Logistics of bottle feeding?

[sweeetpea]

I was doing a prenatal meeting today with a woman who can-not (no flames, please, there is a truly good reason) breastfeed. She asked me a couple of questions about bottle feeding logistics, and I could not answer. I have NEVER had a client who did not or could not initiate breastfeeding at birth. So, a couple of questions for those with experience with bottlefeeding newborns -

Does it make sense for the mom to agree to postpartum pitocin, since she will not be getting oxytocin stimulation from nipple stim?

I assume the hospital will provide formula (since they tend to try to force it one the breastfeeding babes with regularity). How soon after birth is it optimal to give the baby a bottle? Does milk-based vs soy-based make a difference to a newborn with no known family propensity to allergy? (Note: mom is not interested in trying to find an EBM donor) Is there anything else I should know that I can't even think to ask?

TIA,

Sweetpea

[onlyboys]

So, she's not going to put the baby to breast at all?

I'd still encourage skin to skin, on her chest and hopefully some hormones will get moving from that. I don't think that she will *need* PP pit, because in some of the births I've seen the baby wasn't nursing much at all in the first several hours, and none of those moms got pit.

As for formula, I don't have a single clue. Personally, I would say something organic. The hospital will have formula to provide, but I suppose she should be stocked up for coming home. ??? No idea on that.

How do you feel about all this? Is this strange for you?

[sweeetpea]

Oh yeah, very strange! I seriously thought about declining her as a client at first : , because I am incredibly passionate about the positives of breastfeeding.

But, then I found out the reason (really not possible even to put baby to breast), so - okay. But it is still really weird : to be reassuring her that her baby won't die because she can't breastfeed.

She absolutely plans to do skin to skin contact as much as possible, and feed on the baby's cues rather than some arbitrary schedule. I have also explained to her how tiny a newborn baby's tummy really is, and that she can't expect a full four ounce bottle to go into the baby in the early days.

I'm looking at it as an new educational experience for me...

[onlyboys]

She could also do a SNS or something similar, and I have a friend who nursed with no milk for 8 months or so. (She had insufficient glanduar syndrome, with no ducts or whatever).

If this is an emotional issue, rather than medical, it might be time to seek out healing in other venues, like perhaps therapy as she begins her mothering. I've heard of women unable to breastfeed because of sexual trauma in their pasts. Either way, hugs to you and her as you figure this all out.

[hetaera]

As someone who bottle fed her first (he was early and never latched properly, popping on and off and I had sucky advice, developed nipple preference blah blah blah I pumped some but still ended up supplimenting more than I was getting pumping every 2 hours around the clock so I stopped that too. It was very emotional.)

My best advice is bottle feed like a breast feeder.
I held my son for every bottle he got. (occasionally husband would feed him, but he understood how important it was to me that he always be held everytime) I made sure it was nice and quiet and *I* held the bottle, he held my fingers (when he got old enough) It was important to me that he touched me and not the bottle.

hmm... As for formula, *I* suggest nestle good start. and I definately WOULDNT feed soy.
I dont believe that soy is healthy food for developing boys or girls. I think the phytoestrogen in it has the potential to really mess things up. (theres lots of info out there if you google 'danger of soy formula)

My son was allergic to cows milk protein, so the ped had me try him on soy. I did without thinking. Then after a week (because he was getting constipated n it) I decided to look it up and yikes!!

So the reason I suggest goodstart is that its broken down more than the other brands so its easier to digest.

hmm.. What else...
To cut down on gas bubbles... I always made a pitcher of formula (I used powder because its cheapest) at a time. Usually at night before I went to bed I would make up the next days formula. That way when you pour it in to the bottle there arent all those bubbles that would be there from making a bottle individually and shaking it up.

I cant think of anything else. Any other specific questions I can help with, feel free to ask.

(Im probably going to catch on fire for suggesting nestle here arent I?)

[courtenay_e]

Former nanny here. Yes, the hospital will provide formula, but I second the suggestion of an organic one, if she's able to pay the cost difference.

When is a good time to start feeding? I'd put baby to mom's chest in general to promote bonding (if skin to skin is possible)...if baby CAN'T go to mom's chest, ask DAD to wear a button up shirt to the birth, unbutton HIS shirt, and put baby skin to skin on DAD's chest. Baby should bond with somebody in the family!! Then, wait for the regular signs you'd follow to tell if a breastfed baby was ready to eat after birth. You wouldn't just shove a nipple in it's face, you wait till baby roots, right? To give it a chance to acclimate to life outside? Basically same thing with bottle. Wait for rooting, offer bottle. Burp frequently.

I like to make sure that baby has a good "latch" on the bottle nipple just like I'd like to see it on mama's nipple--keeps less gas out of baby's tummy. Also, following LLL's guidelines for bottle feeding a breatfed baby keeps excess gas out of baby's tummy, as it has to SUCK to get milk out of bottle, as opposed to gulping to keep up with the "waterfall" pouring into it's mouth. THis entails holding baby literally perpindicular to the floor and the bottle parallel to the floor, to make it so that the nipple is only half full of fluid and baby MUST suck to get fluid out. Make sure that the nipple has enough fluid in it so that when the baby sucks it doesn't suck AIR, but JUST enough to ensure that.

That's what I'd tell her. How sad.

[MidwifeErika]

Everything I have read states that an animal milk based formula should come before soy, if at all possible. So, I wouldn't do soy right off the bat (and didn't when I was feeding my oldest formula).

As far as the pitocin right after the birth, I would only recommend it if the mom was having a pph.... otherwise I still don't think it needs to be a blanket treatment for all moms who aren't breastfeeding.

Otherwise, encourage her to feed on demand, lots of cuddles and love. With my oldest, this is what I did. I only had her eat as much as she wanted (even if that meant that I threw away half a bottle), whenever she wanted, always fed her with her in arms, and if we were at home I liked to have her on my bare chest.

I wish her the best of luck with her baby!

[Juvysen]

I think I read in a post on here that someone saw a woman using one of those pacifier bottles (like a pacifier w/a tube that goes down into a bottle) and holding the baby tummy to tummy as if breastfeeding. I don't know if it would promote more bonding or not, but I have heard that having the baby being more able to look around w/one eye and not the other on each side helps w/baby's eye development (although I'm not sure where I heard that, so it could be complete cr@p) but it could encourage being skin to skin and such. It's much closer to breastfeeding than holding a bottle with baby facing out would be, I would think.

[heartandhandsdoula]

If she can get her hands on some goats milk, which I've heard is very pricey, they say that it is the closest to humans milk.

[Ironica]

Originally Posted by Juvysen

I think I read in a post on here that someone saw a woman using one of those pacifier bottles (like a pacifier w/a tube that goes down into a bottle) and holding the baby tummy to tummy as if breastfeeding. I don't know if it would promote more bonding or not, but I have heard that having the baby being more able to look around w/one eye and not the other on each side helps w/baby's eye development (although I'm not sure where I heard that, so it could be complete cr@p) but it could encourage being skin to skin and such. It's much closer to breastfeeding than holding a bottle with baby facing out would be, I would think.

I think the eye development thing is more about switching sides. When breastfeeding, whatever holds you use, baby is sometimes lying on one side and sometimes on the other. Bottle-feeders often find a comfy way to hold baby and ALWAYS hold the baby that way, which often means baby is always lying on the same side to feed. This affects brain and eyesight development, since so much of their time is spent feeding in the early days. So bottle-feeders do well to make sure that they hold the baby on alternating sides to feed.

As for what type of formula... babies who are formula-fed are more likely to develop allergies, PERIOD. If she feeds dairy, he's more likely to develop a reaction to dairy. If she feeds soy, same thing. And there's some soy in dairy formulas and some dairy in soy formulas, so he can become allergic to both at once. Casein hydrolysate formulas, which use a very highly processed form of dairy that most dairy-allergic people don't react to, are corn syrup-based, and corn is also a high allergen (it's not on the big 8 list, but is probably number 9 or 10).

So what would I do if I had to feed formula? I'd probably make my own from goat's milk. It's a little more like human milk than cow's milk is, and by making my own I'd have more control over what goes into it. I know there's a recipe or two floating around out there; I'm pretty sure there's one on the WAPF website. (Not a Weston-Pricer myself, but hey, it's a source if you need it.)

[Surfacing]

Originally Posted by onlyboys

She could also do a SNS or something similar, [...]If this is an emotional issue, rather than medical, it might be time to seek out healing in other venues, like perhaps therapy as she begins her mothering. I've heard of women unable to breastfeed because of sexual trauma in their pasts. Either way, hugs to you and her as you figure this all out.

Lots of skin to skin, gazing at baby, holding the bottle instead of propping, providing EBM, and doing lots of other attachment things (baby wearing, co-sleeping, etc.) will foster great attachment. Mothering is about much more than nursing or providing BM. Good luck to her.

[DoomaYula]

Originally Posted by hetaera

hmm... As for formula, *I* suggest nestle good start.

(Im probably going to catch on fire for suggesting nestle here arent I?)

Yes! Boycott Nestle!

[Quirky]

Originally Posted by heartandhandsdoula

If she can get her hands on some goats milk, which I've heard is very pricey, they say that it is the closest to humans milk.

This is simply not true. The closest thing to human milk would be gorilla or chimpanzee milk, but goats and humans aren't any more alike than cows and humans. Goats and cows are much closer to each other than they are to humans.

Additionally, it's not safe to feed straight-up (or even doctored, a la Weston Price) goat's milk to a baby. The sodium and mineral balances are way off what a human baby needs, and feeding straight goat (or cow's) milk to a baby can be very harmful, especially to the kidneys and because of the risk of anemia.

From Kellymom:

Goat's Milk

Using goat's milk before 6 months or regular use between 6 and 12 months is not recommended. Goat's milk is no more appropriate to give baby than cow's milk. If you need to supplement and breastmilk is not available, formulas are a more nutritionally complete product. There are several comparisons of goat vs. cow vs. human milk in the links below. Using this information, goat milk is much closer in composition to cow milk than human milk. Goat's milk is high in sodium (like cow's milk) and is very high in chloride and potassium, which makes the renal solute load too high for babies. This can cause gastrointestinal bleeding and can result in anemia and poor growth (these problems are usually undetected until months later). Goat milk is also deficient in folic acid, which can lead to megaloblastic anemia. Also, infants who are allergic to cow's milk protein are often allergic to goat's milk too.

While it's true that whole goats milk (and whole cow's milk) was commonly used prior to the advent of infant formulas it is also true that the infant mortality and morbidity rate during the times of such substitutions was very high.

There's a lot more information in the links, especially this one with a chart comparing human, cow, and goat milks as well as formula, but the bottom line is that it is much safer and more nutritionally appropriate to feed a dairy-based formula that's had the macro- and micro-nutrients adjusted to better approximate those found in human milk.

That said, if it were me, I'd try an organic dairy formula (whether cow- or goat-based) and make sure to fortify it with omega-3 fatty acids and probiotics.

I'd also make sure to get the Born Free bottles or another bottle that's not made from #7 plastic (polycarbonate, like the Avent bottles) because of the issue with BPA leaching from polycarbonate bottles when they're cleaned. Either the Born Free or the Playtex NaturaLatch nipples/drop in liner systems are good from a safety point of view.

And I'd definitely bottle-nurse, and hold baby close, give lots of eye contacts, follow cues for hunger rather than a feeding schedule, and make up smaller bottles rather than bigger ones to try to avoid overfeeding.

[hetaera]

Originally Posted by YumaDoula

Yes! Boycott Nestle!

At least I expected it.

[SublimeBirthGirl]

This may not work since I don't know what her specific issues are, but she could still put the baby to her breast even if she's not going to breastfeed long term, to get that oxytocin release for her and the baby, facilitate bonding and reduce bleeding. If it's a milk issue, she could use an SNS for awhile. I'd definitely talk to her about how to feed the baby, because a lot of FF babies are put on a schedule, encouraged to finish bottles, not fed when hungry if the clock doesn't say it's time. A FF baby can obviously still be fed on demand.

[AnnaGA]

I was completely unable to BF too (no mammary glands due to breast redux), so I know how it is. I second/third/fourth the skin-to-skin suggestions. I would always feed Andrew topless so we got lots of skin-to-skin contact. He was ALWAYS held and snuggled when given a bottle, and never forced to eat more or on a specific schedule. She can do lots of babywearing, co-sleep (if she wants) and other things to build that attachment. Andrew and I are SUPER close despite my not being able to BF.
As far as formula, I used generic brands since they are the same stuff, just not marketed enough. If organic had been out on the market, I would have used that, but it wasn't out yet. I used the generic "gentle" formula and that worked best for Andrew, since it was already broken down and had only 1/4 the lactose...He would take about 2 oz in the beginning but quickly built up to 4 oz, then 8...HTH!
Thanks for helping this mommy out!

[goodheartedmama]

Originally Posted by YumaDoula

Yes! Boycott Nestle!

As much as I don't like their business practices, it was the only formula my son could tolerate. At that point, I was more concerned with him not being in pain than I was ethics of businesses.

[hetaera]

Originally Posted by AnnaGA

As far as formula, I used generic brands since they are the same stuff, just not marketed enough.

I second that. Parents choice (available only at walmart though, pick your battles I suppose) is a generic brand that also has organic.
They're comparable to Enfamil.

Nestle was the one my son did best on which is why I recommended it, but if their baby deals better theres no shame in generic.

[Llyra]

I can't say, since I don't know what her specific trouble is, but I worry about any baby that doesn't at least get colostrum during the early days-- I worry about baby missing out on the immune protection. Couldn't the colostrum at least be pumped out and fed to baby in a bottle?

[lolar2]

Originally Posted by hetaera

I second that. Parents choice (available only at walmart though, pick your battles I suppose) is a generic brand that also has organic.
They're comparable to Enfamil.

The generic brands at Kroger, Safeway, CVS, Rite-Aid, and Wal-mart (not Costco or Target thoug) are all identical. Made by PBM Nutritionals. This goes for the generic organic too, though I think only Wal-mart has the ready-to-feed generic for some strange reason.