I have a 6-month old baby girl. I am thinking of switching to formula feeding completely. I have been supplementing about 4oz formula each day because I don't have enough breastmilk. For the last couple of days, I gave her 6-8 oz formula and she seemed to be constipated and passing gas. Maybe it takes a few days for her to get used to? Any advice? Thank you!
what kind of formula are you using? i know that Enfamil makes a kind for gasey babies. it also could be the bottle. i had to get my daughter the playtex dispoable ones cause the other kind she had gave her bad gas to the point that she'd be in pain. hope that helpd good luck
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M.S.
answers from
Los Angeles
on
I had the same problem when my daughter was 6 months. I wasn't make enough milk. Have you tried mother's milk tea...it works to boost milk production. my lactation consultant recomended it. When I change my daughter to formula and from formula to whole milk it was a struggle. Try changing the formula, I used the costco brand, which was cheaper and advice from my lac consultant. The only thing is that it's foams up, but it worked for my daughter, niece, and neighbor's baby.
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S.H.
answers from
Los Angeles
on
I had to do the same thing little by little phasing out breast milk and found that I had to try several formula brands before I found one that agreed with my baby. Enfamile gave him gas. Kirkland made him constipated. Simalak was just disgusting and smelly. For us the Nestle Good Start was the best (the orange label - the green also gave him nasty gas). But you should wait a couple days before deciding to switch, just in case it's a fluke.
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A.O.
answers from
Los Angeles
on
Hi there!
I went through SO many eating issues with my little one because he had so many tummy problems. I breastfed for the first 3 months with no formula, but then at almost exactly 3 months to the day - I just dried up!! I had some frozen breastmilk, but the first 3 types of formula we tried he threw up almost immediately and had horrible gas and other problems.
We tried the regular Enfamil with Lipil (yellow accents on can) and he couldn't keep it down at all.
Then we tried Enfamil Gentilease (purple accents on can) which is supposed to help with problem tummies - NO luck!
FINALLY we used Enfamil ProSobee with Lipil (blue accents on can) which is the SOY alternative for the other formulas. IT WORKED!! He was on it for the first 6 months until he reached 9 months of age and then we switched to Enfamil ProSobee Next Step from 9-24 months.
Even now at 27 months, he usually drinks Organic 2% milk, however he still likes his formula at night before bath time and then first thing in the morning :)
Good luck!! Just keep trying until something really works.
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J.O.
answers from
Los Angeles
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J., I am a pediatrician, and my first bit of advice is NOT to give goats milk. It causes babies to get anemic. I have a ten month old daughter who I could not keep up with at about 7 months, despite the fact that I produced like a dairy cow for the first five months ;) I had to go back to work full time also, and what I would advise if you want to start supplementing (of course breast feeding is best, but sometimes it is simply not feasible) is do what several of these excellent mothers have suggested, mix formula and breast milk together while you are switching over, Start with 1/3 formula and 2/3 breast milk, and increase the ratio of the formula daily. Also, I had great luck with Nestle's Natural Cultures (the green can) but all babies need sometime to change their digestive system's from mom's milk to cows milk. It is the difference in the makeup of the protein. Her bowel movements will be very different also, but that is normal. If you do feel bad about going to formula, stop feeling bad. Formula is incredibly well designed, and provides babies with nearly 100% of the necessary nutrients as breast milk. Hope this helps, dr. J.
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A.D.
answers from
Los Angeles
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I am pumping exclusively (to see exact amounts of bm that I am producing) and supplementing with formula. I too just was not producing enough. I have taken Fenugreek recommended by our MD to increase my supply and it has helped. However, I don't produce enough milk for her daily. So, I supplement with Enfamil with Lipil. The ready-to-use I felt made my dtr have blow outs when she would poop. I switched to the powder and I am having better luck.
FYI a baby is not constipated just because he/she hasn't pooped in days. They are considered constipated if the poop is hard like pellots. My dtr went 6 days without pooping when she was on more bm than formula and the MD told me to giveher 1oz apple juice and 2 oz water. 2 days later she had a HUGE blowout.
Hope this helps.
A.
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T.L.
answers from
Los Angeles
on
Some babies just can't handle formula. If you stop the formula all together and nurse a few extra times a day within a week your milk supply will increase and you won't have to buy that expensive nasty formula (have you tasted that stuff)? Drink more water and this will help with the increase in your milk. If you switch to a soy based formula that helps with the constipation as well.
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B.G.
answers from
Los Angeles
on
It's very unusual for a mom not to produce enough breastmilk for her child. Try using a Supplemental Nursing System to both give your daughter the amount of milk she needs and stimulate your milk supply. Also, you can try pumping more at work. Formula is hard for babies to digest, which is probably why your daughter gets constipated and gassy after ingesting it.
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S.O.
answers from
Los Angeles
on
Try Gentlease or Nutrimigen. They're designed to be a little gentler on the stomach and hopefully reduce gas and constipation.
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C.A.
answers from
Los Angeles
on
Is there any milk allergies in your family? If yes, do not use any formulas that have a cow's milk base, but you can probably use a soy based formula. My advice is if you are a stay at home mother then breastfeed as much as you can. Because of milk allergies in my family and my husband's when I went back to work I used a soy based formula but ALL THREE of my children became allergic to that after about six months, with green loose diarrhea. My daughter was also allergic to non fat cow's milk. Finally, my mother-in-law suggested goat's milk, and like a miracle the diarrhea stopped and she gained weight. So if on any formula of milk base or soy base you get gas, green diarrhea, or a combination of both see your doctor immediately. If you use goat's milk, you must supplement with iron and other vitamins but your baby will get the right amount of very digestable protein. I used canned goat's milk and keep it in the fridge already diluted in a container. As toddlers and preschoolers I used one can per day per child which is about one quart diluted. About age five I switched each child over to nonfat cow's milk and we really haven't have too much problems except for one son who feels better off all cow's milk products but does consume goat cheese. Good luck.
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T.M.
answers from
Los Angeles
on
Hi J.,
Don't know if you've read some of the other emails about a Mom who couldn't get enough breast milk going.
But, if you want to HAVE more breast milk, and now you are supplementing only because you don't have enough.....then my suggestion is the same as to the other Mom. Organic carrot juice helps stimulate the milk. Try some from the brand Naked Juice, you can find it at Costco, Trader Joes or Henry's. It's actually in more places then it used to be.
The other suggestion, which is the one that I have found with not only myself but with all the Moms around me that works the best...is a tea from Traditional Medicinal called - Organic Mothers milk tea.
It really works great! Drink it hot a few times a day...or make a pitcher of ice tea from it and drink it during the day. It would help me in making so much milk I'd have to only drink the tea every few days. By the time my daughter was 6-7 months I didn't need it anymore. But it can still help you at this point.
I'm sure you already know the more you actually nurse - not pump - will also bring on more milk?
Breast Milk is the best on any given day for your baby. Especially if you could keep going for awhile longer until she is eating more solid foods and then you won't need either formula or breast milk.
Formula's are tricky. Every baby is different. And by the time you 'experiment' with different formulas until you find the right one for her body....you could just be making a bigger effort towards continuing trying to make the breast milk for her.
If you do end up having to switch to just formula....I believe the whey protein versions are the least hard on their system. The proteins are more easily broken down in their systems. You might want to stay away from those that have iron...I believe they can cause constipation and gas.
If you do go with formula check with your pediatrician as well, since she may know which to try first that is the least invasive for your daughter.
Good luck and don't give up!!
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C.C.
answers from
Los Angeles
on
i used enfamil, and for the gas try dr brown bottles they eliminate the air in. good luck.
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P.G.
answers from
Los Angeles
on
Hey J.,
It does take a few days for baby to adjust to formula. Once she switches though you will find relief. I tried to only breastfeed, but my milk supply was running low too. With our last son, I breast and bottle fed and found it was so much more convenient. It took a lot of pressure off me and I was less stressed out. I think you will find that you are making a good choice - do what works for you.
Good luck.
P.
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S.H.
answers from
Los Angeles
on
could be... because breastmilk is gentler to the stomach... and has a higher water % than formula... just give your baby more water during the day
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B.M.
answers from
Los Angeles
on
Dear J.,
I would think that maybe giving the baby a little water or fruit juice would help the constipation. Check with her doctor. I would also ask her doctor if maybe there is a milder formula you can use. When I was told to wean my daughter, she had loose stools and I was told to put her on something that was lactose free and corn free, so there are all sorts of options out there - you probably don't want to switch around too much, but you can talk to her doctor about what's going on and see if she thinks there is something that would work better for your daughter.
Good luck!
B.
I see that someone advised you to get up every two hours during the night to feed her to build your milk supply. If you opt to do this, I would be careful. I had a baby that slept through the night before six weeks (all I remember for sure is that she was sleeping through before I went back to work.) At six months I was told to feed her "around the clock" - meaning wake her during the night to feed - which I thought was insane! - I never heard of waking a sleeping baby to feed them, I thought sleeping through the night was the normal goal. Anyway, I ended up with a little girl who still had trouble sleeping all the way through the night at four and five years of age, and I couldn't figure out why she kept getting up - my mom was the one to make the connection with the fact that I had to wake her during the night when she was a baby.
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A.D.
answers from
Honolulu
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Aloha J.!
I've totally been in your exact situation, so I know how you feel. My 14 month old went through the same thing as your 6 month old at her age. Yes, it takes a little while to get used to. You can ask your pediatrician for advice....I got some samples on helpful formulas and ended up going with either Enfamil Gentlease Lipil for gas and fussiness or Enfamil Soy. Also, Little Tummies helped my baby to pass gas at that crucial time of transition. There is a whole line of those "Little" products from tummies, to noses, etc. And it was okay for my 6 month old...Hope I helped.
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K.D.
answers from
Los Angeles
on
Hello J.,
Try talking to her pediatrician about it. My sister's baby was also having tummy troubles when she was doing the transition from breast to formula. Her pediatrician recommended a different formula and she's been fine ever since.
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L.H.
answers from
Los Angeles
on
Are you only switching because you don't have enough breastmilk or do you wish to give up nursing? If you want to continue nursing I would go see a lactation consultant (referral through your ped or even hospital). They can recommend a pumping schedule to increase your milk supply. Also, there is an herb called "fenugreek".
I am still nursing an 18 month old and it was TOUGH in the beginning because she didn't latch on right. But, I pumped, took fenugreek, and supplemented until she figured it out.
It's hard work but it can be done... supply and demand! If your body knows you will give formula and your baby doesn't "need" you as much, that too will decrease your breastmlik supply.
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B.Q.
answers from
Los Angeles
on
My daughter had the same problem, when I started giving her formula she didn't want to take my breas anymore. So, for the gas I gave her a drop of the gas medicine and she did much better.
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B.M.
answers from
Los Angeles
on
I found that the formula with iron in it, or extra iron in it, caused my daughter to be constipated also. You may want to ease her into formula using a formula not containing iron and gradually add the iron-rich formula in a week or month. Or, alternate the iron formula with a non iron formula until her system adjusts. I think iron is important so you probably don't want to eliminate it completely and forever but it does cause constipation so you may want check into that.
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C.R.
answers from
Las Vegas
on
Just like when switching from formula to milk, you have to slowly when. Try mixing 1 ounce formula with the breast milk for about 2wks. If it doesn't upset her stomach, then put in 2 ounces and so on, until it's all formula. I went through it with my daughter. Let me know how it goes. :)
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A.G.
answers from
Los Angeles
on
Try switching formulas. My docor says that his experience says that between the Enfamil and Similac. The Enfamil products are less constipating.
She may have a milk allergy. Try the Gentlease or Prosobee to see of the gas goes away.
Good luck. My four month old went through several formulas before I started Nutrramigen. It is the expensive stuff, but his body could not handle the other.
A.
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A.H.
answers from
Los Angeles
on
She is probabaly lacking the MINERALS required for her bodily operations. There are only 11 or 12 minerals in baby formula.
How is your Nutritional intake? I would suggest you add some extreme x2o into the formula (and yourself)...I found that when I DONT add it, my little Tyler gets constipated....
There are over 70 trace minerals in the x2o. He has been on the X20 since his first week of life.....e-mail me direct at ____@____.com and I will guide you, or even go the the xooma website, www.xooma.ca
A.
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M.B.
answers from
Reno
on
First off, congratulations on breast feeding for 6 months!
If you're looking to increase your supply, there are so many things you can try. Some have already mentioned Fenugreek, there is also a tea called Mother's Milk (Pink and white packaging) that tastes a little like black licorice. I used that. Also a beer or two during the week worked wonders for me (Some disagree with this but it worked for me in increasing my supply and I know others it worked for too)
As for the formula, if you still want to go the formula route, just stick with Enfamil with Lipil. I recently read several studies about soy formula being linked with peanut allergies (as well as legume based lotions and creams). If she seems to be having stomach upset there's a few reasons. First off, no matter what they do, formula will never be exactly like breastmilk. So essentially, you are introducing a new food into her diet. I would cut the formula down to maybe 5 oz for a few days and then slowly increase it. You may also want to look at the type of bottle you are using. Make sure she's not swallowing a lot of air when she eats.
She's also at the age where you're probably introducing solids. If you're feeding baby cereal that's iron fortified and the formula is iron fortified, increased iron can cause constipation too.
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M.P.
answers from
Los Angeles
on
Hi J.,
My dauthter just turned 1 but I went thrue the same thing your going thrue. I also breast fed my daughter but I found my self not producing as much milk once I started to
pump at work and my daughter also became constipated. My doctor advice to give her water down apple juice and it
really seem to work!
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D.L.
answers from
Los Angeles
on
J., I know how hard it is to work and breastfeed, but I reccomend that you do it for as long as possible. Not only is it better for baby and free but formula is so hard on their stomachs. I know lots of mothers that have spent lots of money and lots of hours trying to find a formula that does not constipate. Pump and nurse until your milk supply is gone then go to full time formula. I have heard good things about Goodstart by Nestle as a more gentle formula. Keep at it and you won't regret it!
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K.H.
answers from
Los Angeles
on
I had the same exact problem with my first and we switched to Good Start formula. It has less iron so it gives them less constipation. We also gave threw a little prune juice in to her bottles (ask your Dr. how much - I don't remember the amount, but it's NOT A LOT). It worked great for her and Pavilions has a generic brand of Good Start that is much cheaper and the exact ingredients!
Good luck - breast feeding is hard!!!
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A.C.
answers from
Las Vegas
on
Take the herb fenugreek & drink mothers milk tea. Both you can buy at whole foods. Also, whenever possible, get in a hot shower and stimulate you nipples under the water. The combo should up your supply. Also nurse, nurse, nurse!!! I wish you lots of luck & keep your head up breastfeeding your baby is the best thing you can do- be proud of yourself.
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A.C.
answers from
Los Angeles
on
It can take time to get used to the formula. Also, try different formulas. Find the one that works for her. You might also try the infant gas drops. They work wonders! Good luck!
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S.W.
answers from
Los Angeles
on
Yes! It could take up to a month for her little tummy to get used to the foreign substance!!! You can expect this to happen in the future with juice, rice cereal, even water! Hang in there :)
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H.P.
answers from
Los Angeles
on
Unfortunately, a lot a babies get gas and constipation when switching to formula. I have a two month old, and a week ago I stopped breastfeeding her completely. I didn't have enough milk for her. I also have a seven year old whom never took to my breast. For both of them I made this tea from fennel seeds. It helps relieve the gas and constipation naturally. It also helps relax the cramping that can occur in the intestines. You don't even have to give it to them everyday, just an oz. or so a couple times a week works great. I have also researched it and they have used the seed for colic as well, so it is safe:D Hope this helps:D
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D.G.
answers from
Los Angeles
on
Switch to Low Iron. That is what I had to use since I was still nursing too. It really helped.
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A.H.
answers from
San Diego
on
I gave both to my babies also and I think you have to ween in stages. Your baby's system isn't used to that much formula at once. Start back at the 4oz of formula and see if her constipation/gas goes away. Then gradually increase the amount of formula one oz every 2-3 days. This is how I weened my children because I didn't have much of a milk supply either. I hope this helps.
A. H
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K.F.
answers from
Los Angeles
on
Hi,
Formula can be hard on many baby's digestive systems. You might try goat's milk.
All the best,
K.
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T.O.
answers from
Los Angeles
on
breastfeeding is the best. Decide if you are supplementing because you want to be done with breastfeeding, or if you don't think you can make enough breastmilk. Once you make your decision, look into all the information possible. Once you have all the information, you can make an informed decision that will be right for you and your child.
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J.M.
answers from
Los Angeles
on
I used fenugreek and that increased my milk flow. I know you are asking about formula but I thought I'd put that out there if you want to stick with pumping. It's possible you've tried all these things already so excuse me if this sounds presumptuous. :)
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M.M.
answers from
Los Angeles
on
I too did this with my son. It was constipated for a bit. I asked my doctor about it and he told me that he goes over three days or he is really constipated then you can put some prune juice in the formula or give him a bottle of filtered water. I did not juice and it worked. So if I gave him 4oz, two were of the baby gerber prune juice.
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N.V.
answers from
Los Angeles
on
Well no wonder you are not producing enough milk, another child and working, you seem overwhelmed, as did I when I had my second child. The reason your baby may be getting gassy and constipated is that the formula is not agreeing with the baby. Try a new formula, I had to put both of my children on the Soy Formula because their little bodies didn't like any other and had problems. Try it out, and good luck
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C.F.
answers from
Los Angeles
on
Try using the soy formula. It usually works when transitioning from breast milk to forumula. That is what I did with all three of my children (8,5,& 2). It helped a lot.
Good Luck!
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D.D.
answers from
Los Angeles
on
are you using Good Start Supreme comfort protiens? that one was the easiest on my son's belly..you know if you switch you have to introduce the formula slowly..colic tablets also help w/ the gas..i always thought i had a low milk supply but i'm still bfing and my son is almost 2! if you want to build your supply there is this stuff called DOM aka motilium you should google it..when my son was 9 months old my supply really dropped..so i took it for 2 weeks and i was also pumping and went from one ounce to 6 oz's again.
well you might need a formula that is easier on your babe's belly..so try Good Start Supreme comfort protiens..it's the closest to human breast milk i think on the market.
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L.D.
answers from
Las Vegas
on
the first thing i want to say is i had serious production problems and couldn't produce enough milk to breastfeed... and it wasn't for lack of trying. yes, the "breast is the best", but unfortunately it doesn't work out for some of us.
my son started getting constipated at about 6 months. we started using gentlease by enfamil and that seemed to help. our pediatrician also recommended miralax (1/2 teaspoon to 6-8 oz of formula) when all other recommendations didn't pan out(4-8 oz of juice a day, lots of fruit, etc.). when our son gets real backed up we use babylax glycerin suppositories. that induces a bowel movement very quickly in him.
good luck...
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M.B.
answers from
Los Angeles
on
Your "pumping" and extremely busy life is cause anxiety --simply use a nother "prepared" feeding You have given her a good start, now you can relax and she will too, making it easier to be more regular in her bowel movements, and not so gassy.
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R.R.
answers from
Reno
on
I wasn't able to breast feed so my son was a formula baby. His constipation was awful. We would put a capful of prune juice in his bottle and that fixed everything.
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B.F.
answers from
Los Angeles
on
It's a slippery slope - the more you supplement with formula, the less breast milk you're gonna have since you're not breastfeeding as much and then the more you're gonna want to supplement because you THINK you don't have enough milk, etc., etc. Your baby's reaction to the formula says it all - formula is not as easy to digest as breastmilk. My advice would be to be diligent about keeping your milk and trying to increase the supply so you don't have to formula feed. Pump more, nurse more, try the Mother's Milk tea. Good luck!
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M.B.
answers from
Los Angeles
on
First of all, let me say, "Congrats for breastfeeding for six months"! Second, the person, Cheryl S., needs to keep comments like that to herself. I hope you ignore her comments.
Anyway, I breastfed for the first few months until I returned to work, as well. I switched my daughter to Enfamil with Lipil, per the direcion of our Ped. She had some gas issues, so we switched to Enfamil Gentlease. It's easier on their tummies. This, in combination with Mylicon drops, if the gas gets too bad, worked great. She is now 18 months old and a great eater. She loves her milk and it does not bother her tummy. She loves all kinds of food and is not picky. Good luck!!!
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J.I.
answers from
Los Angeles
on
Hi J.,
I gave up on breast-feeding when my daughter was about 6 months because she just wasn't getting enough. When I moved to bottles I found that she had gas problems. I got her onto a bottle designed to help elimiate gas - Dr. Browns. The bottles helped, but we also had to put some Little Tummies in her formula (check with your pediatrician first). Also, if your little one is having a very hard time with formula you can work with your pediatrician on finding one that won't be too hard for her little stomach to digest. If the doctor perscribes a certain formula you might find that insurance will help pick up some of the cost (since they can be pretty expensive).
I hope everything works out!
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D.S.
answers from
Los Angeles
on
First, I think it is very brazen for people who do not know you or your circustances to be dictating what it takes for you to be a good mother. People are entitled to have opinions about what is best for their own lives, but what you choose to do is none of their business. Such judgmental mothers are fortunate to live in a world evidently uneffected by increases in the cost of living, rising mortgages and extraordinary educational expenses--a lot of us just do not live in that world.
Secondly, and with respect to the question you asked, I would try a different formula. Talk to your pediatrician. It may be that her stomach is sensitive to the formula you tried. I have some friends who had to try three or four before they found one that worked for their baby.
Good luck!
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S.M.
answers from
Honolulu
on
It could a combination of her body getting used to formula milk and the formula used. You may have to try switching to a new formula all together (slowly of course to get her body and taste buds used to something new). This is what happened to my daughter when she was younger. We found that using mylocon, (i think this is how you spell it) used to help babies with gas problems, did wonders for our daughter. It really helped make her stomach feel a lot better. good luck
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E.M.
answers from
San Diego
on
Dearest J.,
Constipation is common when switching from breast milk to formula. Both of my girls went through that. Unfortunately I wasn't able to breast feed my girls for more than 4 months each after they were born. I wasn't producing enough milk. What I ended up doing is feeding them at least 3 bottles of water a day and sometimes feed them at least 6 -8 oz of baby prune juice. At least a 1/2 hr or so before feeding them their formula. At first they were fussy when drinking the water and prune juice, but they got used to it. Your baby will reject the water and juice but given enough time and hunger, they'll take it. Sometimes tricking them into drinking it helps. I used to have two bottles ready when feeding time came along. I would start with formula for a little while and then switch the bottles just so they got used to the taste. But as we both my know, each child is different. I used also rub their tummy while they ate, it helped the gassy feelings they would have. Even now when my girls are 7 and 3 I still rub their tummy when their constipated.
Good luck,
E.M.
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K.S.
answers from
Los Angeles
on
Set your alarm and get up every two hours during the night and nurse her, drink lots of fluids and your breasts will make more milk. You will be sleepy at work but you'll get thru.The gas and change in stools is from the formula, it will get better but she needs your milk not formula.
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J.R.
answers from
Honolulu
on
I mixed feeding my son until he wasn't interested in breast feeding at about 9 months. I did find that while all the formulas are regulated for minimal nutritional value, different formulas reacted differently with my child. We ended using the most expensive one, but he was happy, (the Dr. gave us a free sample - and he liked it. It was a Similac brand) and we had no problems. I tried some others but I realized he had bad gas with one and that he liked the one brand the most. You might want check different formulas, and consider doing both breastfeeding and formula!
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R.R.
answers from
Los Angeles
on
hi! you could try either soy or nutramigen or the nestle that is broken down for easy digestion....
It worked like a charm. Unfortunately its a little more expensive (she called it the cadillac of formula's) but they used it right up until they switched him to solids and he never had issues again. Good luck!
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S.S.
answers from
Honolulu
on
Try a non-dairy based formula. Cow's milk protein's are very difficult fo babies to digest. To increase your milk supply you could try some herbs liek fennugreek, Mother's Milk Tea, Red Rasberry Leaf tea, or Brewer's yeast.
Your doctor may be able to give you samples of different formulas to try so that you don't have to waste money.
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R.R.
answers from
Los Angeles
on
Hi J.,
Just give her a few oz. of water in between feedings, to help hydrate her. My 2 month old had crystals in his urine, and the dr. said that he could be getting a little dehydrated from the formula, (he was also constipated). So she told me to give him a couple of oz. of water and it helped. Good luck!
R. M
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H.C.
answers from
Los Angeles
on
I nursed for the most part but when I DID do some formula I liked the Carnation Good Stars, it seemed the mildest.
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S.L.
answers from
Los Angeles
on
my son also had some difficulty switching to formula, but after about two weks he was great. Maybe infant milocan might help, but just be patient it will pass.
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D.C.
answers from
Los Angeles
on
Hi J.,
I supplimented from time to time to give my husband a chance to bond with my kids. I have 3 kids, ages 12, 9, and 6. I had the same problem with formula. My pediatrician is awesome!! He recommended Isomil with Iron. It is a soy based formula which is easier to digest. I no longer had a problem with gas...but if your baby still has gas...my best friend to carry with me all the time was Mylecon infant drops. The easiest way to give the dose is put it in about 1 ounce of formula shake to mix, give to baby and then give the rest of the formula. That way you know that the baby has taken it. Hope this helps....good luck, let me know if you have any other questions.