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Have you seen a lactation consultant? They can help you figure out how much to supplement.

At that age we supplemented 1-2 oz after each nursing session - but every baby is different. She was tranferring about 1.5-2 ounces from a good nursing session.

I feel like this is the hardest thing about supplementing, especially because it changes so fast. Around that age I was offering 2-3 oz of formula at every feeding, which was 7-8 times per day. I had done a weighed feed early on and DS had transferred only 20cc. He was also a lazy, sleeper eater, so I didn't trust him to show hunger cues in the beginning. He used to fall asleep multiple times during nursing.

As he grew he definitely let me know when he needed more at the end of a feeding, so I started increasing the amount I gave him 1 oz at a time. I tried to go by the rule of 2.5 oz per pound of body weight for total daily consumption. As my supply got slightly better, I could pump up to 2 oz. I assume he's getting 1-2oz from me at each feed.

Now at 13 weeks, he weighs 15 lbs - over 6 lbs up from birth weight and right on his curve. He's cut down his feeding frequency so he's taking 5 feeding during the day with 4-5 oz. formula plus nursing at each feeding. He nurses 1-2 times at night to get back to sleep. He takes about 6 oz. of formula per feeding when he's with the nanny once a week.

I will say that there are definitely times when he overfeeds from the bottle, but it just means a ton of spit-up. That's how I know he probably needs a little less.

@mrsrugbee: Maybe the LCs at my hospital weren't great, but I had one tell me she didn't know how much formula to recommend. She told me to ask the ped. The ped said it sounded like what I was doing was fine. Gee thanks for the expert advice. Thank goodness for the Internet!

At 6 weeks DS was taking 3-3.5oz bottles. We did combo nursing, pumping, and supplementing at that age. We would usually assume he was getting 1-2 ounces a nursing and then offer 2 ounces afterwards and he would take what he wanted. He would start playing with the bottle nipple when he wasn't hungry anymore. We gave him slow bottles and burped him frequently because he had reflux. So feedings took FOREVER.

@Kemma: Great point. I waffled between wanting to try to get to EBF (never did but nursed for 19 months) and just wanting a full happy growing baby. Ultimately I think my attempts to wean off formula were more stress than they were worth but maybe if I had been more hardcore we could have gotten to EBF? I'm in the camp - offer plenty but go slow and watch cues for fullness.

@ldh112: What is your goal? do you want to get to exclusivly breastfeed? If so I would make an appointment with an IBCLC asap. You can also rent a baby scale and weight your babe before and after feedings to get a better idea of what she is taking. Also you probably need to work on your supply, so I would recommend pumping after every breastfeeding session....
as for pumping, are you "hand on" with it? meaning do you do breast massage or compression while pumping? Are you sure you are using the correct flanges? an IBCLC can het your figure out why you aren't getting much output while pumping as well.

@ldh112: Glad that you figured out how much to supplement!

I'm wondering about what you said about your supply staying at what she needs... if that's the case you wouldn't need to supplement with formula, right? If you are ready to settle into combination feeding that's great - that's what we did! Just wondering what you meant there.

Hang in there! I remember how hard it was.

Oh man we worked soooo hard to try and keep DS awake. He was always a sleepy eater especially at the breast and never ate enough and then would wake up screaming hungry 20 minutes later unless we woke him up over and over again to finish his 3oz. So scheduling was really important - every 2.5 to 3 hours seems right except growth spurts.

Just wanted to say you are doing a GREAT JOB. My SIL kept texting me that when DS was an infant and I remember crying so hard because I had been killing myself over the BFing thing. What helped was that she went through the same thing two months prior with her son and she switched to pumping and combo feeding so I knew that she understood. Formula supplementation really helped DS and I nurse and pump as long as we did and gave me so much less stress. Honestly DS could have been EBM at 6 months when his intake went down to 24oz (my peak of pumping was like 24-26oz a day) but I stuck with one formula feed a day and banked the difference. Unsurprisingly both my nephew and son are 13 and 11 months and are doing fabulously as combo fed and then eventually FF babies.