xed breast and formula from day 1: anyone done it with success?

[Greythorne]

My best friend is pg with DC1 and she has mentioned that she wants to mix breast and formula from the start.

I know about nipple confusion and reduced BM supply......but would like to know if there are tips to make this work? Has anyone done mixed feeding from the get-go?

My friend wants her DH to be able "to do his turn" with the feeds and the night wakings, hence this choice.

I feel like she should maybe wait until the DC arrives to decide how she wants to proceed with feeding, but have not said as much. Don't want to come over all bossy and know it all.

So any tips would be useful to pass on to her.

Sorry, title should read "mixed".

I think she might find her supply drops away doing that.

I think I'd suggest that she breastfeeds on demand for the first 6 weeks so her supply is established, and then start mix feeding.

This can be done, but the bf part of the equation does not last very long. If she starts with the formula straight away, her bf might last days only. That's the risk - nippl confusion is not such a risk.

She needs to know all that.

The baby will still benefit from breastfeeding, but she needs to know that any formula impacts on bf and the effects of bf.

She also needs to know that fathers can do a great deal in the early weeks and months and their support for bf is crucial.

I did mixed feeding from about the third day as I was stuggling waiting for my milk to arrive.
My midwife supervised this though and she was brilliant. Here are the tips she gave me:

• Night feeding is the baby putting their order in with the milkman for the next day. So try your best to night feed if you can from the breast.
• Try if possible to limit FF to once a day, as your baby will realise at the start that the bottle is less work than the breast.
• We tended to give DD her 10pm feed from the bottle as it meant I could go to sleep early and then be up to do the night feeds.

I'm sure there will be more expert people along soon but it did get me through a tough patch and also meant that DD could take a bottle when my parents minded her for a couple of hours.

I think it's very unlikely to work long term if she's doing it from day 1. If she wants to continue breastfeeding until 6 months or a year, for example, she should seriously consider breastfeeding completely at least until she has got through the 6 week growth spurt, and then starting to mixed feed.

If you can show her any resources, kellymom perhaps? On supply and demand, so she has a full understanding of how it works, she should be able to minimise damage to it. It's most fragile in the early days when breastfeeding is getting established - anything which interferes with the normal course of breastfeeding is likely to affect supply, how easy this is to overcome will depend on how much interference there is really.

I would advise if she does want to start mixed feeding from day one to keep the bottle feed at a fixed time and a fixed amount, a very small amount - perhaps express colostrum, fed by syringe or cup, until the milk comes in fully. (If she wants to make this work long term it's well worth her looking up about the tiny volumes of milk a breastfed baby would take in the early days) Basically whenever the baby has an extra demand to go with the breast rather than the bottle and keep the bottle feed just once a day to begin with.

However, if overall the convenience/benefits of bottlefeeding are more important to her than the long term breastfeeding relationship, (and there's nothing wrong with that, if it's what she wants) then she might as well go for it - better to mixed feed for a few weeks/months than not breastfeed at all. Any breastmilk the baby gets will make a difference.

Just another note though - it's possible to get Dad to help with night feeds if Mum is fully breastfeeding. He just needs to bring the baby to her, latch him/her on and wait for baby to feed, then he can do the nappy, winding and resettling bit. Mum will probably be disturbed a little bit, but I think you would wake up anyway, unless the baby sleeps in another room which isn't recommended.

kendoddsdadsdog
how long did you continue to bf for? do you consider the ff had a negative impact on your supply?

TIKTOK
so, you think nipple confusion is not the big problem, but lack of supply will be?
just checking

I am, frankly, a bit worried about broaching this with her as I know she thinks I am a bit earth mothery (still bfing DD2 at age 2 years 1 month) and she has made a few comments along the lines of, "but you breastfed for AGES!!!!!" and "no wonder your girls went straight from breast to cup, they were really OLD" etc.

I do think she needs the info, but not sure if I am the best person to send her links to kellymom etc.

I was rather hoping someone on here would say, yes, it's absolutely possible to mix from day 1 by doing X, Y, Z.

thx

I mixed fed from birth. Mainly this was due to DD being in SCBU for a week and my milk supply never actually settling in very well. (It was a running joke amongst the midwives how little I managed to produce).

I noticed no nipple confusion, but then she was fed via a nose tube early on so who knows what was going on in her little mind. Wherever possible I BF (to try and keep the supply going) and tried to limit FF to once a day. I also tried expressing and freezing BM but was spectacularly bad at it. I think I only once FF during the night, but this was after 2 hours of crying (both baby and me) and cracked, bleeding nipples.

Did it limit my supply? It's hard to tell. I tried everthing I could to improve my milk supply but in the end even the midwives and HV had to admit I didn't have enough to feed her properly. We were in and out of hospital during her first 6 weeks, so I was under fairly constant medical supervision at the time my milk supply was establishing. In the end I gave up BF at 6 months when she grew teeth and liked to practise chewing on my nipples (ouch).

I found the whole thing a positive experience to be honest. Yes she had a hard start in life, but the fact that she took a bottle (even if via a nose tube) from day one meant her father and grandparents could take over occasionally. DH and I developed a routine on weekends where I gave her the first feed of the morning from the breast then he would take her and have "Daddy Daughter" time, including the next feed, leaving me to catchup on my sleep.

Greythorne, there is not a lot of good evidence for nipple confusion, despite some anecdotal stuff. But the evidence that formula feeding from the start interferes with breastfeeding establishment is massive - no one who really understands how bf works would think this a good idea if the mother is interested in continuing to breastfeed more than a very short time indeed.

What KDDD has said is useful, but this bit: "Try if possible to limit FF to once a day, as your baby will realise at the start that the bottle is less work than the breast" does not hold water (sorry, KDDD!). Babies simply do not have the cognitive ability to figure this one out, and in any case, breastfeeding that's going well is not harder than the breast - bottles have no let down reflex for a start :)

Limiting ff is essential, if she is to have any hope of bf, of course. Many - but not all - women prob can 'get away with' one small ff a day, as long as they are bf a lot the rest of the time and as long as it is not given from the very start.

As for sharing this stuff with her - not really sure! Hopefully a midwife will put her right either ante- or postnatally.

I BF for 5 months (I went back to work at this point so kind of tailed off gradually)
I didn't mix feed every day so was generally ok supply wise plus, later on I used to express and feed.
DD also had acid reflux so it helped to be able to add the gaviscon to her bottle.
Point I was trying to make I guess is that my midwife really helped me and it was done for a reason.

Am sure the guidance helped with the fact it was quite comfortable for me. Don't take what I say as gospel - just my experience.
TiktokThe bit about the bottle/breast being easier was told to me by my MW so I just assumed it was correct!!

tiktok
got any links to kellymom or an LLL site which would explain this? I have done a search but not come up with anything.

TIA

LLL have a tonne of meetings and I'm sure your friend could join before she gives birth? There is also something local to me called Bosom Buddies but not sure if it's national.

My experience of nipple confusion is that it's more about different techniques for bottle v. breast. DD was on bottle top-ups after scbu to start and weight issues and we had lots of latch issues with her lifting her tongue and not opening her mouth wide.

I have mix fed from the start (due to low supply/milk not coming in) and am still going strong at 4 and a half months.

Personally, I would have preferred to EBF but have never managed to re-establish supply sufficiently. I have managed to keep formula supplements within the same limits (between 180-250 ml daily on average, with a few fluctuations), but it took quite a lot of effort around the 2-3 month mark to keep my supply of breast milk high enough to even keep mixed feeding.

Never had any nipple confusion or any particular preference for the bottle - baby takes both absolutely happily, with a preference for breast if for comfort, e.g. when sleepy.

The big advantage of mixed feeding is that you can share the work while the baby still gets some of the benefits of breastmilk - but based on my own experience supply does become an issue and i'd definitely second those who say EBF for the first six weeks if you can. I almost gave up on a few occasions and got quite depressed about it.

PS why don't you suggest to your friend that she express milk if she wants to share teh feeding with her DP?

I did it from about 2 weeks. Was terrified about the whole 'nipple confusion' the midwifes kept banging on about but we had no problems at all.

I didn't want to do it and it took me ages to come to terms with giving him a bottle of formula a day but I was losing the plot with lack of sleep and figured a sane mother was important.

Still doing it at 5 months.

Greythorne - if I were you I would explain to your friend that mixed feeding is the absolute worst of both worlds. It makes breastfeeding harder to establish (if it's possible at all) AND you have to do have all the faff of bottle feeding. PLUS because breastfeeding is not predictable in the sense of when and how much, it makes it very difficult to manage the bottle feeding bit. I have mixed fed and I would never ever do it out of choice.

Plus, if you subscribe to the virgin gut theory, the first couple of weeks is particularly important for exclusive breastfeeding if at all possible, as it's the time when the most harm can be done to the gut environment. Your friend might want to consider this if, for example, there are any allergies in her family.

I think it's a shame that your friend is thinking in terms of her DH "doing his turn". Breastfeeding is such a wonderful thing for the bond between mother and child. Sure it CAN feel like a chore, especially in the difficult early days, but it is also a brilliant excuse to put your feet up and have your DH wait on you. Her DH can "do his turn" at night by getting her a drink/biscuits and keeping her company. Or he can get good sleep so he isn't too tired to help out at other times and let her get a rest. Also research suggests that breastfeeding mothers actually get more sleep overall than bottle feeding mothers.

I totally agree about nipple confusion though - never experienced it with either baby. But we have it in reverse now that DD is EBF!

I think it might be a similar scenario as has been suggested with dummies. Namely that those using bottles/dummies are likely to be those having more problems with breastfeeding. So any perceived problems with latching might have occurred anyway, hence the use of bottles.

We used one bottle of formula per day (at 7pm) from the start and it worked absolutely brilliantly for us. It really took the pressure off waiting for my milk to come in, which it did eventually. It meant that the baby was very happy in those first few days when I'm sure she wouldn't have been if she was hungry and crying for it. We're still going strong with BFing at 5 months; still one bottle of formula a day. That bottle has meant I have been able to have flexibility in my life. While my DH feeds DD I can get on with making dinner, calling friends, going out if I want to. I haven't had anything wrong with supply and the baby has been really contented. It has also meant that we can go out and about and someone else can give a bottle as she's used to it and knows what it's all about.
So I'd say your friend's strategy is a really good one. Best of both worlds I reckon.
Some advice, it's better to limit the bottle to one per day (keeps your supply up) and to always have your partner give the bottle (prevents baby being confused). I'd also highly recommend NUK newborn teats as they are slower flowing and make the baby really work for the milk, like they have to when they are BFing.

I mixed fed with my 1st, tried bf it wasnt working so decided to bottle fed, then mw encouraged me to try again - which i did but he had 1-2 bottles of forumla or expressed milk a day too

I wanted to add: although I've managed to do it, I wouldn't recommend mixed feeding as a choice. For me it's been very much a last-resort solution in order to keep breast feeding at all.

Kiwiinkits - newborns require such a small volume of milk per feed they shouldn't really be very hungry if fed frequently. That isn't really a great reason for advocating formula from the get go. Was your milk an unusually long time coming? I think you were quite lucky to get away without a big impact on supply.

Ditto to the above. The first week or so are crucial and the less you have interfering with bfing the better. Alot of my DDs issues stemmed from a scbu stay plus early feeding/illness problems meaning she didn't practice latching when the instincts should have been really strong.