If she only plans to breastfeed for "up to six months" you'll be stuck with formula no matter what. Six months isn't old enough for solid foods yet. Ideally children should breastfeed for 2-3 years, but there's no hard upper limit.

If she can't or wont do this, the best alternative is to contact a human milk bank. This site should help: http://www.hmbana.org/

Also also, this site will send a breastfeeding consultant to your house if you're having problems: http://www.llli.org/

Wow, some people seem not to have children here... It's great to have ambitions and a strict plan when you plan to have kids but if you believe that it will be the perfect ride, you guys are fouling yourselves big time!

Breasfeeding is not easy, esp when you have little support besides your man and a job to go back to within a couple of months after the delivery. Breastfeeding is exhausting, difficult and a lot of mothers do not produce enough milk. On top of that, some infants cannot suckle properly because of the non alignement of their upper and lower jaws, which means that mothers have to pump all their milk, which means triple work: pump, feed, and handle all the logistics (freeze, clean bottles, etc)

Commercial formula is disgusting and it's a relevant question to ask to know if you can make a homemade version of it. The Weston Price website is a good source for that. If you look at the recipes though, it might be actually easier to stick to breast milk as it can be pretty hard to get raw goat milk in some places in the US.

I wish you and your wife all the best and hope she will enjoy breastfeeding because if it doesn't feel awful to her, half the work is done ;)

Travis, you're a man, right? Did you know that it's possible for men to lactate with the right supplementation and/or emotional upheavals (as in his wife dying in childbirth or being particularly worried about a baby's health)? I don't want to hear you bitch until you've had a child attached to your man-tits for 2-3 years. Maybe you can be the wet-nurse for BobbyD's child if you care about their business so much.

There's no reason to expect that your wife won't be able to nurse. Chances are that with appropriate steps taken, it'll go great! Just do the best you can to insure no mom/baby separation, lots of skin to skin time etc. And even if those are interrupted, chances are that breastfeeding will will go well.

Best videos ever - from Jack Newman's International Breastfeeding Center, a world renowned center for managing breastfeeding and feeding difficulties.

Given the risks associated with feeding formula (decrease in IQ, increased risk of infections, increase risk of death from diarrhea and other gut issues, increased risk of various kinds of childhood cancer) it would seem prudent to 1)plan for success and 2)get support on board should issues come up. A board certified IBCLC is a good place to start though admittedly, it does occasionally take time to find the right one for a given set of issues. And heck, if formula does become necessary, don't sweat it. Do the best you can to avoid it but if it's needed just keep moving forward and know you're doing the best you can.

Fwiw, I would be very comfortable using the recipes from WAPF. If raw milk is of concern, make the formula with pasturized milk. Just heat the milk to the temp necessary to kill potential pathogens - You can find it in scientific references regarding the pasturization of human milk. You could even just use already pasturized organic milk from the store as the base for the recipe.

Basic trouble shooting: Even if mom has major supply problems, it's simple enough to use a nursing supplementer at the breast to feed baby supplemental feeds (commercial or homemade formula) until mom's supply catches up. Or if mom seems to have a primary supply problem that is not resolving, it can be used as long as baby is nursing.

Latch issues - if baby doesn't latch on in the first few hours, don't hesitate to use a nipple shield. Many IBCLC's and post partum nurses at the hospital discourage their use and wrongly so. If a baby isn't latching well in the first 24 hours, everyone starts to get a little nervous and right around 24h a bottle will be given (most of the time). If a nipple shield, used properly, had been introduced much early, baby will generally be at the breast making everyone much more comfortable and (essentially) eliminating the need to consider a supplemental feed.

I help many, many people with breastfeeding in a pretty intensive way and can tell you that as long one is committed to breastfeeding, it almost always works if everyone stays open to the options (ie using a nipple shield and/or at breast supplementer if needed) and relaxed. While it generally works well right away, occasionally, it takes time for a baby to get started on feeding well from the breast.

The last four babies I worked with went thusly - shared with permission from the moms who are glad to use their stories to help others -

Baby 1 2 weeks postdates (ie late), failed pitocin induction, cesarean birth -no suck reflex at birth (which was overcome over the course of four or so hours), @4h finger feeding baby with a supplementer, continued for 24h as needed.

@24h, baby was able to latch with shield and supplementer at breast - sometimes. By 48h, baby was able to regularly latch with shield and supplementer. Milk was in at 72h, baby still needed supplementer and sheild - was not able to transfer milk on her own without supplementer. Mom's supply was excellent.

By the end of the fifth day, baby was able to nurse at breast, with shield, without supplementer every time. many attempts were made to wean baby off shield. only occasionally would baby nurse without shield and only for a moment before refusing. goal is having baby happy at breast so I encouraged it's continued use with occasional attempts to wean from it. One day, at four months, baby went on without the sheild and has been nursing without it ever since.

This baby had a smallish lower jaw and possibly just needed some time to grow a bit so she could latch more deeply in order to transfer milk on her own.

Baby 2 uneventful normal unmedicated birth - many attempts to get baby to latch resulted in one minimally successful latch after about 3 hours. Baby had a very small lower-jaw, and mom had very firm breast tissue - this can be a tricky combination as it's baby's lower jaw that does most of the work of breastfeeding.

At 12 hours, baby was given 30 mL formula (a totally inappropriate amount for a 12h old baby) at the hospital as they were not able to get baby to latch. after that, we were not able to achieve a successful latch until, after many attempts, we used a nipple shield and supplementer.

At 3-5 days, it was clear that supply was marginal so mom pumped after feedings to increase supply. Another option is to not pump, but continue feeding baby at breast with supplementer very frequently, switching sides frequently to stimulate letdown, take herbs and medications (domperidone) to increase supply and eventually, most will reduce and finally eliminate supplementer.

This mom didn't want to use any formula though so she was very committed to pumping. Long story short: baby was dx'ed with a type 4 tongue-tie, had a frenotomy and still couldn't nurse without the shield and supplementer. Mom bottle fed a lot and pumped a lot. Slowly increased feedings at the breast with the shield after her supply was up from the frequent pumping.

After 5-6 weeks, she began nursing without the shield occasionally but baby still got lots of bottles. At 8-9 weeks, baby suddenly started nursing very well - no shield. Mom returned to work. Baby gets bottles at daycare and nurses happily at home in the am, at drop off at daycare, at pickup at daycare, in the evening at home. She sleeps through the night and has been since six or so weeks of age. Mom encourages others to not be stressed if breastfeeding is not going well because it'll all work out eventually.

Baby 3 Planned cesarean at 39 weeks due to breech presentation. Extremely physically adept. From birth, baby could roll both ways!

No latch was achieved for approx 24 hours in spite of continuous contact of mom and baby and continuous excellent lactation support. Baby was born at a Baby Friendly Certified hospital so there are no procedures that will interrupt nursing. Still, baby wasn't nursing. B/c of the certification, I couldn't get a nipple shield from the hospital staff, the IBCLCs were unavailable on the weekend and locally there wasn't one to be found (fwiw they can be purchased at Target).

At 24h baby did successfully latch but came off repeatedly for all feedings through 72h. Baby and mom both stayed very calm and were very patient. While it was probably frustrating for baby to not be able to maintain a latch, her calm persistence was really impressive. By day four, baby had lost more than 10% of her body weight, by day 5, 14% in spite of frequent feeds, breast compression.

Keep in mind that cesarean birth often delays Lactogenesis II ('milk coming in") until day 5. And C-sec babies loose more weight anyway due to loosing fluids from mom's IVs and lack of being squeezed through the birth canal.

At 72h, mom started pumping (hand expression is better for colostrum removal so we did both. great video here) Fed baby colustrum via feeding tube attached to syringe while baby would nurse. Used breast compression to increase milk transfer.

Also, at the beginning of the fourth day, we supplementing at breastwith formula as needed to keep baby actively nursing at breast until she was content. Mom really didn't like pumping so we didn't do much of it. Maybe just a couple of times.

At 4.5 days, in the middle of the night, mom's milk came in, baby went to the breast, we immediately discontinued use of the supplementer and it was clear things had turned around. From the beginning, this baby has been willing to sleep 4-5 hour stretches at night, initially being woken in order to insure adequate stimulation of mom's breasts, then later, we left her to her own sleep cycle.

She regularly sleeps 4-7 hours at night without feeding, makes up her intake during the day. This baby needs to be left unswaddled during the day in order to insure adequate feeds. If swaddled during the day she will sleep and sleep andsleep meaning she doesn't get enough food and mom's supply goes down. Unswaddled during the day, swaddled at night is perfect for her.

Baby 4 cesarean birth. mom: 'flat nipples'. baby: very very small lower jaw and mouth. stage 3 tongue tie. mom reluctant to allow a frenotomy. I suspected that even with a frenotomy, like baby 2, this baby still wouldn't nurse well right away but would need to grow a bit in order to breastfeed well - that tricky combination of small jaw, small mouth and firm maternal breast tissue was at work.

At one week, baby was exclusively bottle feeding and mom was pumping. Showed mom how to properly use a nipple shield and supplementer at breast. Baby was resistant at times due to prior frustration with unsuccesful latch attempts. Over the course of 3 or so feedings in a row, baby started eagerly accepting feedings at the breast with supplementer. Bottle feeds initially would cause this baby to start refusing the breast, though generally I find "nipple confusion" not to be a problem.

At 14 days, baby was always willing to feed at breast with supplementer, shield and breast compression. Mom pumped after feeds and had a great supply.

At 21 days, baby was able to move easily between bottle feeds and breastfeeds (with supplementer, shield and breast compression) but still only in the "football hold" or upright in the baby bjorn (loosen straps to appropriately drop baby to the right level).

Somewhere between 3 and 4 weeks, baby was willing to feed without the supplementer, consistently and at 4 weeks, baby started feeding without the shield and is now taking almost all feeds at the breast in that wonderful easy, automatic, don't have to think much about it sort of way. She will also take a bottle.

From the beginning she's been sleeping from about 7 pm to 8 am waking to feed at 8:30pm, 10pm, 3 or 4 am and 6:30am.

Have your help/resources lined up in advance. Wishing you the very best!

I think the most important thing about breastfeeding is to relax! It's natural and with your support your wife and baby will be great at it. PERIOD! You should breastfeed for the amount of time that everyone feels comfortable with it. My son weened himself at 10.5 months. He went onto formula until about a year and now he drinks organic milk. That's what worked for us - what works for you might be different - but its your choice - don't let anyone else tell you any differently. There are so many opinions out there - and so many people willing to force them down your throat (seriously when you have kids its nuts what people will say to you in the grocery line). Remember you are the paretn - your opinion is the one that matters and no matter what decision you make, it is the RIGHT one!!!

That being said - with the worry about the flavour of the liver based formula - babies don't really have advanced palette's yet - so your babe might not mind it - so go for it - amybe don't make 11 gallons, but make a small batch and try it out. And if they don't go for it the first time - try again a couple weeks or a month later.

Good luck and Congratulations!!!

I had three breastfed children. My fourth was born in August and for some strange reason my milk never came in. I'm paleo plus organic full fat dairy, and I thought I'd be even a better Bessie than ever before. Yet even with round the clock pumping and a serious lactation consultant, we could not get more than an ounce out of me each session.

By day 4 we obviously had to supplement, poor baby. So we got the most organic commercial formula we could find. Yet it made me ill to read the ingredients. we literally wouldn't feed our pets that crap. Our pets eat organic paleo too! And this was our precious baby.

I researched 24/7 (with baby in arms) online on how to make a better formula. I think I found every scrap of info on the Weston A. price infant formula that could be found on the world wide web. It took a couple weeks of serious thinking before we decided to gather the ingredients and begin to make the formula. We started slow. We use the raw cow's milk formula and we replaced the hard-to-digest yeast flakes with B complex drops, and added a teense of grade B maple syrup per bottle for smooth digestion. There was a transition for baby's tummy and we worried, but she came through the transition and has been growing and thriving ever since.

I can make up the day's formula by heart in 15 minutes and it is a joy to do. I was heartbroken not to be able to breastfeed her, but her formula is so rich and healthy and nourishing that I truly feel great about it. Her brothers also enjoy bottle feeding her.

While not applicable to you all here, with your great diets, there is ample though hidden evidence that breast is NOT better if the mama is malnourished with a crappy diet. Yes, the baby gets the nutrients first, but sometimes there just isnt anything healthy in the mama. Breast is best only if mama eats well and is well. My milk theoretically would have been great with my diet, but I believe this rich, whole formula is the next best thing.

Please, don't dis me. There are many of us out here for whom it just didn't work. We tried everything. I breastfed 3 babies for an average of 2 years each. Sometimes it doesn't work. For real. Also, this formula is used a lot by adoptive moms - relactation does not always work either. So always be supportive of women who just couldn't breastfeed, and know that there is a truly healthy alternative when necessary.

Feeding babys a formula derived from cow's milk increases the danger of developing type 1 diabetes. There's a protein in cow's milk that resembles the human pancreatic beta cells and so provokes an auto immune reaktion which results in the final destruktion of the pancreatic beta cells and type 1 diabetes. There have been studies on identical twins...

http://healthcareupdates.com/2010/12/22/type-1-diabetes-mellitus-and-possible-causes-of-it/

There is no reason to use formula when there are women out there who have pumped too much and are begging for someone to take their freezer stash off their hands.

Someone already mentioned MilkShare. Here it is again. http://milkshare.birthingforlife.com/

The newer, more popular connection is through Facebook for the most part. They've been getting quite a big of press. http://www.hm4hb.net/index.html is newer

According to World Health Organization, infant feeding has 4 options

1. Breast milk from the mother's breast
2. Breast milk pumped from the mother, delivered in a bottle.
3. Breast milk from ANOTHER MOTHER
4. Artificial Breast milk Substitute (formula)

that's right. Formula is 4th best.

My oldest spent 8 months on formula when my milk dried up due to 2nd pregnancy (not completely normal) in 2006. A friend at the time had a freezer FULL of milk that she wound up shipping from Hawaii to a milk bank out of state or something when I would have picked it up at her house across town, had I even THOUGHT about milk sharing.

Your wife is going to do great. Like others have said, start going to La Leche League meetings NOW, during pregnancy. Don't wait another month. LLL's are traditionally pretty crunchy people who will LOVE to hear all about your paleo adventures. You can go with her and be the awesome, supportive hubby all the other ladies envy your wifey for having. It sounds like you have some great resources right here on PH when the time comes and issues are happening.

My friend who had all the milk had so much because she was a working mom scared of losing her milk. From the time her baby was born she pumped as if she had a second child. She was a serious dairy cow because she told her body that she needed 2 babies worth of milk. If your wife can do that too, even if her milk dries up, you'll have your own freezer stash to pull from for a long time. Of course with milk storage guidelines, you'll have to be strategic about what you pump and what you use and keep it first in first out...but you could definitely set your wife up to lactate for 6 months but feed breastmilk for 12...or more. You can't try tricking your body a few weeks after birth though. You have to tell it you have twins from the beginning. Establishing milk supply is a lot easier than increasing an already established milk supply.

Good Luck. You have no idea how great your wife will be. She'll be amazing, especially with all the support you appear prepared to be!

I have breastfed 3 children. I second that breastfeeding can be difficult. With the support of dad and a good doula, who is also experienced in breastfeeding will be important to establish breastfeeding. Once established, breastfeeding is soo easy. If your wife makes it 6 months, she wouldn't necessarily need or want to stop just because of a part-time job. I breastfed my older 2 children about 2 years. I worked part-time or full-time and pumped early on. But, by the end of the first year I had stopped pumping. Baby ate table food, drank water at home, then nursed at night and in the evenings/weekends, etc. on demand. Formula was available, but my husband found they didn't need/want it except rarely from about 10 months on. My youngest is now 10 months old and I have stopped pumping at work. This is due to the inconvenience of pumping and the fact that it takes me about 1/2 an hour to get about 4 oz. Not worth it when I can spend that extra time nursing baby after work. Bottom line, just because your wife will be working doesn't mean she has to deal with a pump to keep nursing. I would get a good hand pump to help if she gets uncomfortable, but otherwise she can avoid it and still continue to nurse. Sorry, I don't know about making the infant formula, goat's milk might be a good alternative while she was working, but I would consult a nutritionist if it was to be babies primary nutrition.

http://paleohacks.com/questions/6840/what-if-someone-cant-breastfeed-enough#axzz19cB5pcJc addresses this.

"She plans to breastfeed up to six months if all goes well, and I am thankful for her willingness to do this."

Um, wow.

You can make up a fat-rich formula using A2 milk.

Otherwise, most commercial formulas are a blend of whey protein and omega 3 oils. You could easily make up your own formula from whey protein isolate, heavy cream, cod liver oil and some fish oil. Other necessary nutrients can all be blended in to make a smooth liquid. Try to get mercury/contaminant-free sources of cod liver oil and fish oil.

That being said, a liver shake might not be too unpalatable to the baby because food preference is a question of culture.

Bear in mind you cannot reproduce certain substances e.g. IGF1 in formula - some things can only come from breast milk so for the sake of the long-term well-being of your child, you might want to speak to your wife about breast-feeding for a longer-term or maybe, finding a wet nurse.

If you don't want to breastfeed/pump milk for 2 years, you probably shouldn't reproduce. I think the !Kung do it for 2-3 years.