home and he nursed a lot late afternoon/evening/night/early morning.

If you're pumping that much and he's happy, 15oz is a lot to have in 9 hrs but not unheard of, especially if he's awake. It's either half of his day's milk or slightly more than half, so if you want to do some reverse cycling then cut down a bit, but if it's working for you and your supply doesn't take a hit, then maybe it's getting you more sleep. I was always afraid not to err on the side of more night nursing and less bottles.

[neonalee]

nak

"about an ounce to an ounce and a half per hour is typical" this is what I keep thinking about, even knowing that babies are different. I worry about this provider because she is willing to do breastmilk, but is much more familiar with formula. I'm pumping more than he's eating. I can pump prob around 8 oz even days I am nursing all day. I have PLENTY, but I'm so used to being able to pump/feed so easily... I don't want to damage the supply so that I start worrying over every ounce, kwim?

I guess it is working as is and I just don't want her giving him more. On the other hand, if he actually is hungry I don't want to withhold food, or comfort.

[lunarlady]

My DD was a big eater during the day, and took 4 4oz bottles during the 9 hours I was gone. This is only one ounce more than you are sending. I always sent my milk in the bottles so they wouldn't serve extra. BF babies still suck when done feeding, but too much milk and they will just spit it up, wasting your liquid gold you so carefully pumped. I had one provider ask for more, but I said that was all I could send, so try to stretch it out better. Sounds horrid, but I knew DD wouldn't starve with 16 oz going in, and they found other ways to soothe her after she had eaten.

[StephandOwen]

Putting on my flame retardant suit here.....

I'm going to play devil's advocate and come at this from the DCP's side (because I was one for quite awhile in an infant room and have dealt with this many times).

If someone told you that you could only nurse your little one for *x* amount of minutes and at that time you had to stop- no matter what- what would you think? What if you stopped him at that time and he proceeded to SCREAM and scream and scream and scream? What if he was obviously hungry but you were told you couldn't nurse him again for at least another hour? Would you seriously be okay with letting him scream for an hour?

Sometimes babies just need more milk. I always hated it when parents would get upset at me because their baby drank all the milk (and I mean drank- I don't mean I threw away an ounce here or there or overfed the baby so he spit up 2 ounces at every feeding). I can't tell you the number of times that just another .5-1 ounce was all the baby needed to be full and happy so I would "borrow" that from the next bottle. Of course, then that starts a never-ending path of "borrowing" a little from each bottle and when you get to the end of the day there is nothing left to feed the kid- which ticks off the parent when they come to get him/her and the kid is hungry! (and lest anyone think I lied to the parents- I never did. We tracked when feedings were and how much was fed and that info was available to all parents to see)

If he is getting 6 bottles currently but 2 or 2.5 ounces isn't enough for him, why not send in 6 3oz bottles? Try that and see if it works. There's not much worse than holding a screaming baby who is hungry but knowing you aren't "allowed" to feed him for another hour

[rhiOrion]

What stage nipple is on the bottles? If it's not a stage one, maybe try those. Then it'll take longer to get the milk out of the bottle, which may help with comfort sucking needs.

I think it is absolutely possible to overfeed when bottle feeding. But he's not getting such an absurd amount- just more than most kids would need. so I could see it going either way.

[Momily]

Another former daycare provider here, and I have to agree that asking someone not to feed a hungry baby is unfair, to both your child and the provider. It also sounds like your child is giving pretty clear cues that he wants slightly bigger feedings. If given them, he may well start to stretch out the time between his feedings and not ending up taking more volume. At that age many infants are taking 3 to 4 oz at a time, and going a couple of hours between feedings.

[Mosaic]

Originally Posted by neonalee

This is what I'm thinking of replying. We would like DS to receive 5 bottles of 3 oz at a time spaced at least an hour apart. We would like him to be burped after 1 or 2 oz. If he's crying for more we would prefer other comfort be given before more milk (I don't really know if she is already doing this or not). I will include an extra 2 oz in the bag in case he really is hungry for more.

Am I being unreasonable?

Honestly, I think this is reasonable. If feeding the bottle takes 15-20 minutes, and they're spaced an hour apart, he would only go another 40-45 min. before eating again. Though if you're gone 9 hours, are you going to send 9 bottles?! And I find it hard to believe that a 2mo can really drink down 3oz and be legitimately hungry 40 min. later.

But maybe send 1 bottle with more milk in it to see how he does. For my DD, she could eat more in the first bottle of the day, then she ate less for the others. Maybe he needs 4, 3.5oz bottles instead, to see if he will be satisfied for longer so that he can go longer than an hour before eating again and maybe even get one or two solid naps in during the day to help as well.

I don't have any proof of this at all, but it makes sense to me that if the pump is less efficient than the baby, then the pumped milk has less hindmilk than a baby would usually get in a nursing session. So it makes me wonder if that the lighter foremilk in a bottle just doesn't satisfy the way a nursing session does (not to mention the cuddle factor).

[neonalee]

And here's my big dilemma - I agree at least some with all of you! Completely contradictory, but there it is.

Originally Posted by lunarlady

...but too much milk and they will just spit it up...

Yes, I have seen DS do this (sometimes I let DP bottle feed him when needed)

Originally Posted by StephandOwen

Putting on my flame retardant suit here.....

I'm going to play devil's advocate and come at this from the DCP's side (because I was one for quite awhile in an infant room and have dealt with this many times).

What if he was obviously hungry ...

StephandOwen - no flaming here, I appreciate all points of view. Truly, if he's still hungry that's something different, but how do I know? Maybe the underlying problem is that I'm not 100% comfortable with my choice of DCP? We're actually looking at someone else tonight because her hours are better, but I don't really feel bad about possibly leaving DCP #1.

Originally Posted by Mosaic

I don't have any proof of this at all, but it makes sense to me that if the pump is less efficient than the baby, then the pumped milk has less hindmilk than a baby would usually get in a nursing session. So it makes me wonder if that the lighter foremilk in a bottle just doesn't satisfy the way a nursing session does (not to mention the cuddle factor).

That's an interesting theory about fore vs hindmilk. Add to that oversupply/oald...

In the beginning I didn't tell her how much to feed him because I didn't know. Her notes since then show all feedings at 2 - 3 oz (note that most of those bottles are filled herself, not set by me) and there were days she sent some milk home. So how do we suddenly get to 4+ oz bottles? We don't send all bottles - she has requested 2 pre-filled bottles per day and the rest in a freezer bag. So today we sent 2 bottles that had 3 oz each, plus the balance in the bag. Sent 17 oz total. We use breastflow bottles with stage 1 nipples. It was her saying I needed to "send more" and that she needs to give him bottles of more than 4 oz that got me worried.

As always I appreciate the time taken to post any and all opinions, thanks mamas!

[JudiAU]

I think asking for five bottle feedings a day is a little unreasonable. Three or four bottles are standard during the day and honestly, LO will adjust just fine. Bottles don't ever, ever need to be more than five ounces but 4-5 is reasonable. Just state that LO is never to fed more than 4-5 ounces at atime.

[StephandOwen]

Originally Posted by neonalee

Maybe the underlying problem is that I'm not 100% comfortable with my choice of DCP? We're actually looking at someone else tonight because her hours are better, but I don't really feel bad about possibly leaving DCP #1.

That could play some part in it. Please keep in mind that there is an adjustment period for all involved (including baby and dcp) so if you start at a new place and are having feeding issues again, give it time! It takes time for a dcp to really understand each of the babies cues. Sure, we take care of lots of different babies but they are ALL different, unique individuals. I know when I was working that job it took some time to understand each baby and what they needed. It would be so much easier to slap on a schedule (all babies eat x ounces every y hours) and let them cry in between (and I'll admit that some of the people who worked in the same daycare I did, did just that), but that's not what you want to happen (I assume). You've had almost 10 weeks to learn everything about your baby. All of his cues, everything. It will take a dcp a little time to learn them too During that learning phase they might overfeed the baby from time to time. It only takes 1 projectile spit up all over you to learn that it was too much and most of us don't make that mistake again

[neonalee]

Originally Posted by StephandOwen

...You've had almost 10 weeks to learn everything about your baby. All of his cues, everything. It will take a dcp a little time to learn them too

LOL - this is exactly what I starting thinking as I read the beginning of your post. And saying "learn everything about" is being very generous! Though I have learned to recognize the "I'm about to spit up" look

Originally Posted by StephandOwen

... It only takes 1 projectile spit up all over you to learn that it was too much and most of us don't make that mistake again

Only 1? Then how come I still haven't learned not to pick him up right afterwards yet?

[StephandOwen]

Originally Posted by neonalee

Only 1? Then how come I still haven't learned not to pick him up right afterwards yet?

Because he's your baby Mama's don't mind the projectile spit (or poop....). DCP's try to avoid it

[texmati]

Originally Posted by GuildJenn

I'm not sure I believe it's that possible to overfeed a baby. Might be a growth spurt or a comfort thing, but what do you see as the issue if he eats more at your DCP's and less at home for a while?

it is. especially with a primarily breastfed baby being fed by people who are used to formula feeding.

A bf baby is used to being able comfort suck at teh breast, and to them the sucking==momma is nearby==I'm safe, warm and comfy association is very strong.

My parents used to feed my son so much that he would vomit (not spit up, but actually vomit). This never happened at any other time.

[texmati]

OP, can you take a couple days off (or during the weekend) and pump and use bottles? and just see for yourself how many bottles he takes? No one wants to leave a baby hungry, but over feeding at daycare can really wreck a mom's bf-eeding relationship. We had a sitter at home, and I was able to work at home occasionally (out of sight), and pump and have the sitter feed. I'm not saying that the baby should take the exact same amount every day, but it was helpful to have a rough idea if we were on track or not.

I'd also introduce a paci if you haven't already.