To think that if the FF and BF "camps" joined forces BFing would improve?

[WriterofDreams]

DS is now 8 weeks and mix fed - he gets one bottle of formula a day. When I was making the decision to mix feed I found it quite hard to find any information on it. Most information I found said that I shouldn't introduce formula for the first six weeks, shouldn't pump for six weeks, shouldn't use a bottle only a cup etc etc. It all seemed very biased against using any formula at all. It all seemed so rigid and difficult that I was tempted to give up BFing altogether. DS wouldn't latch after three days and all the advice I got was to keep trying, stay in bed, call helplines. If I wasn't so stubborn that would have finished me off and I would definitely have given up. Instead I gave him formula, calmed down, waited for the extremely helpful MW who sorted out my latch and took up BFing again, with great success.

Surely for a person in my position for whom exclusive breastfeeding isn't really an option (due to medical problems) it's better to BF as much as possible, rather than switching completely over to formula? All the advice I received, especially online, seemed to suggest that exclusive breastfeeding was the only way to go and that if I introduced formula it would have catastrophic results for my supply. I'm sure for many new mothers this sense of rigidity, that it's all or nothing, is hugely daunting and off putting. Wouldn't it be better for the advice to say "feed as much as you possibly can, if you need to use formula, that's ok but aim for exclusive breastfeeding and the closer you come the better." I don't know if it's just me but as a new tired mum I got the sense that BFing was something I had to dedicate myself to come hell or high water in order for it to work. In fact I found that a few bottles of formula here and there where convenient made us both happy and made BFing possible for me, and in fact prevented me from giving up altogether.

So AIBU to think new mums should be given a more balanced view on BFing - a less "all or nothing" approach?

I think the info re supply etc is true though?

they should be told the truth, making stuff up to make you feel better won't actually help anyone.

Well I think common sense prevails as it did for you. What people tend to forget is that advice is just that 'advice' it's not the law and you as a parent has to decide what works for you and baby.

The supply thing really confused me actually. I was told missing a feed would mess with supply but also that when I fed I wouldn't run out of milk, there would be enough for DS. Which is true? I know for me introducing formula made no difference at all to my supply. Maybe it does affect some women?

Yeah yeah, that's what the OP is looking for - people to make stuff up to make them feel better.

I gave formula early (severe weight issues, was ill-advised) and am still feeding at 15 months.

YANBU, OP.

I'm not sure what your post means Buzz, can you clarify?

I do agree with you - BF/FF is really presented as an all or nothing thing, to the extent that often if a mum gives her baby a bottle she might think "That's it for BF then" and stop completely, whereas often it's possible to keep BF going alongside FF for a while at least.

The problem is though that there are problems introducing FF too early. If you need to then obviously you should, but too often top up bottles are reached for as a first resort by midwives or HVs and this can cause many more problems than it solves. It's much better to try other things first and go for formula as a last resort, IF you want to keep BF going. If you don't mind mixed feeding, then that's different, but for many women BF is hugely important and emotional, and they should be supported to succeed, not just told "Oh it's OK, you can give formula as well. It's no big deal." when it IS a big deal to some people, and there may have been a chance they could carry on breastfeeding.

But yes I do agree, if a mum is in the situation where she needs (or wants) to give formula she should be supported to carry on breastfeeding alongside this if she wants to. Often it's just an attitude of oh well, the problem's sorted now, she doesn't need any more help. If it's a want to give formula rather than a need then she should be able to access information about how it is likely to affect supply etc though, so she can make an informed choice.

Good post Bertie, I see what you mean. People tend to avoid mentioning formula for BFing mums as it could discourage them further as well as damaging supply.

BUT surely if you give one bottle of formula in a day and then none the next day this will have no effect on supply? Surely it's just like the baby missing a feed due to being extra tired and sleeping for longer or being sick for a day?

If you feed on demand you will make enough milk (medical problems excepted) - as the milk is removed from the breast it sends the signal to make more. If you miss a feed, because the milk is not being removed, it sends the signal to the body that the baby doesn't need as much milk (because they aren't drinking it) and you will produce less.

It's possible to rebuild supply if it has been interrupted, but the body is "calibrating itself" if you like, in those first few weeks and so it will be difficult to "re-program" if you don't follow your baby at this time. It doesn't mean it's impossible though. Supply isn't as fragile as it is painted. But if you're already giving bottles and then come up against a supply problem, the temptation is to top the baby up with more formula rather than keep breastfeeding to stimulate more supply. So it's a destructive circle, but you're right that a lot of it is misinformation and more information would help.

Well sort of - but the baby wasn't tired or sick, it did have a feed, so the baby and the breasts aren't "in sync" any more. So the next day the body might produce less and then the baby will be frustrated and/or hungry and need to feed more to get the supply back up again. It's unlikely to be hugely damaging, but it still makes things more complicated than they need to be.

I agree that supply is painted as being more fragile than it actually is. I don't think the body is a responsive as people make it out to be. DS is a very haphazard feeder and this seems to have had no effect on my supply. For example one day he'll feed on and off for three hours in the morning, then not for nearly four hours, then on and off again for two hours, and then other days it'll be a steady feed every two hours or so. Surely the body doesn't have such a strict "timer" that this'll affect supply? In the same way one bottle isn't really going to make any difference I think.

She wants the experts to advise things that simply not true, thats all. Formula in the early days is very likely to sabotage your chances of successful BF. Telling people otherwise won't help them at all.

She/you, sorry, not concentrating.

Also I do think that people avoid mentioning formula to BF mums - but this is often because it can be an emotive issue, especially if they are getting pressure from friends and family. I think there is actually a policy which is don't bring it up unless the mum specifically asks - which I think is probably fair. Unfortunately when the mum does ask often the HCPs give insufficient advice. I heard a mum ask her HV whether she should give her 13 week old formula the other day as she was too young for solids and the HV said "Hmm, you could, but it's a slippery slope." - not very helpful. She could have said "There probably is no need to, but if you want to do this you need to know it could affect supply" and then gone through all the ways to help reduce the effects of this. And also found out why it was that she wanted to give formula and gone through other options to try. Then the mum could decide oh yes, I think I will do that, or oh no, that sounds like too much trouble, I'll just carry on. But I guess they just don't have the training.

No but the body will sync with your baby, even if they are haphazard. It's impossible to explain this, I don't think we even know how it works, but we do know that it works best when the mum and baby are in sync - ie that the baby isn't getting milk when the body thinks it isn't.

He probably takes roughly the same amount over a day - or a 2-day period, or a 3-day period (again we don't know what the timing period is) even if he has shorter feeds sometimes and longer feeds at others.

No I don't think mixed feeding is impossible - I'm saying it's best to be educated about supply and demand before you start. One FF a day at a set time is probably one of the least intrusive ways of mixed feeding, because the body will calibrate around that. Same with women who go back to work but continue to feed in the evenings, and even at weekends. The body will work this out too and women don't tend to get engorged during the days that they work, even if the baby feeds all day at the weekends.

But usually this kind of pattern is introduced much later than the first few weeks, when supply is much more established and robust.

Oh and it's important to introduce FF slowly as well, especially important the earlier you do it. So e.g. introduce one feed a day, then a week or two later introduce one more feed a day, then a week or two later the third, etc (I don't know how many feeds would be usual) - if you just suddenly started FF during the day when back at work for example not only do you risk the body thinking the baby has stopped feeding completely, you risk becoming engorged leading to mastitis etc.

But hopefully women would be told this anyway.

What buzzlitebeer said.

But yes I do think it's odd. Mixed feeding often does lead to full FF because of lack of information/knowledge. So let's discourage anyone from trying to do it, rather than, oh, I don't know, making that information and knowledge available?

I'm breastfeeding, but was told pretty much what bertie has explained. Short term you might not notice a difference on supply, but over theong term you will prob find it hard to keep up and a 'slippery slope' ensues. A friend has a 4 mo old and was mixed feeding from start (as recommended by a midwife who said she might as well do it from the start as she'd end up doing it anyway ) and her little boy has gradually weaned himself. Her supply slowly dropped, he was getting antsy so she would get frustrated and giving more formula, then he started deciding the boob was too much work. She tries to express to give him a little BM but is struggling.

I think that is what they were worrying about. She only gave one feed a day FF to begin with, but I suspect it was a night feed. These are the worst to miss as they are the fatty, supply building ones.

NinkyNonker that's the kind of thing I mean. Baby gets frustrated at the breast and instead of being given information on how to remedy this, mum is just told (or thinks, logically,) your supply is dropping, you don't have milk, give formula - he'll be hungry.

But yes it's likely this was exacerbated if she started mixed feeding before her supply was initially established.

Also, expressing is no indication of supply. The baby is more efficient at getting milk out than a pump - again, women aren't told this (and certain books even advocate expressing as a measure of supply, which it isn't an accurate measure, at all)

I agree with what Bertie has to say. It is a really fine line. IME, there is a 'real life' backlash against breast feeding, which counteracts the 'pressure' put on Mums by healthcare professionals. What I mean is, friends and family tend to say 'don't let anyone pressure you, do whatever you need to do, happy Mummy = happy baby', blah, blah, blah and the result is that mixed feeding starts up and almost inevitably leads to exclusive formula feeding. Not that there's anything wrong with that, but I guess that is why some people try to dissuade Mums from it (in addition to the supply issues, which I agree are overplayed - we negotiate through growth spurts easily enough, so that shows how quickly supply responds).

To be honest, I don't disagree with what you say, and I say this as someone who exclusively breastfed DS until 6 months (and then very gradually intro'd formula), and am still purely breastfeeding DD (6.5 months old) and won't actually give her formula at all.

A better slogan than 'breast is best' is 'every feed counts'. I feel like this is a much more positive message, much less guilt-laden and feels a lot more, achievable I guess. Even if you don't keep going with breastfeeding, if you've done some feeds, at least it helps. :)

There is also an incredible lack of faith in boobs.

So many problems come down to doubting our boobs' ability and assuming a worst case scenario instead of what is usually a very short-term adjustment thing, or else something which is perfectly normal and just needs to be ridden out.

Not sure if I'm explaining myself well, but I have noticed this a lot. Not sure why we doubt our boobs so much, but it has definitely worked in the formula companies' favour (not meaning to be controversial here).