Monday, February 9, 2015

Our Introduction of Formula - Not an Easy One

It happened, my breastfed baby got formula.  And I freaked out.

I knew the time was coming for Baby Max to sample some formula, but I was just not ready.  As a registered dietitian, "Breast is Best" has been deeply driven in my head.  Honestly, I did not even have a plan beyond breastfeeding.  No back-up plan.  Nothing.

He was first given formula two weeks ago at preschool (aka daycare).  Max's teachers asked me to send one more bottle (in addition to the three we were already packing) with him because he was getting hungry towards the end of the day.   At first I tried to figure out how this 4th bottle could be expressed breast milk, but it was just not possible.  I was already breastfeeding or pumping every three hours.  I decided to take a risk and pack a ready-to-drink bottle of formula we received from the hospital in his diaper bag, hoping that I could pick him up in time before he would need the "extra" bottle.  Well, my idea didn't go as planned - a few day after packing the emergency extra bottle his teachers gave it to him.

At first I was terribly distraught over the idea of giving him formula.  Would it decrease my milk supply?  Would he not want to nurse anymore?  Would he tolerate the formula? So many questions were running through my head.

After a few days of struggling with these thoughts and a visit to the pediatrician, I finally accepted the thought of supplementing the breast milk with formula.  At Max's two months well check his weight was in the 10th percentile, falling from the 40th percentile at his one-month check-up.  His teachers also noted he was getting extremely upset and showing signs of hunger in between feedings. He needed more volume at each of his bottle feedings and I couldn't produce anymore. I knew it was time to supplement. (And yes I tried some alternative tricks to increase my breast milk with limited success)

Throughout my schooling, I was educated on all the benefits of breastfeeding.  According to the American Academy of Pediatrics exclusive breastfeeding for the first six months decreases a child's chances of being overweight or obese as they get older.  Breast milk also contains substances such as antibodies, immune factors, and enzymes that can protect your baby against numerous diseases and infections (both while breastfeeding and sometimes after weaning).

With that being said not every mom is able to exclusively breastfeed. There are a number of reasons moms are not able to breastfeed much or at all.  One of the main reasons is the inability to produce adequate amounts of milk.  In my opinion, the absolute most important aspect of feeding my child is to make sure he is getting adequate calories and protein to grow.  If that means I have to give him a little formula to provide adequate nutrition that doesn't make me a bad parent. Not all moms are able to breastfeed -  I feel blessed to be able to provide my baby the current amount of breastmilk.

Our current schedule involves nursing him before we leave the house and before he goes to bed.  At school, he is fed two-5 oz bottles of expressed milk + one-5 oz bottle that is usually a combination of breast milk and formula.  Sometimes he has a 4th bottle at school of formula or he is nursed immediately upon arriving home.  Of note: I always make sure the combined bottle of formula and breast milk is given to him during his first feeding.  Unlike breast milk that can stay refrigerated for up to 3 days, prepared formula can only be refrigerated for 24 hours.

So what formula did I decide on?
Other than the initial bottle of formula Max received, we have been offering him an organic formula. I personally wanted to provide him with a  formula made with organic cow's milk that was not treated with growth-hormones, steroids, or antibiotics.  This formula has worked for our family, but doesn't mean it is the best choice for all families.

Give breastfeeding the best shot you can.  Seek support from friends and family. I am incredibly thankful for the support provided from one of my best friends. She has been a tremendous wealth of knowledge and offered encouraging words when I just want to give up.  However, if you can not physically breastfeed know that you are doing the best for your baby.

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