Combination feeding - advice needed

[NewMummy5July2011]

Hi
I'll try to keep this short, but basically had a very traumatic labour that ended in an emcs. My beautiful little girl was in NICU for 3 days and we were separated during my stay in hospital too. I was very traumatised myself after the birth (and still am to be honest) and we had alot of feeding problems. We weren't allowed to leave hospital until we had 2 full days of feeding and pressured to ff due to the nature of my baby's condition.

I initially spent 5 days trying to get my milk supply up - expressing and feeding every 1-2 hours. Once milk started to come in, my girl was on the boob constantly for 10 days - literally I would feed her for over an hour, and 15 min later she would be crying like crazy for more. I was spending 24/7 feeding her, she was distressed and I was distressed too.. we were both exhausted, DD crying all the time - I was in agony and couldn't even leave the house or take a shower.

Was so emotional it got to the point where I was hating bf and couldn't really get any helpful advice. I desperately wanted to bf and was so determined to do it, but just felt defeated. So decided to go back to trying out some formula. Did a top up after one of the feeds. The difference in my girl was amazing. She started to play, and was alert, and was able to sleep. She was like a different baby.

At the moment I'm bf her and finishing off with formula. One side is too painful so I only express from that side. The other side she latches on fine. Just wondered if anyone had any advice for how to effectively combination feed and if this is the best way of doing it. As much as I want to continue to give her breastmilk, feeding is a real faff and I can see myself eventually getting frustrated with it and switiching to formula 100% of the time. I can't realistically continue with the feeding pattern forever otherwise it will get very difficult to get out and about.

Sorry for the lengthy post - I'll await some expert MN advice.

Bumping for you.

I had a similar story and eventually ended up FF, my little girl had a hospital admission which pretty much killed off my expressing and it turned out she had Cow's Milk protein allergy and very severe reflux so next time (if I am so lucky) I will know to perhaps avoid dairy! I know the feelings you are going through but KNOW THIS- whatever decision you make feeding wise you are still that little girl's Mummy and she loves you and the decision you make will be the right one for you both. Others may have opinions and make comments which upset you but you will be fine!

BUT- others will come along now to give advice who are more experienced than me. I just didn't want to to go unanswered,

all the best x

kickassmunkiii - just wanted to say thank you for your post and your support - it really helped to lift my spirits!
x

Have you a local NCT? or La Leche League? They are good and will offer lots of support.

Perhaps there is a breast feeding counsellor at your maternity hospital? There was one at mine and she wasa godsend.

NCT breastfeeding phone number 0300 330 0771 open until 10pm EVERY day

Thinking about you xx

Thanks - I've spoken to NCT counsellors on the phone and while they have been helpful, I haven't been able to get anyone to come out to the house which is what I think I really need. I haven't tried La Leche League, so may give them a try.

Thanks again for your support xx

La Leche League 0845 120 2918

Just to save you a bit of time! Enjoy your new baby. x

Check out www.kellymom.com for loads of great advice.

You say one side hurts - in what way? Is it the breast tissue itself or the nipple? If your breast has small red patches, or small lumps, or feels inflamed, it is possibly a bit blocked - in which case feeding from that side first will help clear the blockage. Use cold compresses and ibuprofen between feeds to relieve any inflammation and a warm, moist compress for a few minutes before the feed). If it's the nipple, have you tried any creams? You can try wetting the nipple with breastmilk when the baby has finished and letting it air dry too. I know women who have continued to breastfeed with nipples that are bleeding, and eventually they do toughen up - perhaps ask your MW or GP for help with suitable pain relief or advice on using nipple shields.

In terms of reducing the amount of formula you're giving your DD, you need to monitor exactly how much you are giving your daughter in these top-ups. Aim to reduce the amount by not more than 1oz per 24 hours. Your breasts work on a supply and demand basis and will produce more milk as your baby grows and consumes more of your milk.

Also, has your daughter been checked for tongue-tie? Ask your GP to check if not. If she is not feeding well from one side, try other positions, e.g. the 'rugby ball' hold (tricky, but you'll get there will some cushions and maybe a friend or partner's assistance - you basically hold the baby under your arm, rather than across the front of your body. It means the baby has to feed from your breasts with her head turned in the same direction - it might make it easier for her. Varying feeding positions is also a good way of ensuring you empty your breasts fully at each feed.

Finally, it is totally normal to have to wait 5 days for the breast milk to come in (even with out an EMCS!) and in the first 6-8 wks totally normal to BF a baby every 2-3hours (depending on size, under 8lbs every 2-2.5hrs from start of one feed to the next).

Whatever happens, I wish you well. Sounds like you've had a rough time, but take heart that your love affair with your beautiful baby is just starting and that things will only get better for you.

Hope this helps.

wow, well done on giving your daughter so much of your breast milk under such difficult circumstances!
As I have b/f and combined fed 3 babies I thought i would share my expiriances, however what worked for me may not work for you as you have different baby and circumstances.
With my son he initialy fed 1hr on 20 mins of throughout the day for the first 8-10 weeks but he slept at night from 11-6 (waking once from 2-3) from birth. So at about 5 days I started to express milk from one breast when feeding from the other and my partner gave the 2 am feed of expressed milk so I got 7hrs sleep @ night which realy helped me. Between 8-12 weeks my son started to feed less frequently and for shorter periods so between 3 and 4 mths there were 3 hrs between feeds and each feed lasted about 20 mins. Our son started solids about 5 mths(when he was trying to pinch food from my plate whilst in his sling) by 6/7 mths he had cut down to 3 breast feeds a day and he continued to b/f untill 13 mths. I was able to get out because I was happy to b/f in public, wearing lose tops for discretion, but that wasnt untill about 10-12 wks as before then he wouldnt go long enough between feeds for me to get anywere!
With my twin daugters I tandem fed for the first 3 mths, so didnt find it fessiable for me to express. On of my daughters was still waking every 1/2 hrs at night at 3 mths and I was realy feeling like I was cracking up from lack of sleep so we bottle fed her formula at night (which my partner did so I could sleep). We started to give our other daughter a bottle of formula each day from 9 mths as i was returning to work when they were 10 mths. My daughters are now 21 mths old one of them chose to stop breastfeeding herself 2 weeks ago, the other one still feeds once or twice a day.

Hi, I'm no expert either I'm afraid but just wanted to let you know that I also had issues feeding in the early days and began topping up with formula too when DS was a week old. I was advised to do alternate breast and formula feeds for a few days (in part to give my mangled nipples a rest but also to have a bit of mental respite from feeling my baby was hungry and I couldn't feed him).
Each time DS had formula I expressed and though I only got perhaps 20ml, after three or four sessions I'd have enough for DS to have a bottle of EBM.
DS is four weeks old now and is down to one formula feed per day (the 11pm feed so I get a bit of sleep, about 100ml). I'd like to get back to exclusively bf'ing but will not beat myself up if I can't. I am definitely a better more patient mother with the extra couple of hours sleep I get!
Please remember to take care of yourself - I was hardly eating or sleeping due to stress and my milk supply is so much better now that I'm doing both. Every time I bf I make sure to eat something myself and drink tons of water too. It really does help. I take fenugreek as well.
In terms of help, I googled and found a private lactation consultant as well as asking the midwives and health visitors. Mumsnet has been brilliant too. Others will be along with more info on volunteers etc no doubt.
Good luck!

So i feel that we have succsfully combined breast and bottle feeding. Things which i think helped us were
-using those tomitipee bottles that are more breast shaped
-using expressed milk (rather than formula) in bottles were possiable
-having partner give bottles rather than me, so i could use the time for rest/ a bath.
-having short term goles to b/f to the end of the day, wk ,mth
-reminding myself that it will get easier
-setting limits on the times/ amounts of formula i would give, so i still incressed feeding during growth spurts which ment that my milk still incressed as our babies grew.
-getting as much rest and help with practical things (cooking,cleaning etc)as possiable.
I think one of the things i found hardest was that i had a feeling of failing because using formula as well as b/f. I would never think that of someone else it was just that my goal had been to fully b/f. Letting that go, accepting my new goal of combimd feeding was a hard process but getting there has felt very freeing. I also spoak to LLL on the phone for support which was helpful. I wish you well on your journey.