Allergic to Formula and On Nursing Strike!

Dear Lactation Consultant,
My daughter is five months old. She takes 4-5 feedings a day of about 8 ounces. She also has two "meals" of cereal and baby food. Up until about three weeks ago she was only getting breast milk. I had to begin supplementing her with formula because I didn't have enough milk stored up for her to drink while I was at work. She couldn't tolerate regular formula so we began giving her bottles with ½ breast milk and ½ soy formula. That worked ok so I thought we'd figured out our problem.But then she began to have a runny nose and spit up frequently and in large volumes.

She would not nurse because she was so congested. I took her to her pediatrician who told me to discontinue the formula, which I did immediately. Now her nose has cleared up, but she still will not nurse. Every time I put her to my breast she cries and will not latch on at all. It has been over a week since she nursed. Do you have any suggestions as to how I can get her to nurse again?

She has never had any problems nursing, but she does have a short frenulum. Could she be weaning herself? If so, can I continue to pump and feed her breast milk?

How long will it be until I will dry up? I'm extremely concerned because she appears to be allergic to formula! What will I feed her if I dry up? Thank you for any help you can give me!

Jody

ANSWER

Hi Jody,
I'm sorry to hear that you and your daughter are having a hard time right now. Let me see if I can answer your questions below. I think we can get her back to the breast. But it may take a little time.

My daughter is five months old. She takes 4-5 feedings a day of about 8 ounces. She also has two "meals" of cereal and baby food. Up until about three weeks ago she was only getting breast milk. I had to begin supplementing her with formula because I didn't have enough milk stored up for her to drink while I was at work. She couldn't tolerate regular formula so we began giving her bottles with ½ breast milk and ½ soy formula. That worked ok so I thought we'd figured out our problem.But then she began to have a runny nose and spit up frequently and in large volumes.

It does sound like she is sensitive to the formula.

She would not nurse because she was so congested. I took her to her pediatrician who told me to discontinue the formula, which I did immediately. Now her nose has cleared up, but she still will not nurse. Every time I put her to my breast she cries and will not latch on at all. It has been over a week since she nursed. Do you have any suggestions as to how I can get her to nurse again?

I think the problem she may be having is that your milk doesn't flow as quickly as from the bottle. So she is probably getting frustrated at the breast -- and then wants nothing to do with it. What we need to do is get her to have positive associations with being at the breast again. So that means we will need to transition her slowly back.

She has never had any problems nursing, but she does have a short frenulum. Could she be weaning herself?

Possibly. Or she is just getting frustrated. I don't think her frenulum is the issue at this point.

If so, can I continue to pump and feed her breast milk?

Absolutely. In fact, it would be a very good idea for you to continue to pump to maintain your supply.

How long will it be until I will dry up? I'm extremely concerned because she appears to be allergic to formula! What will I feed her if I dry up? Thank you for any help you can give me!

You will need to empty your breasts 8-12 times a day. Check out our resource sheets on milk supply at BreastfeedingMadeSimple.com. There are more specific suggestions on how to maintain a supply. You may consider renting a hospital grade pump for the next month or so until things are back on track.

Here are some suggestions to get your baby back to the breast. First, try to catch early hunger cues. When your baby is smacking, sucking on her hands, etc..., try bringing her to the breast then. If she become upset, stop and go ahead and feed her with the bottle. Toward the end of the feeding, when she is not frantically hungry, try bringing her to the breast again. If she becomes upset, continue with the bottle. Don't try to force things (that will only make it worse).

You might also try her at the breast before she is really hungry. Sit with her, skin-to-skin, and just be with her. That will often trigger those feeding reflexes--even in older babies. If she bobs towards your breast, just support her and let her try. In the meantime, continue pumping and using a bottle. It's extra work, but it won't be forever. The main thing you want is for her to have happy, pleasant experiences at the breast.

Give that a try and let me know how it is going. And you can definitely maintain your supply with a pump in the meantime. www.Ameda.com also has some information on maintaining your supply with a pump.

Good luck and please keep me posted.

-- Kathy

Kathleen Tackett

Dr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, and Research Associate Professor of Psychology specializing in women's health at the Family Research Lab, University of New Hampshire. She is a Fellow of the American Psychological Association in both the Divisions of Health Psychology and Trauma Psychology. Dr. Kendall-Tackett is a La Leche League leader, chair of the New Hampshire Breastfeeding Taskforce, and the Area Coordinator of Leaders for La Leche League of Maine and New Hampshire.

Dr. Kendall-Tackett is author of more than 140 journal articles, book chapters and other publications, and author or editor of 15 books including The Hidden Feelings of Motherhood (2005, Hale Publications), Depression in New Mothers (2005, Haworth), and Breastfeeding Made Simple, co-authored with Nancy Mohrbacher (2005, New Harbinger). She is on the editorial boards of the journals Child Abuse and Neglect, Journal of Child Sexual Abuse and the Journal of Human Lactation, and regularly reviews for 27 other journals in the fields of trauma, women's health, interpersonal violence, depression, and child development. Dr. Kendall-Tackett is the "Ask a Lactation Consultant" columnist on Pregnancy.org and serves on the Board of Directors of Attachment Parenting International.

Dr. Kendall-Tackett received a Bachelor's and Master's degree in psychology from California State University, Chico, and a Ph.D. from Brandeis University in social and developmental psychology. She has won several awards including the Outstanding Research Study Award from the American Professional Society on the Abuse of Children, and was named 2003 Distinguished Alumna, College of Behavioral and Social Sciences, California State University, Chico.