Combination feeding?

[JazzieJeff]

Hi, I was wondering... I'd quite like to try combination feeding. I'm planning on giving a breast pump a shot, and was wondering how much expressed milk is enough for a feed? Do I sit and express the breast/both breasts until empty, or does 2oz of breast milk = 2nd of formula milk for example?

Thanks in advance
Xx

I try to express the same amount as the formula box suggests and he normally takes most of it. For example, at 8-12 weeks it should be 5 x 6 oz feeds (my DS feeds about 7 times rather than 5 so takes a little less at each feed).

You can express through out the day to make up a whole bottle though, so you could express a couple of oz at three times a day and then use that at night, rather than trying to get the whole amount out in one go. Just remember that you have 24 hours from when the first lot of milk was expressed to use the bottle (some people say it's 48 hours, I'm not totally sure whose right).

Thanks for the reply, it's so confusing! How long does it take to express a feed?

breast milk can be kept for several days in the fridge due to its amazing antibacterial properties

if you want to combination feed, it'd be much, much, much easier to do the breastfeeding direct from breast and supplement with a bottle

things to bear in mind:
expressing isn't as efficient as a baby. it may be difficult to express enough long-term,

you'll be very busy with expressing (which you would need to do throughout the day and ideally in the night too), plus washing/sterilising pump equipment, plus making u[p bottles, plus washing all the rest of the bottle feeding stuff, plus actually feeding the baby!!!

your supply of breastmilk is initially hormonally driven, however, if you don't remove much you won't make much. the less you express/breastfeed the less you will make. mums who are exclusively expressing would want to do so at least every 2-3 hours to ensure an adequate supply. if you are doing a lot less than this due to using formula as well you may find that your supply dries up fairly quickly

I tend to find it depends on the time of day, I can express about 5-6 oz in one sitting in the morning if DS didn't feed during the night and it takes about 15 minutes (I'll only express from one breast in the morning).

At night time, I can only get about 4-5 oz and have to express from both breasts for about half and hour or more.

I am trying out combination feeding, but I tend to only express the last feed of the day, at about ten o'clock as we do a dream feed before we go to bed and DS wont stay on the boob if he's too sleepy.

I do worry about reduced milk supply, but he's never hungry after his dream feed and sleep through til 4am at least. If I feel like my milk supply is dropping I try and encourage DS to eat more frequently through out the day, every hour or so.

I've also been known to use the odd bottle of formula here and there, but I can say there is no difference between how long DS sleeps with regard to having formula for his last feed. I will always express if I'm replacing a feed with formula so as to make sure my body doesn't think it's getting a break and stop making the milk.

Again we tend to use formula for the dream feed, if my hubby has offered to do the night feed, I'm pretty poop at planning ahead so express the dream feed and he then uses that during the night, we have found that using expressed milk settles DS better than formula, but not as good as boob.

Hope this helps, I'm still just trying it out at the moment and just doing what feels best.

As to amounts of breastmilk, babies don't need to increase the amounts over time (after 6 weeks) and the body changes the contents. This means you can't meaningfully compare formula amounts to breastmilk amounts.

With mixed feeding, babies easily take more than need as they can't suck without swallowing which then causes them to suck again. Normal amounts are 25oz a day with a 19-30oz range.

Just like formula feeding it's really easy to overfeed them without realising.

I started of with a bottle a day from 3 weeks, but only because I returned to work part time at 5 weeks and full time by 4 months.

I can honestly say that if I have another one (and get decent mat leave) I will have no pumps or bottles in the house. BF go through natural fussy stages, but when your mix feeding the temptation is think they'll go off boob and stick to bottle only.

You also need to watch out for bottle preference induced nursing strikes and maybe be prepared to not use bottles, when they're difficult to feed to ensure you stick with mixed breast/bottle feeding, if that is your aim.

I felt under pressure to let DH feed her before bed, but honestly the added pressure of trying to fit an express in the mornings was a right PITA, so overall don't think it helped ME. Did a whole night off once, that was great.

Depending on your fridge, you can store milk up to 8 days, personally we go for up to 5.

As for how to express (both boobs/one boob), really just whatever works best for you DCs feeding pattern. It's also variable, so sometimes you'll get 7oz and the next day (exactly the same conditions) you'll get 2oz. Some people express for a set time, others until they get to a certain amount. Just get your feet up, read a magazine or watch some telly. You can also express at the same time as your LO feeds. It is possible, I couldn't do this until she reached a certain size.

For feeding in the day, we determine how much milk she should/we would like her to have. So if it's been 3 hrs we offer a little over 3 oz. If she's happy afterwards we leave, otherwise we (I should say DH) offers more.

hth

ps OP love your username

oh and here's the link to the relevant section of kellymom.

Thanks climberchick everyone needs a bit of fresh prince appreciation ;)

Thanks also for the replies, seemingly there's no other way to go than to exclusively breast feed according to the nhs... The amount of bf info I've had rammed down my throat! I appreciate the education but I'd like to express too for my own reasons.

I was thinking about perhaps using a bottle of ff for the middle of the night feed only and using breast milk or expressed milk the rest of the time. The only thing that worries me about bf ing is that I won't know how much milk ds is getting and if he's getting enough, because obviously your supply ebbs and flows. I want to reassure myself he's eating enough, and I like that a bottle allows me to do that.

Xx

JJ, i do understand that. when my first son was born i wanted to breastfeed but he wouldn't so we started off bottle feeding and eventually got him to take the breast

I found it really, really difficult not knowing what he was taking at each feed

but actually there are other ways of telling whether your baby is getting enough. the amount of wet/'dirty nappies for example, putting on weight etc etc

it IS a big leap of faith though, and you have to have the confidence to trust that your baby is taking what s/he needs.

I guess the way i look at it is that there is no reason to believe baby wouldn't get enough.... thankfully mine have all been big fat babies so it was clear they were eating plenty, but i can see that for someone with a baby that gained slowly it could be a concern

is this your first baby?

i would definitely see if you have a local la leche league group. they're very welcoming to mums to be and could answer any questions you might have about breastfeeding, ensuring a good supply and of course expressing and feeding ebm.
i found them really helpful when i was having a tough time, it's quite reassuring to be able to meet up with other mums who are having the same experiences as you

thisisyesterday thanks for the reply; yes this is my first and I do feel quite uncertain. DH is fantastically supportive and kind to me; he's desperate to get involved as much as he possibly can, and I really don't want to leave him to just change nappies! I'd want to be able to offer my baby a feed too if I was a Dad and this seems like the way forward to me, as both of us can be as involved as the other. I agree, bf ing is a leap of faith with regards to 'is baby getting enough to eat?' I will have a look into a support group, I think there's one near us.

To be honest I'm pretty disappointed in the midwife/hv care in that I've had to come on here to ask questions since I'm daring to do anything other than exclusively bf :-/

Thankyou so much for the help
Xx

Don't have experience of combi feeding, just wanted to pick up on something in your last post - I exclusively breastfed DD until 6 mo when we introduced solids and her Dad certainly did more than nappies. Play, cuddling, pushing around in the pram, bathing, changing, dressing, naps together etc - there's more to looking after a baby than feeding.

Good luck with your decision :)

The whole making sure they're eating thing is a bit of a misnomer.

If they eat less one time (which is normal) you started panicking and try and get them to take some more. Also if they're sick (which I've heard can be more likely with a bottle) then you're back to where you started.

Not trying to discourage you, but it may not be as reassuring as you first thought (and forewarned and all that). Just remember to not compare with FF babies.