Am I doing this properly? Combination feeding

[Janey1985]

Hi,

I was hoping someone more experienced than me could reassure me!

I am a first time (fairly anxious) mum and my baby is 5 weeks old. She was born at 36 weeks and because of this reason we were advised to do formula top ups as she was very sleepy initially and not interested in bf.

She has now regained her birth weight with the help of shields she is now combination feeding. I feed her every three hours, I start by expressing off the breast I’m not intending to feed her on - what I can express varies depending on time of day, but I usually get between 20ml-60ml each session.

I then bf her on the other breast this can be a short 15m session - 50mins but at night she likes to feed occasionally over an hour or so. Obviously not really focussed throughout but whatever time she comes off shield I can see milk in shield. The shorter feeds feel more like fluttering than the stronger jaw movement I get in the longer feeds.

After this I feed her ebm and then if necessary top up with formula so she gets 60ml each feed from her bottle.

She is gaining weight nicely now around 35g a day.

I really want to get us to pure BF but am worried that I may not make enough milk. I say this because when I tried to move to bf after she regained her birth weight she lost 4% of her weight and midwife got cross with me and told me I was causing medical issues.

I know fed is best, and I was a formula fed baby but I really want to bf her and I really want to get off this three hour cycle as I only have 15m break on average before the next 3 hour stint begins... I don’t know how practical the current arrangement is long term...

Has anyone got any advice as to how I can make transition? Also, this probably sounds really dumb but she is getting a decent enough amount of milk off breast isn’t she?

Thanks for any help given! Just want to do a good job!

[milkjetmum]

So do I understand correctly that you offer one breast each feed? If so I would suggest the next step could be to skip the expressing, but offer both breasts each feed and then do formula top up. This will also save you some precious time! Or pump and feed at the same time? I used to do that at morning feed.

Are you feeding 3hr cycle on purpose or is that just the way dd likes it? I'd suggest to try feeding on demand for a while, this will stimulate your supply further. Totally normal to feed every 1-2 hrs in these early days.

If all goes well with that you could then consider only offering top ups with some feeds and gradually phasing them out. But many people like to keep a bottle going so they can go out etc in later days so maybe bf for most feeds and one or two bigger bottles a day is an alternative target.

Good luck!

[Janey1985]

Thanks for your help! I would love to feed on demand but she is so chilled out that only 10% of the time asks for food otherwise just sleeps and is very tricky to wake. When I tried feeding on Demand after she regained her birth weight she lost it again and the paediatricians told me to continue to combine bottle and breast. When she feeds she has a good latch, but at some of the three hour feeds she isn't interested and I just give ebm or formula...

It just feels like such a mindfield and I don't know what to do for the best... :(

[BroccoliOnTheFloor]

Congratulations on your baby.

The local support groups for BFing like La Leche League and Sure Start might have good advice. I'm sure they have seen similar babies. What you are doing now sounds really tough om you, but it's so great that the baby is gaining weight. It will get easier!

[blackdoggotmytongue]

Ok so one of mine fed on demand every two hours day and night until I stopped breastfeeding, one fed on a 4 hour schedule as an scbu baby (tube fed then expressed milk, then switched to formula at 6 weeks as she was unable to latch due to her disability), the other one was a four hour demand feeder that was combination fed after 6 weeks.
We had to set alarms for the ex-scbu baby as she wouldn’t wake to feed and could only dream feed due to muscle tone.
Different babies have different preferences but my demand feeder was the highest need of mine - if your dd likes 3 hours, that’s great.
In your case, I would probably be offering both breasts at every feed and pumping afterwards. If you are stopping breast and topping up with formula, your body isn’t going to be getting the message that it needs to produce more milk (pumping first and then topping up with that sounds like a glorious faff- doesn’t that just create stuff to sterilize?
Is there a reason you are still using shields?
In short - there is no ‘right’ way to feed - but if you are hoping to stop using formula, then you need to be doing more actual feeding to increase your supply, and less formula topping up.
It doesn’t really matter though. As long as she is happy and growing, you are doing a grand job

[tiredmumsclub88]

Hiya- I have a now 14 week (10corrected) Little boy who was born at 3) wks. He wouldn't latch either - so we used shields - and have done since week 3 after a week in SCUBU for hypoglycaemia. I would continue with shields- but if your LO can latch without then take them away- we are 14 wks in and still using them! BF from both sides- I would suggest using a BeeMom silicone pump on the other (no electricity/batteries needed- it's amazing). Top up with EBM and then formula if nec. You need to find a happy medium where you are happy, LO is happy and gaining weight- that's the ultimate goal - how you get there is down to your Mummy instincts! 36 wkers are particularly tricky - keep going -you're doing fab XX

[tiredmumsclub88]

*36 weeks not 3!!