combining breast and bottle feeding

[kittyt]

I have twin boys who are 6 weeks old. Until now they have been exclusivly breast fed. However, DT1 has recently developed a huge appetite (cold weather perhaps? maybe a growth spurt?) so we have started giving him formula after his 7 o'clock breastfeed so that he is completely full at bedtime. I am now wanting to introduce a formula feed at the 11 o'clock feed for both DT1 and DT2 in the hope that it will fill them both up so that they sleep hopefully until about 2.30/3, instead of waking up at 1.30 AND 3 which is what they are doing at the mo. What I am wondering is whether having 2 feeds from a bottle a day will affect DT1's ability to breast feed. So far, he is coping fine with 1 bottle and the breast at all other feeds, but will having 2 bottles in one day start to comfuse him? Thank you!

[indiemummy]

hi, if you are still wanting to continue breastfeeding the rest of the time, try one of the bottles with a teat shaped like a nipple. It should make it easier for them to go back and forth from breast to bottle. Lots of people do a mixture of breast & bottle feeding successfully - good luck! x

PS Don't forget that you don't HAVE to offer additional formula, you should produce enough breastmilk to satisfy even the hungriest babies even during a growth spurt and if you would rather NOT introduce formula, ask your gp / hv for help!

[tiktok]

kittyt, it's not really possible to predict what your twins will do with regard to switching back and forth - some babies seem to manage just fine, some develop a preference for the teat, and some are ok and then reject one or the other later. If enough people post their own experiences here you will see I am right!

What is also not known, but which is prob a little more predictable, is the effect on your milk supply - going a longer time without bf or expressing reduces your milk supply, and intro'ing more formula as you plan to do, will almost certainly have this effect.

If you can wait until the babies are somewhat older, two things will happen: they will go longer at night, and your milk supply will be robust enough to cope with less frequent stimulation.

Hope this helps

[TwinkleInSantasEye]

Hi kittyt. My DS is 20 weeks and I've just stopped bf him after mixed feeding to a greater or lesser extent since he was 2 weeks old. He never had a problem switching between bottle and breast - in fact there is a school of thought that says the sooner you introduce a bottle the better as it can make things easier later on.

My DS, ever adaptable, got used to breast, breast with nipple shield (for a while), Avent bottles and Tommee Tippee Back to Nature bottles. He didn't care which it was as long as he got some milk! The Tommee Tippee ones are one of the closest to the real thing I think - they're nice and wide and flexible (my DS actually made them turn inside out sometimes causing endless amusement for my DH!). The one thing I would say is to use the slowest flow teat he'll accept and stick to it, otherwise he may start to prefer the faster flow of the bottle to your breast, or get distressed by the difference. My DS still won't accept anything faster than a 0-3 months teat.

As for the effect on your supply, Tiktok's right that it will vary from person to person. It also depends how committed you are. As I said, I successfully mixed fed for months, but just recently I noticed my milk drop off dramatically and DS became less interested - a vicious circle which I didn't feel it was worth trying to break since I'm going back to work soon.

You could perhaps minimise any impact on your supply by still giving a breastfeed at 11 o'clock with a formula top-up??

Hope this is helpful.

[kittyt]

thanks for all your help everyone. I was planning on expressing just before 11 and keeping the BM to give to DT1 as a top up at the next days 7 oclock feed as he is always starving at this time. I would then give then both formula at 11 to help them sleep a little longer. At the moment, I BF at 11, and then one will wake up at 1.30, the other at 2, then this continues so I am getting up at 4, 5 and 6 to BF either one of them. I used to wake the other one up to feed them at the same time if one was already awake, but thought I should stop doing this in order to at least give them both the chance of sleeping through the night. Maybe I should go back to feeding them at the same time then? The problem is that at the mo, I am only getting about 3 hours of broken sleep a night, with very little chance to catch up during the day - an extra hour during the day if I am lucky. The end result is I'm knackered, crabby and worried the tiredness will affect my milk supply anyway. HELP! I'm confused!
PS: tiktok, you are a legend, the amount of people yuou have given great advice too - thank you so mcuh!

[tiktok]

at 'legend' !!!

I can certainly understand your need for sleep, kitty - but tiredness will absolutely not affect your milk supply! I posted a link to a paper that showed this the other day. Will find it later and post it in a minute. There is no reason why tiredness would affect the physiological process of milk production, any more than being tired affects your ability to breathe, or make blood, or lymph, or to perform any other normal physiological function. The study I posted showed this in practice - mothers' mood and fatigue did not affect production.

But you need to sleep to feel better and more energised, and every mother of twins, especially, should try to get help to have a break. Is there anyone who could take the dts out for an hour once a day for the present? How about a teenager or a student you know and trust, off school/Uni for the hols, who would wheel them out and about for an hour each afternoon for a fiver? That would be money well spent!! The fact you know you have an hour off will boost your energies in itself What about neighbours or friends who have offered to help? Maybe you can take them up on that offer. Some people would be thrilled to be asked, believe me - they would (rightly) think of it as a special treat to have your twins to parade around with

There is no point (IMO) in trying to hurry your twins' ability to sleep through the night. This is something you cannot engineer while they are this young, so do whatever you need to do for the most sleep for you - if that means feeding them together, then that's what you can do. Look after your needs for sleep and rest at the moment, and think about supprting them going through the night at a later stage, when they are not so new and you are not so knackered. If it saves you time, then maybe your dp can give one of them some ebm in the night ( but obv not if it is quicker to feed them together).

If you leave too long a gap between feeding (or expressing) then you will make less milk - there is no getting away from that, it's biology It's the frequency of feeding that drives the supply. If you use that 11 pm feed to give the twins formula only, then you are extending the gap between feeds to make it longer than your babies would leave it naturally - giving your body the wrong message.

You could think about topping up with formula at 11 pm to try to lengthen their sleep, but to be honest, I think this will have its downside - you are then messin' about with formula and bottles which adds to the hassle. It's up to you - maybe it's worth it to get another hour sleep. You have already intro'd formula so the exclusiveness of bf is no longer an issue....it's all a question of what works best for you, and what preserves your choice to breastfeed, and too much formula won't preserve that choice.

Over to you

[tiktok]

This thread has the link.

[kittyt]

Thank you so much tiktok. Never realised that it was the time gap between feeds that drives the supply. I thought it was frequency, which I guess is the same thing thinking about it! The most important thing to me is to give my DTs the best start I can which I think is breast milk, so will revise decision to give them formula. (also very interesting to know that my being tired does not affect my milk production - one less thing to worry about!)Maybe I'll go back to feeding them at the same time at night, as that provided me with more sleep than the present system. At what age would you say they might be able to start having their feeds stretched/being encouraged to sleep more at night? (they were born at 36 weeks 4 days, so need to have their ages adjusted - due date was 1st dec). We have only moved to cambridge recently and so know very few people yet (apart from our NCT group, who all now have tiny babies of their own) so have no one I can leave them with. However, DH is wonderful and around a lot at the mo, so am not having to care for them on my own all the time. Thanks so much for the help, and will read the article on the thread you posted now.

[kittyt]

another question tiktok! (sorry to be such a pain) - I am trying to get the twins to follow a 3 hour routine during the day. They have taken to it really well and are eating and sleeping at the right times. However, they are now starting to get hungry before they are due a feed. If I put them on the breast, there will not be enough milk when they are due a big feed 30-45 mins later. Is it ok to give them cooled boiled water to fill them up instead? Otherwise I end up feeding every hour for 10 mins or so.

[tiktok]

kitty - it is fine to feed them sooner than 3 hours. You will not be pinching milk in any way - you are never empty, anyway.....remember, it is frequency of feeding which drives the supply, and the shorter the gaps between feeds the faster the milk is replaced. Cooled boiled water is absolutely not the thing to give them - it's a proper nuisance to prepare, especially for two babies, and there are no calories in it....it can spuriously fill tummies and stretch feeds out a little, but this is what you don't want to happen because in so doing, you risk the babies not getting enough to thrive.

I actually think this is a small risk only with healthy babies and responsive parents - they will kick up and ensure they get the calories they need - but what is the point of giving it ? By the time you have faffed on preparing it and giving it, to two babies, via bottles which you have to sterilise, you might as well have given them a breastfeed, surely??!

Your dts were born a wee bit prem and they are doing fantastically well - they may well need feeding more often than 3 hourly, and honestly, you need to respond to that instead of messing on with water or trying to 'make' them go 3 hours....I don't think you will be cnsistently feeding every hour for 10 minutes, truly.

There is no getting away from the fact that your twins are gonna be hard work for a while yet. Going with the flow is likely to be easier than trying to get them into a feeding schedule just yet...try to have a schedule for other things like bathing or do things in the same order, but do whatever you need to do to make the feeding easier without worrying about 'getting' them to go longer

In time you will be able to to this, but for 3 week-old (term adjusted) twins, it's much too soon to expect them to be in a routine, believe me

[kittyt]

thanks tiktok. Will avoid the water then. DT2 (who is the bigger of the 2) is feeding well and is not demanding food all the time, it is only DT1 which makes it a bit easier. As long as there will be enough milk for him at each feed then I'm happy. I expressed at 11 last night to see how mcu hmilk I had, and there was only 3 oz total from both breast combined. I just worry this is not enough to satisfy two hungry babies! I just hate hearing DT1 crying after having been on the breast for 45 mins, and still being hungry. It is rare that it gets that bad, but it upsets me and I've been trying to find a soloution for him so he does not have to go hungry. Think I will go with the 'feed when he is hungry, and if he is still hungry after a 45 min feed, offer formula' approach. I forget they need to have their age adjusted, as I keep thinking of them as being almost 7 weeks. Thanks ofr all your help and advice. Have a fab christmas. {smile]

[kittyt]

ooops, meant to have a at the end there, sorry.

[TwinkleInSantasEye]

Kitty - I'm no expert but I wouldn't worry about the amount you expressed. As I understand it, the amount you are able to express is not an indicator of the amount of milk you have available. Some women just find expressing easier than others.

[tiktok]

Oh no....not the 'express to see how much I am giving' trap !!!!

Expressed milk is not a guide to how much milk your babies can get from you at all.

You are doing great and so are your dts

[kittyt]

does the amount you express and the amount they can get from you differ greatly then?

[MerryChipmonkAndAHappyNewey]

Kitty, the amount you can get by expressing is usually far less than what the babies will get by latching on themselves. The most well-designed breast pumps are in fact babies!

[kittyt]

well that's a relief! otherwise my babies would starve based on what the pump gets out of me.