Quote from: Warren Dew on June 04, 2011, 05:37:16 PM

For instance, we're going to have to wean our son in a month or so at 17 months, rather than let him wean naturally at 36 months or so.  We can't afford $3/oz for human breast milk.  So I have open right now a chart showing the amounts of 38 different nutrients in various formulas, human milk, and cow's milk, trying to figure out how close an approximation we can get to human milk from other sources.

Getting a little O/T but I'm facing the same thing right now Warren, and we have twins. My wife is reaching the end of her ability to lactate, and she's tried all the tricks to keep it going. I replaced the commercial formula we were supplementing breast milk with using the raw cow's milk formula on the Weston A. Price foundation's site.

http://www.westonaprice.org/childrens-health/319-recipes-for-homemade-baby-formula

They are doing well on it but they are only 9-months old so we have a long way to go and I want to make sure I'm doing the right thing. Any thoughts on this concoction?

I moved the discussion here so it could get its own thread.

The paleo way to go with twins at 9 months would be to continue to allow them to try to nurse whenever they want to, but also get them started on solids if you haven't already.  If they have incisors they can eat meat cut into thin strips, and scrambled eggs unless your doctor says they should wait for 1 year for that.  They can also eat applesauce and bananas for calories and a variety of other soft foods.  With a few more teeth they can handle hamburger.  They can go from just tastes of solid food to a significant intake within a couple of months.

I think it's better to add solids than to supplement with formula.  Formula just displaces breast milk in the diet, and the reduced demand will result in reduced production.

Ideally one would let them wean naturally and never have to use formula or milk.  However, if your wife's milk production drops too rapidly, or if she has to stop nursing for other reasons, that may not be possible.  There are no great choices here, but I can tell you what happened with our daughter.

When we initially weaned our daughter, it was because my wife had to stop nursing so we could try for a second child using IVF; she was old enough that we didn't want to wait for a more paleo child spacing of 3-4 years.  We had some frozen breast milk, and initially mixed it 50/50 with the formula that appeared best to us, which was Baby's Only organic toddler dairy formula, with the Baby's only DHA/ARA additive.  The mix started at about 9 months, and we ran out of breast milk and put her on just formula at about 13 months.  During this time her solids went from just tastes to maybe 50% of calories.  We also used Similac single serving bottles when out of the home for convenience.

My impression was that there were three significant issues with the switch to formula.  First, while on breast milk, she was gaining in head circumference percentile - from 40th at birth to about 80th at 9 months - while afterwards, her trajectory stayed at about 80th percentile without further percentile gains.  Her cognitive development followed a similar trajectory:  she generally tracked at 1.5 times her age until about a year old, but has since tracked at about 6 months ahead, which is a decreasing percentage of her age.  Second, she was quite a bit leaner than typical for her age until she went on the formula, at which point she started gaining more body fat; she isn't fat, but now looks more like the average child of her age.  She also started insisting on eating some nonpaleo starchy foods.  Third, she started getting some tooth decay on the fronts of her upper incisors, a pattern apparently typical of bottle fed toddlers.  On the plus side, her height, which had been dropping on a percentile basis, started picking up when she went on formula.

We eventually switched her to milk with some extra pastured cream, which didn't seem to have much different effects from the formula in the above mentioned areas; I feel like her cognitive development isn't as fast as I'd like, but comparing to milestones it's still running about 6 months ahead of her age.  Brushing her teeth regularly does seem to have fixed the tooth decay.  Cow's milk does contain three times the protein that human milk contains, which probably explains why she shows little interest in meat - she's already got enough or too much protein.  I'd really like to get rid of the milk, but we haven't been able to resist the cuteness plus tantrums to date.

Just for comparison, our son, who has been nursing to his present age of 16 months, started at 30th percentile in head circumference and has reached 80th percentile, and has really good language abilities for his age, using a few short but clearly pronounced sentences, for example telling parents to "sit down".  He's significantly ahead of where his sister was at that age, perhaps because he has been paleo since the beginning of pregnancy.  He is behind on weight and height, more so than is normal for breast fed babies, though part of that is just that breast fed babies tend to have growth curves that slow from about 1 year until weaning.

On reviewing the evidence, I guess I think most formulas are comparable and there's little to choose between them.  Within a brand, if there's a DHA+ARA version, get that; it can't hurt.  Toddler formula contains sucrose as opposed to lactose in infant formula; I thought the sucrose might cause a preference for sweet foods, but the switch to cow's milk, which has lactose instead of sucrose, hasn't appeared to change our daughter's food preferences.  I'd get a dairy based formula rather than a soy based one just on the gut feel that cow's milk protein can't be as far from human milk protein as soy milk protein is.  I would probably choose a formula over actual cow's milk to avoid the excessive protein, at least until the age of 2, because of concerns about the excess protein causing the child not to like meat.

Edit:  the Weston A. Price recipe does look like it would get much closer to human milk than cow's milk is, and perhaps would be better than infant formula as well if made from pastured ingredients.  It also looks like a heck of a lot of trouble, though.  Sorry about all my rambling before actually finding and answering your question.

Warren,

Thanks for the info. and for sharing your experiences. My twin boys were born at nearly full-term last August. As with most twins, they were both a little smaller than typical full-term singles and we were told that they would probably eat like mad and catch up within a few months. They did, but my wife couldn't keep up with milk production from the beginning, in spite of all the lactation coaching and "tricks of the trade" that she tried. So not knowing any better, we supplemented with commercial formula, which the hospital gladly stocked us up with before we went home, not unlike drug dealers do with school kids right outside the school gate. Fortunately my wife was able to keep up enough that the formula supplements made up a minority portion of their diet most of the time for the first few months so I never put much of a critical eye on the whole commercial formula issue. We were "mostly breastfeeding", which according to all the "experts" was actually an enviable position to be in with twins.

Then there was the big Similac recall, which is exactly what they were eating. That got me to start looking more into formula in general and the more I read, the more disgusted I became. Especially the sugar levels and inclusion of soy and corn products in all of them. Then my wife's milk production started slowing down at about 6-months, but that was when we started adding solid food to their diet. First it was just organic brown rice cereal. Then we added mashed banana to that. Then later cooked egg yolk from pastured eggs.

Later we added other solid foods, and we make all their food from fresh, organic fruits and veggies. Mostly carrots, peas, sweet potatoes, applesauce, and butternut squash. I know, not paleo. I haven't yet convinced my wife that this is the way to go. But for now, the addition of solid food helped slow the demand for milk a little, even though my wife was furiously pumping and doing all she could do to keep it going.

Between months 8 and 9, we added protein in the form of pastured chicken, pureed and mixed in with their organic brown rice cereal. Then the inevitable came along and my wife just stopped producing. We had hoped to keep feeding them breast milk for at least 18 months but that ain't gonna' happen. We had some banked, but not more than a few weeks worth, and for whatever reason, they both hated previously frozen breastmilk. We were told that it tastes more bitter than fresh. I don't know personally, I'm taking the word of the lactation consultant my wife spoke with. For greenchild, that is the primary reason we eliminated the possibility of utilizing a milk bank or milk share program. But thanks for sharing the idea. I'm sure there are many successful cases in these programs.

To make matters worse, between months 6 and 9, one boy decided he would not eat formula and would not take a bottle no matter what. We tried all the tricks to get him to drink that stuff, even spoon feeding and syringe feeding. But he wouldn't have it so he ended up getting the lion's share of the breast milk while the other, less picky twin, got less breast milk and more formula. So between the slowing breast milk supply, the Similac recall and my increasingly dim view of the whole formula industry, and one kid's apparent disdain for the stuff, I decided to seek out an alternative, which is the aforementioned home made concoction on the Weston A. Price foundation web site.

You are right, it is a PITA to make and expensive. I used real, raw, pastured milk and cream, which I buy every week at considerable expense. I make our own whey from the raw milk as well. I buy all the best stuff and I make a fresh batch of it every day, sometimes twice a day. But the little guy who wouldn't take a bottle loves it, and the other guy switched over just fine. Both are healthy, growing, and happy, and they are now at a "normal" size for singles of the same age so I'm glad I took the chance on this stuff (so far). I have some concerns about it, mostly certain vitamin levels such as seemingly excessive levels of vitamin A, and low levels of vitamin D. I've posed the question to the WAP site to see if I get a response. But overall, I think this is a far cry from the processed crap that comes in a can or a bottle. I refuse to let my little boys eat any soy, which will be a challenge since my wife is of Chinese descent. But so far I'm winning on that front, partly because even our pediatrician agreed with me on that (about the whole estrogen analog thing).  So far, so good.

As we are able to add better quality and more proteins to their diet, I'll back off on the "milk" until they've been weaned off of it completely. Even though our pediatrician supported my position on soy, she'd probably make a major scene if she knew we were feeding cows milk to them, let alone raw cows milk. But one thing I've discovered through the years in dealing with my own chronic health issues is that most doctors haven't a clue about nutrition. So we're flying under the radar on this one with her for now.

The Weston A. Price formula at the link in the original quote tries to match various features of human milk with dairy and other products.  For example, they recognize that dairy has too much protein, so their formula is only about half cow's milk; the other half is mainly water plus cream plus lactose to cut down on the protein content, with some ingredients, like cod liver oil, to add micronutrients.

They also try to better approximate human milk by adding whey to better simulate the balance between whey protein and casein, and adding coconut oil for monounsaturated fat.  Of course dairy whey is still different from human whey, so the matching isn't perfect; basically they're trying to do the same thing that commercial formula manufacturers do, but with more natural ingredients.

I was exploring a similar idea and it's nice to see that others have done it.  For my daughter, I'm not that concerned about micronutrients, since she eats a lot of solids, so something simpler might be sufficient to take care of my worries about excessive milk protein.  I'm thinking some mix of milk, cream, water, and some form of sugar, maybe with a DHA/ARA supplement, might do what I want there.