I have 4.5 month old daughter and a serious milk supply problem. After months of exclusive breastfeeding, and constant stress about having enough milk, nursing 15 times a day, etc., I have begun supplementing with formula (around 12 ounces/day). The problem is that I am very committed to breastfeeding, maybe overly so. I was very determined to get to six months exclusive, and continue nursing for at least a year without ever using formula. The fact that I can't feed my daughter myself is tearing me up. I really believed that every woman could exclusively breastfeed if she tried hard enough. Every couple of days I get so upset about it that I stop being functional. Has anyone been in a similar situation? What did you do in order to deal with it? Are there support groups, counselors, or any other strategies that could help me deal with this issue? In my head I know that I'm being the best mom I can be by supplementing, but it still feels terrible. (I am not looking for advice about how to increase my milk supply or to just stick with exclusive breastfeeding -- believe me, I've tried it all and my daughter was starving and miserable.) Thanks so much for your help. Tamar

THE MOST DIFFICULT thing for me emotionally after giving birth was the discovery that I was not producing enough milk. Like you, I had felt, if one was really committed to breast feeding, it would work. I worked with a lactation consultant. I pumped and nursed round the clock. I ingested fenugreek and Brewer's yeast, tinctures, mother's milk tea, tons of water and even a prescription drug--Domperidome--which was the only thing that actually had a notable positive impact. Still, I didn't have enough milk. Most people seemed not to understand the emotional impact of the situation--particularly people without children or those in other parts of the country. They thought they were being supportive when they said positive things about formula (like ''I was formula fed and I'm fine.'') and thought I'd feel better if I just let go of all the hoops I was jumping through trying to produce enough milk. Then on the other side were all the people who didn't understand all I had tried and thought that if I only did X I was sure to have enough milk.

My husband tried really hard to be supportive, but realized that he couldn't really empathize in the same way as another mother. He encouraged me to join a mom's group, which I did (in fact I joined two). I can't explain why, but even though none of the others in the group were going through what I was, and we didn't even discus it that much, it somehow helped. I think it was in part because it also coincided with me getting out more and being more active in other ways. I think part of why the issue of producing enough loomed so big in the beginning was because producing enough milk and caring for my babies was basically the focus of all my time and energy. Being active, doing things I enjoyed, socializing with other moms and babies, and occasionally meeting people who had gone through the ordeal of not producing enough, helped move the issue into a less central role in my life. I also found it a big relief to hear other people had been through similar things.

One woman told me her lactation consultant had told her ''formula isn't the antiChrist'' and that that had helped her ''give herself permission'' to feel O.K. about using it. I was also inspired by a woman who told me she pumped until her child was 6 months old as well as using formula because the baby had never learned to latch on and the mom didn't have enough milk. I was ready to give up pumping at 2 weeks, but kept telling myself ''one more day'' until I too made it to 6 months.

As time went on, I started to feel like there were some benefits to doing both breast milk and formula. My babies still got enough breast milk that I'm sure it helped their immunities (no colds or any kind of bug until 8 months). I developed innovative ways of feeding them while doing post-partum exercise (choosing bottle or breast depending what was easiest to do while doing a particular exercise). I didn't have to be the one to get up for night feedings, and I think it may have helped them sleep through the night more easily. I was free to go out for more that a couple hours at a time without my babies. As they got older, I could do things while my babies held their own bottles. Not that any of that changes the impact of feeling like your body can't do what you feel like it should, but for me, it was part of the process of growing comfortable with formula being part of our lives.

I wish you well, and hope you won't be too hard on yourself. Julie

I agree, there is very little support for doing a hybrid system. I think this is a shame, as it can be such a lifesaver for all concerned. I got my greatest support from my family, who could all see how much healthier and happier we all were. The subject also came up recently at our playgroup, where another mother was feeling defensive about not breastfeeding exclusively. She was relieve to hear how many other women had also experienced difficulty with breastfeeding, and had ended up compromising. So it's not as unheard of as everyone pretends.

Think of it this way - life is a series of compromises, and parenting is filled to the brim with them. This is just the first of many you will make! Congratulations, you have successfully solved a serious problem - one that you never expected to encounter. Celebrate that, and please stop beating up on yourself! emma

My advice to you is to try and let it go. I had a wonderful lactation consultant at Kaiser (Joanne Jasson) who said ''Rule number one is: feed your baby.'' And this is from a woman who also believes in exclusive breastfeeding as do most lactation consultants.

Try to be happy that your baby is getting enough nutrients now that s/he is getting some formula. Give her/him as much breast milk as you can and have, and be assured that anything is better than nothing. Give yourself a big pat on the back for how hard you tried. Know that you are not alone. This issue is not worth having post-partum depression over. Also, dad can help feed now that baby is not breast only, and that is nice for him.

My first child nursed for 16 months, taking both bottle and breast, and I had to wean her to get pregnant with number 2, otherwise we'd be nursing now! Number 2 weaned himself at one year. I tell you that so you know that giving your baby formula does not mean that s/he will stop nursing.

I hope other moms who are in your situation currently will respond to you so you can share your stories. I'm sure there are plenty out there. Been there

Now although I wish I could have breast fed, I have seen that formula worked just fine for him. My son who was just over 6.5 pounds at birth quickly caught up in birth weight and is now a thriving 10 month old, 21 pound boy who is almost 2.5 feet tall...so clearly formula has provided what he needs to grow and thrive! He is already into quite advanced baby food, and appears to be working himself right out of the bottle stage on his own. I bring this up just to give you a context, that might help you think about what your childs future might look like.

In addition, I absolutely adore the fact that he looks right into my eyes when I feed him his bottle, and latches on to my finger to guide the bottle. His Dad loves that he can share in the feeding, and my nights have been pretty stress free, relatively speaking, since we share feeding.

Finally, he has only had one cold so far, and he is happy all the time. So, although I have worried about the fact that I could not provide him an immunity help, he seems to be doing just fine without it.

Hope this helps. Rockridge mom

With my first daughter I supplemented with formula after about 5 months--around the time she started eating solid foods. If you do this earlier you may need to be consistent about which feedings are formula and which are breastmilk otherwise you may have problems with a diminishing milk supply or with engorgement.

I found the evening feedings were the best time to supplement since that was when my milk supply was lowest. Also, when I introduced the sippy cup I used formula not breastmilk. It all depends on what you are doing--working part time, full time or not at all as to how much flexibility you have around which feedings to cut out.

As to which formula is best, I'm not sure but I've heard there are some questions about the way soy is produced--ie genetic engineering. Also, I've heard that something in soy mimics estrogen which is why they recommend it for menopausal women. I'm not sure they know what effect this might have on infants. I would be very interested to hear from someone who knows more about this or knows where to find out about it.