Combination feeding

[Bettie2192]

Any tips/advice for combination feeding? I want to mainly breastfeed but I also want to include a few bottle feeds so my husband can do some feeding. Also my baby will be born a few weeks before Christmas and it would be nice on Christmas Day to not have the baby relying on me all day, so that other family members can have some bonding time and do a feed (We will be surrounded by family all day including both sets of grandparents so lots of people wanting time with the new baby!).
Is it better to use formula or expressed milk for the bottle feed? If I’m expressing, won’t my breasts get confused and think the baby is eating more than they actually are, e.g if I expressed enough in advance for like a whole day of feeding.
I will ask my midwife about this but it’s always good to hear about other people’s experiences.

[LouiseTrees]

Putting a pin down to respond to this properly tomorrow. I’m a combi feeder. Lots of tips and tricks.

[Bettie2192]

@LouiseTrees ooh thank you :)

[PurplePeopleMeeter]

I expressed from day one and it worked well having an option with a bottle. Also added FFs which eventually overtook the BFing then my supply dried up at about 4 months

[Nemma96]

I'm a combi feeder and my LB is now 6 months.
I've only ever breastfed a few time but actually express which I'm still doing, if you want to breastfed then I was advised to not use a bottle for 6weeks as a bottle is quicker and confuses the baby. (Midwife in hospital used a bottle why I was asleep which is why I have expressed and not breastfed).

[Twizbe]

I combi fed my first.

I will get onto tips and tricks, but full disclosure, I hated it. I much preferred exclusively breastfeeding. I'll go into details on why later.

In terms of tips. The main one is to establish breastfeeding first. This will take a few weeks (around 6) and will involved cluster feeding and feeding on demand. It's worth looking up the fourth trimester in advance so you know what cluster feeding looks like and what it isn't (baby not getting enough)

We used pre made formula in pre sterilised bottles at first with my son. A good start if you don't want to express. My son is actually allergic to milk so it wasn't a good idea for us, but that isn't universal.

He never had any issue with swapping from breast to bottle. We pace fed bottles and I recommend you look this up too. We never changed teet sizes either. Your boob holes don't get bigger so no reason to make bottle holes bigger.

By 16 weeks we fully went to combi feeding and we replaced 2 feeds a day with special formula. These feeds were at 10 and 3. We avoided a bedtime bottle because of my son's issues with reflux and allergies, issues he didn't have when fed from the breast.

By 7 months (we weaned early due to his issues) he was on 3 meals a day and had dropped his lunch time breastfeed. That meant I was only breastfeeding morning, evening and overnight.

So, here's why I hated it. It's soooooooo much more work that breastfeeding. Once breastfeeding is established, whipping the boob out is a lot easier than sterilising bottles, making up formula or expressing and then expressing missed feeds. It actually made more work for me. In an average week of 14 bottle feeds, husband could only do 4 (the weekends) so it didn't give me a break at all. The special formula we used didn't come pre made so I had to faff around with kettles and powder. If we went out I had to remember all that kit.

My sons issues meant that any cows milk based product that went in, came out again in a stinking mess.

My youngest was exclusively breastfed and it was a much nicer experience. Even though we tried her with a bottle at the same time we introduced one to my eldest, she refused point blank. Whether a breastfed baby takes a bottle is a matter of chance. I don't think it has anything to do with when you introduce it.

My husband has never fed her, but he was still able to help and give me a break. He did that by taking care of the house and toddler, he'd hold her, wind her, change her. He'd take her for walks to let me sleep. To be honest all that was more helpful than the faff of making a bottle. At Christmas, your partner can be on hosting duties, cooking duties etc, also depending on how birth went you might not be up for much on the day anyway.

I hope this is useful. Combi feeding can work, but from my experience it isn't the 'best of both worlds' that it's sometimes presented as.

[Quackersandcheese3]

We didn’t introduce bottle til 6/8 weeks. However dh did 2 bottle feeds of formula and I breastfed the rest of the time.
I didn’t go a whole day without breastfeeding.
I was able to express and it was fine but tbh it’s a bit of a chore ( getting the milk out of my boobs , sterilising , storing etc) and just seemed easier and quicker to get the baby to feed off me.
Stopped breastfeeding at around 7 months and just did bottles of formula along with weaning .
Combi feeding really worked well for me and dh and dc , It’s totally the best of both worlds . Hope it works out for you too.

[FudgeFlies]

Hi, just jumping on with a quick question. do you have to express during the times your planning to bottle feed (wether that be formula or breast milk) to ensure supply isn’t reduced? Or can you express for bottle feeds any time throughout the day?

[Twizbe]

@FudgeFlies

Hi, just jumping on with a quick question. do you have to express during the times your planning to bottle feed (wether that be formula or breast milk) to ensure supply isn’t reduced? Or can you express for bottle feeds any time throughout the day?

You can express at any time of day.

If you want to maintain the supply you need to express the feed you're giving in a bottle. This is most important in the early weeks while supply is establishing.

Once established it will adjust with demand quicker so you might not need to always express a missed feed

[user1493413286]

I did combination feeding with a bottle of formula: the purpose for me was to give me a bit of a break and allow my DH to do the last feed at 10.30 and when I was doing that with expressed milk it just felt like one more thing to do to express. I know other people who have worked it in fine but that was my experience. I also liked that it meant I didn’t need to plan in advance if I was going to go out.
We were told to time the introduction of a bottle carefully so that breastfeeding was established both the latch and supply but not too late or they might refuse a bottle so we started at 6 weeks. Your body adjusts to what you expect from it so mine adjusted to doing one less feed a day but equally I knew that if I stopped that formula feed then it’d adjust to one more feed a day as babies feed a bit differently each day anyway

[Guineapigbridge]

Combi feeding worked well for us. I tried pumping but I didn't get much out and it felt like just another job to do instead of sleeping or having a shower so I stopped it in favour of formula. Decided to do one bottle feed a day. Breast milk seems to be abundant in the morning and less abundant in the evening (that's why babies are grizzly in the evenings, partly) so we always did the bottle feed at either 5pm, 7pm or 10.30pm feeds. Routine babies and they thrived on it. All much older now.

[Guineapigbridge]

Started at 2 weeks (no trouble with latch etc)

[Maggi85]

Hi I combination fed my DS I did one bottle of formula milk a day from two weeks old he never had any issue taking a bottle and was happy with formula - my OH used to give it him for his midnight feed so I could get a few hours sleep. If I hadn’t give him a bottle I think I would’ve struggled to exclusively breast feed. If I went out for a couple of hours he would have a bottle and happily swap between the two - I only breastfed for 18 weeks though and just gradually increased him on bottles towards the end.

[FudgeFlies]

@Twizbe thank you!

[Shinygreenelephant]

Hi, I combi fed my oldest when I went back to uni full time and it was great - all the benefits of breastfeeding but you actually get a break now and again! I started her on bottles of expressed milk from about 8 weeks then when she was about 6 months I gradually started mixing in formula as I was struggling to express enough for full days in uni. Worked really well for us and it also meant she was never greatly attached to the bottle, so easy to get rid once she turned 1, but also less addicted to breastfeeding so weaning wasn't as difficult as if I'd kept exclusively bfing. Worked well for our situation at the time

[Twizbe]

A couple of tips I forgot in my main post.

I think someone else mentioned evening grizzles. This is the witching hour(s) and happens however you feed. It's developmental and just a thing newborns do. It's worth reading up on it so you know to expect it.

Give small bottles. Max of around 4/5oz. If they still seem hungry offer the breast. I've already mentioned pace feeding.

All formula is nutritionally the same so it doesn't matter which one you use

What you can express is no indication of supply. Baby is the best at getting milk out.

Expect little and often feeds for the first few months. We seem to have become obsessed with intervals between feeds. Newborn can't tell the time. They've no idea how long their milk should last.

Formula doesn't help them sleep better. Breastmilk has a sleep hormone in it. Formula sits on the stomach heavier and takes longer to digest. That can mean it actually makes them sleep worse in the evening.

Most bottle feeding advice is aimed at exclusive formula feeding. Sites like KellyMom have better combi feeding advice. It's useful to think of it as breastfeeding first with a bottle rather than bottle feeding with breastfeeding (if that makes sense)

[Gumbo]

I introduced a bottle of formula for the midnight feed when DS was 12 days old - honestly, it saved my sanity as he was very tiny and fed like clockwork every 2 hours. so it gave me a chance to get some sleep while DH fed him. It worked brilliantly and I'm so glad I did it - it also meant that he'd happily take a bottle when required

Good luck!

[fabulous40s]

When they are that little they sleep a lot so you might be surprised and get to eat your Christmas dinner in peace.
Paced feeding is important. I combi fed my first from birth but gave up by week 6 as the formula made my LO constipated and it was just so much easier to breastfeed (no bottles, no forward planning, no mountain of equipment).

[Bettie2192]

Thank you everyone for all your comments and advice! Lots to take in. Seems like the most common option is to add a bottle of formula rather than a bottle of expressed? I’m still undecided which I’d prefer, expressed or formula. I’ve got a while to think about it, and I’ll have another read of all the replies later to see if I have any questions that come up.

[Bettie2192]

Im still a bit confused about how expressing works. For example if I decided on Friday that I needed to express milk in advance for 1 or 2 bottles on Saturday, wouldn’t my body be confused that so much milk was being taken on Friday but hardly any on Saturday?

[Twizbe]

@Bettie2192

Im still a bit confused about how expressing works. For example if I decided on Friday that I needed to express milk in advance for 1 or 2 bottles on Saturday, wouldn’t my body be confused that so much milk was being taken on Friday but hardly any on Saturday?

You'd need to express the feeds you missed on the saturday. This is why combi feeding can be less of a help than it first appears. You still need to do the feeds just not giving them directly to baby. Not expressing the feed could confuse your boobs and impact your supply. It could also cause mastitis which isn't fun.

A Haakaa style pump is a good (cheap) investment for occasional expressing. You use it as you feed baby so is very quick and easy to use. It's also easy to clean.

[Bettie2192]

@Twizbe so I’d have to express again on the day I was feeding by bottle? Wouldn’t I constantly be playing catch up then?

[Twizbe]

[quote Bettie2192]@Twizbe so I’d have to express again on the day I was feeding by bottle? Wouldn’t I constantly be playing catch up then?[/quote]
Yep and yep.

Breastfeeding works on supply and demand. To keep the supply, you need to keep the demand.

If you regularly swap one feed for an expressed bottle you can get into the pattern of expressing the missed feed to create the next day's bottle. But that defeats the object of it being a break for you.

If you regularly swap one feed a day for a bottle of formula and you're happy to adjust your supply you won't need to express that missed feed. But you shouldn't do this until your supply is established. You also shouldn't swap out too many feeds at once as you'll risk mastitis.

If you think you'll only give a bottle every so often... you'll have to express the feed you miss so that you don't adjust the supply.

[Bettie2192]

@Twizbe aah ok thank you for breaking it down for me, I get it now!
Had a quick look at the haakaa pumps, they seem like a really good idea

[Twizbe]

[quote Bettie2192]@Twizbe aah ok thank you for breaking it down for me, I get it now!
Had a quick look at the haakaa pumps, they seem like a really good idea[/quote]
Aldi have their version in their baby and toddler event.

I used mine a lot with my second to help with engorgement in the early days.