Supplementing with Formula? - Evergreen Park,IL

Try the carnation formula. My neice had the same situation and it was the only formula that worked for her. It is also less expensive, but provides the same nutrution at the others.

I agree with the previous post, express breast milk and mix with cereal. Start with very thin cereal mix. If she is gagging maybe the formula is coming too fast through the nipple on the bottle? I would start introducing solids and not worry so much about the formula.

My little one took to the Enfamil Gentlease with few problems. I've also heard that breastfed babies switch to Carnation/Nestle a little easier. Try mixing the two together instead of doing one or the other for the supplemental bottles. Also - a word of advice from a mom who experienced "sticker shock" when she started supplementing and ultimately switched to formula - we went to the Target brand and dd never noticed the difference! Much cheaper and still FDA controlled. :-)

I breastfed my son well past a year, and he was long and slim as a baby, usually about 85-90th percentile for height and 30th for weight. That was just his normal shape, and unless your daughter has suddenly become much skinnier, I wouldn't worry. Also, if she is 9 months old, she could be starting to eat other foods like bananas, sweet potatoes, etc., and she'd probably tolerate that better than the formula.
Have you talked to La Leche League? I suspect they'd be helpful also.

C. (mother of 4 kids, ages 17-24!)

This response is mostly directed to other people who responded with "advice." Mamasource is usually such a good resource for all us other moms -- great for advice, support, understanding. However, there are a few topics that brings out the biased and judgemental responses and breastfeeding issues are at the top of the list. This mom asked for advise on help with supplementing with formula. She and her husband gave the issue "a lot of thought and discussion". Please give this family the respect that they have made the best decision for their family. You have every right to feed your baby breasmilk only but you shouldn't judge and try to convince others if they make a different choice. N. - don't let others tell you what to do; trust your own instincts and decisions. You did get some helpful responses. Good luck to you and your family. I'm sure all will be fine.

Sometimes when doctors suggest supplementing with formula, they really mean a bottle. Offering a bottle after nursing is one way of making sure baby has really had all he/she wants.

Has your daughter ever taken a bottle before? If she has (and it's the formula she's rejecting), you could always try offering a bottle of breast milk. If she's never had a bottle, it could be the bottle she's rejecting. If so, it might help if someone other than you gives it to ... just until she gets used to it. Also, she's definitely old enough for a sippy cup, so you could skip the bottle altogether and offer her a sippy cup. That works with a lot of babys who were never given a bottle early in life.

Formula is not the answer! Is she gaining weight? That's what matters, not what percentile she's in. Formula is by far inferior to your breastmilk as your daughter is showing you by refusing it. Check www.kellymom.com or www.llli.org for more information on normal weight gain and increasing milk supply. Trust your daughter and yourself. Your doctor is ill informed about breastfeeding.

Just encouraging you that your daughter may be fine without supplementing. Breastmilk is so rich in everything. If you want to reconsider if this is really necessary you may want to go to www.kelly mom.com Hope this comes across helpful, and not pushy.

Hi N.,

As long as your daughter is gaining (and not losing) weight, I don't think you need to worry about supplementing. Just keep breastfeeding and feeding her solids -- you maybe even could try giving her full-fat yogurt at this point. Make sure that you get plenty of fluids (and plenty of rest and calories) in order to keep up your milk supply.

My daughter has been low on the charts for weight -- she was a small baby (6+ lbs) at birth, and I breastfed her exclusively (and then introduced solids around 6 mos.). She is a decent eater/nurser, but is super active, so she burns lots of calories. Also, the growth charts your doctor has are actually made for formula fed babies (not those who are exclusively breastfed), so it's natural that your baby will be on the small side.

Good luck,
R.

my child has always been small and exclusively breastfed. Doctors rely on percentiles a little too much and i go to a docotrs practice that makes sure your child is growing, but doesnt compare it to the national average which is based on FORMULA fed kids which is why breast fed kids always come in being "smaller". It is far easier to overfeed a bottle fed child. Has she grown, does she nurse well, is she happy or wanting more after you nurse? Honestly do you feel she needs formula? I personally wouldnt if I felt she was a good nurser and was a happy growing baby, but it is up to you. Someone has to be at the bottom of those charts! I would consult a breast fed baby chart and do more research.

Has her growth curve changed? Has she recently started being more active (crawling, etc.)? Any signs of dehydration on hot days?

I supplemented for both my kids by that age, so it's not like I'm against it, but I can't tell if there's really a health concern or if your pediatrician is just encouraging you that it's OK to do something a lot of women quietly do (supplement w/formula).

If you aren't sure, check in with your ped again - and grab some free formula samples (I know our pediatrician usually has some near the front desk). They might recommend something like pediasure if there's a geniune issue and they just want to put some weight on quickly. (but that's not for infants without ped recommendation; maybe there's an infant version?)

Also, as an experiment, give her formula first one feeding - that's going to give you an idea if she really doesn't like it or if she's just full when she's done nursing.

You may not be having a problem. Would you be in the 5th percentile for your weight? If you have tasted those formulas, you don't blame her. They are nothing like the slightly sweet perfect formula that your body has been providing for her. *If you are eating well* your breast milk is all she needs for the milk in her diet. There is nothing that can be formulated in a laboratory that equals what GOD has already created. Your (human) milk is perfect for your precious daughter. **Express a little breast milk to mix with cereal(give it to her with a spoon as Wendy M suggests)and then let her finish up with breastfeeding.** Please get in touch with you local La Leche League for breastfeeding support.

N., I agree with other posters. Being in the 5th percentile in and of itself isn't cause for concern and shouldn't be a reason to supplement with formula. Is she content after she breastfeeds? Is she pee-ing enough and pooping sufficiently? Is she generally healthy? Is she very active? Also, I would think that, if weight is really is an issue, the solution is to introduce and encourage more fattening solid foods.

Hi - we went through the same exact thing at our 9 month check up- our little guy is exclusively breastfed and was getting 3 solid food meals a day, but his percentiles went down, so our doctor had us come in in month later for a weigh-in. He had said if he didn't gain we would have to add formula or even nutrition shakes! Of course this made me feel bad for numberous reason, all of which you probably went through too. Breastfed babies tend to grow faster the first 6 months, then slow down, and for formula babies, it is the opposite. As long as she is healthy, I wouldn't worry about it. When we went back a month later, the doctor said he was progressing fine, and wan't concerned at all. So, I think we honestly stressed ourselves out for a month over nothing! Best of luck.

My daughter wouldn't take formula until I started making her cereal with it at about 5-6 months. She liked being fed food with a spoon, and it got her used to the different flavor. Your daughter is definitely old enough she should be getting some food at this point, and that will help with her calorie intake and weight gain too. Try cereal made with formula, and she probably should start on veggies and fruits too. Our kids were almost exclusively on table food (soft and cut small) by 10-11 months. Good luck!

I would contact your local Lactation consultant and see just how much your daughter is taking in. (weigh before and after) I do not think I would supplement with Formula at this age. MY son is 10 months old now, and his wt droped a very small amount, but lets think about it he is moving more. My doc said to give him more protein. So we give him chicken, veggie burgers, turkey burgers, ham & beans two times a day. My doc also seemed to think that my little one was taking in too much milk, so I feed him solids first and then give him his milk. As long as your daughter is not sick (all the time), and has not lost weight I would not worry too much. Some kids slow down more than others.

Either get a second opinion or at least get with a lacation cosultant to find out how much milk she is taking in.

Good luck.

Someone has to be the 5th percentile! The only cause for concern is if she was 95% an suddenly went to 5. Are you and your husband smaller people? Is your other daughter small? 5th is not abnormal, it is just the lower end of the weight range.

I would try your local la leche league. I would also consider cutting back on solids, or after nursing give some solids to supplement rather than formula. Solids do not have the calories and nutrients that breastmilk has.

This is very bad advice from your pediatrician! Expecially at 9 months when you have obviously done a great job sustaining her on your milk until now. I would find a new ped or get a second opinion, but I would also consult either a lactation consultant or la leche league since it is apparent that you ped is not very well educated on breastfeeding. Good luck.

At 9 months I would nurse on demand and supplement with solids instead of formula. Has she been dropping percentiles? If she's been tracking 5-10th the whole time I would not worry. Also see other coments about supplementing w/ pumped milk - there is no reason you need to give her formula at this stage I don't think.

Avoid formula. I was in the same situation. Your little love was made for breastmilk. Breastmilk has 10-15% fat. Our doctor said less table food and more breastmilk until 9 months of age. She suggested skipping lunch and sticking with only 2 meals/day. In addition she said to pump and use breastmilk exclusively in our son's cereal - 2 oz in the am and also pm. Maybe you could try this for one month since your baby is already 9 months? A jar of sweet potatoes or chicken dinner has ZERO % fat. Yes, there are those who will say it is crazy but I can tell you it worked. Our son was lazily nursing at 6 months because he was so filled up on a big baby food lunch but he nursed very nicely after we started skipping lunch (yes, he was hungry!) and he gained almost 2 lbs in the month after we had our 6 mo. appt. Of course, you must take the time to pump to achieve this. I pump right before bed and get 3-4 oz to use the next day. Email me for more details as I am adamant about nursing until he's 1 year old. You made it this far - good job and keep it up!

At 9 months your daughter is discerning and knows when something is not as good as MOM!I would suggest a bit of baby cereal that is warmed with milk and spoon fed to start the feeding. She is old enough for a few spoons of it...If you can express some milk of yours it might make the transition easier...Do not try to fatten her up she sounds like a treasure.Yuck on those formulas...I breast fed all 3 of mine and I hear too many terrible things about those formulas...Does she ever get a bottle of juice? Real juice no sugar watered down juicy...Smiles, D. J

N.,
Your daughter is just fine. It is quite normal for breastfed babies to become leaner around the ninth month. Those charts they use are based on formula-fed babies who keep gaining weight, but breastmilk changes when babies start solids to accommodate their changing diets. My baby did the exact same thing and my dr. told me to supplement. I did some research and talked to a LLL leader, who said this was normal. My daughter is now two years old and is perfectly healthy. She's in the 75th %tile for height, and 10th %tile for weight, and I figure she'll stay that way through high school. You don't need to supplement with formula. If she still looks hungry, just put her back to the other breast, even if you already used it. There's always more breastmilk in there.
Best of luck to you.

Congrats on breastfeeding for 9 months! I've done all of mine past a year and recently saw how rare that is. I wonder if this is why...

If there is really a concern about weight, (which I don't see unless the curve has drastically changed), what about her other meals? I assume you feed her fruits, veggies, etc. Should she be given more then?

If it's the milk supply you could try pumping after you feed her to build up your supply a bit, but at 9 months, she's the one who regulates it, if she was hungry, she'd nurse more.

You could try formula before nursing (just an ounce or two) and see if she takes the full nursing.

Doctors wanted me to supplement my 7 month old twins and I refused-we had a few issues, but with a lactation consultant, things were fine after a month. A friend is still struggling with her 4 month old twins because she did supplement them (doesn't have enough supply). (Sorry, only have twin examples right now).

You can always ask for a second opinion.

Good luck!!

I would just keep breastfeeding her. My ped. also told me to supplement and my son fought me tooth and nail not to eat the formula (he hated it), but I made him drink it anyway and eventually (at 8 months) stopped breastfeeding because the formula was easier. Now my son is almost 2 and has eating issues. If I show him food he runs away. He hates to eat. I blame myself for this, because my thoughts keep going back when he didn't want the formula either but back than he didn't have a choice. Keep breastfeeding, your baby will be fine and healthier. I wished I kept breastfeeding my son. Hopefully you have introduced her to infant cereal and fruit already.

I just wanted to chime in with many others--don't do the formula!!
Unless there are other health concerns, which it doesn't sound like, then really so what on the 5th percentile? My pediatrician doesn't even use them, as you're comparing to other girls without any regard to genetics, health, activity level, formula vs. breastmilk. A breastfed baby will typically weigh less, as they are not eating unnecessary fillers.
My girl is still in the lower birthweight, at 14 months, and we are only breastfeeding at sleep times. She is able to dirnk milk and eat other solids, but she's too busy and therefore lightweight. My doc says she's fine, as she's growing and learning. Ask more details from your doc why he would push the additives and cost of formula at 9 months. Maybe see another doc for another opinion. My doc is Fred Ettner out of St Francis hospital, if you need another opinion.
Good luck, and be proud of yourself for caring about your kids' health!

Have you tried mixing a little bit of formula with your breast milk? Gradually up the formula and cut the breast milk. You can still nurse, I nursed and then bottled every other feeding and it worked fine.

The chart that your Dr is using may be based on formula fed babies. I believe they have come out with a new chart for breast fed babies since there is a significant difference in what each contains.
My daughter was always in the 3-5% and I breastfed her as well. She was petite but very active and showed no signs of any delays. There is no reason to add formula unless her weight is dropping or she seems lethargic or shows other signs of possible delay.
If you are really concerned you may want to add rice cereal (mixed with a little breast milk) to her daily diet. This way she's still getting the wonderful benefits of the breast milk but also getting the extra iron and calories from the rice cereal.
I would talk to a nutritionist or Lactation consultant if you have more questions. Otherwise in my opinion she's probably just fine. My daughter is almost three now, still petite, but more active than most kids her age!
Best of Luck!

Has she been losing weight? If she hasn't been losing, I wouldn't worry about it. Perhaps see if she'll nurse more often instead. My daughter was in the 5th percentile for the first two years of her life, she kept to her own little curve and is just fine. She was just smaller. Neither one of mine would touch formula and the didn't really care for baby food either, just began solids when they were old enough to eat small table food.

Hi Natalie,
As a mother of 3, now teens, I have experiened this dilemma several times. Try mixing 1/4 formula with the breast milk first (ie: 2.oz formula to 6oz breast milk). If she tolerates that well, after a few feedings move up to 1/3 formula, then 1/2 & 1/2 , and so on until she takes all formula.
Take your time. It's no hurry.
Good Luck
Mama Robyn

N.
Could you also try goats milk it is the closet to our human milk in the protein chain. Since she is eating try giving her some different kinds of cheeses too. Good Luck!
J. O

I breastfed my daughter as well. When I needed to start giving her some formula, I mixed my pumped milk with the formula (instead of water) to help her with the transition. It seemed to work for me. Give it a try.

Good Luck

My daughter was 8 months when we switched to formula. The trick for us was to make sure it was warm enough. She was used to the temprature of the breastmilk, so we warmed up the formula enough that it seemed almost too warm. (Check the temp on your wrist or take a sip yourself...it is gross though! lol) Gradually, we were able to give it to her at room temp. She'll adjust to it if you stick to it. Good Luck!

Exclusively breastfed - meaning no table food yet? You mention giving formula after nursing and eating, I imagine the eating is eating food! So, you are nursing along with giving her table food?! If you really mean exclusively breastfed, I would certainly suggest starting to introduce food!!! That could certainly help in the weight gain department!

I would mix it with lots of breastmilk - pump and start with maybe 80% breast milk and gradually add more formula. Also, when she eats rice cereal or oatmeal, does she have formula in that or breast milk? It is true the taste is quite different and it will likely take her a bit to adjust. I would just keep trying and start as I said with mainly breast milk. Also, formula is not awful. I breast fed my little one exclusively for the first 6 months and then mixed it as I was full time at work and the pumping arrangements were not good. while yes, breast milk is best, the doctor is right, a supplement may be needed here. The growth charts are from formula fed baibes but actually breast fed babies tend to gain more in the first 6 months and then less in the second six months and it sounds like your daughter has never been over the 50th percentile. So a little supplementation will likely be good for her. Definitely don't give her juice -there are very few nutrients in juice. It is mainly sugar and the low sugar variety is low sugar and still little else. good luck.

Hi,

Try watering it down as a way to transition her or mix in your breast milk with it. I had to suplement to because my kids ate tons and were eating much early.

L.

The reason your daughter is at the 5th percentile is because the doctor is using the older version of the WHO growth charts which are based on formula fed infants. Formula fed infants are typically larger because they may eat larger amts (are also more prone to obesity latter in life). Being at the 5th % is not bad if she is eating well and also taking some other foods such as fruits, veges, and a form of protein - maybe meat or even cheese/yougart. Formula has NO MORE calories than breast milk it may even have less. Your breast milk is perfectly suited to her nutrition. Her doctor suggested this just because he can't know exactly how much your daughter is getting. I would suggest that you pump 2-3 times a day after nursing her and give her Breast Milk in the bottle!
Just my advice as a mom of 2 healthy kids, plus I am a L/D nurse and lactation consultant.
Good luck.

I am not sure if you already had this suggestion, but I was worried about the same thing w/ my son. He absolutely hated anything but BM. My pediatrition had said that what I could do was slowly introduce it to him. So if I usually gave him an 8 ounce bottle of BM, then what I should do was give him 7 ounces of BM and 1 ounce of formula. Then when he got used to that, increase it to 6 and 2. And just keep doing that gradually. You could try that and see how it goes. It worked great for me.

You may have found some solutions that you like by now. In case you'd still like to hear some more suggestions, here are some resources that I hope might be helpful for you...

http://www.askdrsears.com/html/2/t023600.asp

http://www.askdrsears.com/html/3/T030100.asp

http://www.askdrsears.com/html/3/t031100.asp

http://www.askdrsears.com/html/2/t023200.asp

http://www.llli.org/NB/NBJanFeb98p8.html

http://www.llli.org/llleaderweb/LV/LVAugSep99p75.html

Best wishes,
J.

I agree with the others. I would call a LLL leader and run through your senario with them. There may be some things to "tweak" and if there are... it'll be easily correctable and if not - you'll have some peace of mind. You say she is exclusively breastfed. That technically means you don't give her solids. exclusive doesn't just mean breastmilk only, no formula. It means ONLY breastmilk. Has she always hovered around 5% or has she dropped? If she is dropping and you are NOT offering solids - you might consider starting but making certain you always nurse first and that she is still nursing at least 8 times per day.

Call a LLL leader, they are fabulous and free!

I had a similar situation with my son. I agree with the previous post, supplement with solids rather than formula. I just made an effort to feed my son more solids with higher calories (e.g., instead of just giving fruit, mix cereal with the fruit) and he was fine the next time we had his weight checked.