Breastfeeding in the day and formula at night, from birth, any tips?

[ThreaderickDorrit]

I am hoping to breastfeed my next child during the day and for my DH to take over at nights. I have previously exclusively breastfed day and night but last time round I got so ill from repeated mastitis and sleep deprivation. My DH wanted this baby so badly and he needs very little sleep so before I even got pregnant he promised to do the night feeds to allow me some rest and to ensure that the baby takes a bottle and we can move to formula quickly if the recurrent mastitis is a problem again.

My plan is simply to breastfeed exclusively for a week so that my milk comes in etc and then to hand the baby to DH and the spare room at 11pm and to let him get on with it until 6/7am. We have bought some Avent bottles and a tub of Aptimal (we have never owned a bottle or formula before so this is all new). Do we need to think of anything else?

OP, please explore this properly and get some good information so you can make a choice based on facts and an assessment of what's likely to happen.

No, breasts cannot tell the time, and make less at night and more in the daytime if night feeds are not breastfeeds - what happens is that with well-established breastfeeding, you don't need round-the-clock removal of milk to maintain a supply...but this does not happen in a week. Very few women would be able to build up and maintain a milk supply if they go your suggested 7-8 hours. Short term you risk engorgement, blocked ducts and mastitis; medium term you risk a serious drop in milk supply so you struggle to breastfeed at all.

Combining bottle and breast the way you envisage might work if you leave it several weeks first, but you still risk a drop in supply,and you still risk full, engorged breasts (and this is something you don't want, with your known tendency to mastitis :( )

Obviously, you do need to work out how to avoid mastitis and illness from lack of sleep....but honestly, your plan at present is not likely to help you. There has to be another way, and I hope you get the chance to discuss it more. A call to any of the bf helplines so you can have a proper dialogue might be a start.

Sorry, just to clarify: "No, breasts cannot tell the time, and the don't make less at night and more in the daytime if night feeds are not breastfeeds

As a fellow regular blocked ducts/mastitis sufferer with ds1 I also worry that this seems like a risk of getting seriously engorged when your milk comes in = mastitis potential

Two of my early mastitis episodes were triggered by blocked ducts due to ineffective breast emptying when my milk came in. Another came when ds dropped a night feed at 8 wks and the top I was wearing pressed against my extra-full breasts for a few hours causing a blockage.

I'm on day 6 with ds2 and have just had the night of poor-latch hell because my milk came in with a vengeance yesterday evening. The difference (hopefully) is that I've known what to be careful about so hopefully, (oh god please!!) although I'm tender and full feeling still, will avoid getting so many blocked ducts - I suspect I'll always be a bit prone.

If you left it a couple of months though you'd effectively be simulating a baby sleeping through the night, a bit early but some do sleep through that early, so I guess that would be far more doable.

Thank you for all your advice. I am disappointed that so few of you think our plan will work but I take on board what you say and will seek further advice. Maybe I will stretch out the time I allow the feeding to establish. I have friends whose BF babies have slept 7-8 hour stretches from 6ish weeks so I really do believe that it must be possible for breasts to cope with that length of a break.

I have no idea why I suffered so badly with mastitis last time round. I did get my daughter's latch checked, I did see a BF expert, I rang LLL and spoke for hours, nobody could explain the problem. When I say it was regular bad mastitis I really mean it, it was raging fevers (40+) with terrible pain and awful shakes and it happened about 10 times in the first 9 months. I had countless antibiotics etc. It ruined my experience of the first months of her life and made me so miserable. I carried on feeding until 14 months but even after the mastitis stopped at 9ish months my immune system was in an awful state and I seriously could hardly function. As soon as I gave up BF completely things got a lot better for my health. It is for this reason that I have to find a way to ensure I get decent long blocks of sleep. If I cannot find some way of ensuring that then I will not BF for long at all. My other children deserve a healthy energetic mother.

Did she get checked for tongue tie? It's very hard to spot. My dd had it and I had mastitis exactly as you did. Twice. Was awful.

Sleeping through at 6 weeks is rare - most 6 week old babies do not. Plus even six weeks in your breasts are well in their way to establishing supply - 2 weeks in is early days. That's why it's unlikely to work.

Also there's the small chance that baby is intolerant to formula - unusual but it does happen.

Breasts are able to cope with that long of a stretch, but only when supply is established, (past 6-8 weeks minimum) and even then, you'd have to stretch it out slowly - you can't go straight from 2/3 hourly feeds to an 8 hour stretch, because your body would think the baby had died and start to dry up your supply. You might manage to do it if you stretch it out slowly but I don't know how this would work as formula tends to fill them up for longer, so for example if the baby was used to feeding every 2 hours, you fed them at 11, they get hungry at 1am but the plan is to keep them going until 2am. An hour is a long time for a baby to scream, water isn't advised as it can fill them up but dilute calories, and if you give her a FF she will probably go back to sleep and sleep for 3-4 hours leading to a gap of 5 or 6 hours rather than 3 - still a huge jump for your breasts/body to adjust to. You could express in the night but this is probably more sleep-disturbing than feeding, even if it is short term.

We didn't do this consistently i.e. every night but we mix fed to a smaller extent from very early on, with DH giving a bottle of formula every two or three days to give me a break as I found feeding very painful for the first month or two; and he did regular nights from about eight weeks. I ended up back in hospital at six weeks (when obviously he had to have formula for a couple of days) and as I'm also struggling with PND the GP said it was crucial that I no longer did every night.

I have had no problems at all with supply. Baby is now 4 and a half months and we are fully mix feeding - he has two or three bottle feeds a day (as I have started back at work) and I feed him the rest of the time. I am aware that my breasts may reduce production eventually but at the moment they are fine and to be honest I feel better for feeding a bit less.

No probs with nipple confusion here, but we did have bottle refusal. We thought that introducing a bottle at the very beginning would avoid it but it didn't - he was fine with the bottle until about six weeks but then he developed some views of his own and between six weeks and four months he went through two or three phases of refusing a bottle. Obviously we had to sort this out as I was going back to work. It took a few weeks but he no longer objects to a bottle and will take one even if I am in sight.

Just a week of only you is perhaps not long enough but I really understand your concerns. Maybe your DH could do one feed a day (perhaps late evening so you can get a bit of sleep) starting very early on, but you could hold off doing the whole night for a few weeks? But also - if it doesn't work out and you switch to formula completely it's not the end of the world. Your health and sanity matter too!

Definitely worth considering a side-car cot if you didn't have one last time. They are a bit pricey but a really good compromise if you are not comfortable with/don't like real cosleeping. We have a 'BabyBay' that I got on ebay. Not having to get out of bed made a big difference to night feeding I found, as did an ipad for reading while feeding - gives just enough light that you don't need another one to latch the baby on and keeping things dark helps to establish the night time idea early on apparently.

That is a good point - why don't you just try it and see how you go? If you end up switching to formula that isn't the end of the world. You have to do what's right for your family.

OP - re: the mastitis. I had recurring mastitis with DS2, and it completely floored me. It turned out that I had a post partum overactive thyroid (basically, my thyroid gland dumped its entire contents into my blood stream in one go!). One of the symptoms was a rubbish immune system, and recurring infections.

Did they test your thyroid function? Other symptoms were severe weight loss, nightmares, aching wrists, shaking and panic feelings.

Thanks again. I know I could just give it a go and if I get ill I could give up and move to formula, I was just trying to maximise the chance of success without suffering but maybe I am going about it all wrong. I am worried that without a plan I will give up really early which will make me feel guilty as both other children had BF for over a year. Ultimately I am a lot less committed to BF that I was the first two times round.

Sitting - thats for the tip about your thyroid. To be honest I don't think I had any of those other symptoms other than maybe the anxiety which I rather put down to being ill ALL the time.

Having had mastitis 11 times myself, which only stopped when I dried that side up, there is no way on this earth I would skip feeds for 6-8 hours at night with a newborn. It is almost making mastitis inevitable IMO.

Feeding at night is very important for overall milk production and although no doubt some ladies could never feed at night and not have their supply dry up, most couldn't. I have a pretty robust supply, but not feeding at night dried my milk up with DS3. (he had a heart condition and STTN from birth) I wish someone had told me that would happen.

Of course, if you don't mind your supply drying up then that's fine, but you'd still be risking the mastitis, which is what you're trying to avoid. Perhaps you could find another way round such as your DH sleeping separately with your baby as planned and bringing them to you for feeds, then settling back to sleep again for you. That way you'd barely need to wake for feeds if you fed laying down. You might find that even in another room your DC woke you if they cried anyway, i can fall asleep downstairs with the television on and DD asleep upstairs in the opposite corner of the house to me and I still wake at the slightest cry.

Sorry to hear that you suffered to Midori.

I have been reflecting since my last post and the more I think about it the more I think that probably BF is just not the right approach for us this time.

I had hoped that I could find a way of providing BF without getting too tired or too ill but it seems that is probably not possible and that mixed feedings actually ups my chance of problems. I really think the for me the benefits of BF are overshadowed by the benefits of a happy, healthy mother who can interact with all her children and avoid PND. I have given my all to breast feeding twice now and I know it takes a lot out of my physically even if I enjoy it emotionally. I also want flexibility to go out with my other children and leave the baby with a bottle and if that can only be guaranteed through exclusive formula feeding then so be it.

It is common for subsequent babies not to be BF as long as previous ones. If the worst comes to the worst, you really will get over the guilt .

You really shouldn't beat yourself up if it doesn't work out - it sounds like you are doing your level best to plan ahead. There are some really good suggestions on here and I wish you all the best. That thyroid suggestion sounds like pursuing to me, in particular.

Yes - I'm sure that you could find a way to make it work if you really want to :)

My plan would be DH in another room with baby (or baby in cot in your room but you wear earplugs or something!) - DH brings baby to you to feed, you latch lying down, and he takes the baby back to its cot when finished. His sleep will be terrible - but it would only be for the first few weeks or so, and/or you could take turns. If you want the benefits of co sleeping but with the baby in their own space, you might want to look at a bedside cot.

Also, get some support in place to pre-empt any problems. Maybe look into getting your thyroid checked before the birth if possible to rule out immune system problems, and see if you can find an expert on tongue tie in your local area. It should be enough to see your local BF expert and phone a helpline but sadly this isn't always the case and sometimes (often, unfortunately) you have to push for good, well-informed support. Was the expert you saw last time accredited? Milk Matters are a breastfeeding organisation which specialise in tongue tie support and might be able to help you find something local to you - google them. Or see if there is a LLL group in your local area. If you're happy to share your local area on here, someone might know a good person to go and see. (I can help you with Warwickshire!)

Oh sorry x-posted I hope my post doesn't come across as pressurising. If you feel that FF is right then that's definitely the right thing to do - it's important to take the big picture into account as a whole.

Cross posted. I don't think it's all or nothing though. Please do get some additional advice from one of the helpllines, or a BF professional.

You could always commit, say, to BF for the first week so the baby gets the colostrum and all the other good stuff, and then just see how it goes. Or make an advance decision to switch to formula one week in.

There are options. Planning ahead to not BF doesn't make you a bad mum. Don't beat yourself up.

I just wanted to pass on some anecdotal positive advice that may help you hon. My sister had an awful time BF with number one, mastitis recurrently, a cyst, the works, and when she really needed her little one to take a bottle due extreme tiredness and agony (about 3 months in) she just wouldn't, and every time they cried her breasts swelled with milk and it was awful for her, really distressed her tbh. This time, she swore on mixed feed from day one. She didn't do it until out of hospital so she wouldn't get any comments from staff etc but from about 4-5 days in she has done so, and every day number two has a bottle in the middle of the day, and also at night about 10.30pm - this takes him through until 4-5ish, then she bf's him. Sometimes he will get an extra one at about 10am. It has saved her sanity. But it was totally fine from the beginning. He sleeps better at night than her first one too. I loathe the way people bully women on the topic (and it's really nice to see women helping each other on this post and supporting you here BTW ) - you do what works best for you - much, much worse is an exhausted mum who can't function, and then suffers PND, than a bottle. And please think of it this way, yes in an ideal world we would all BF fine - but so would we grow our own fruit and veg out the back, collect milk and eggs from local farm, eat everything local and organic. But we don't live like that - do what works for you. x

Both my kids mic fed from first week. Ds now 4 months and still doing so. Did dd until 18 months

I didn't do day time breastfeeding and night time formula from newborn, but I did introduce an occasional (not consistent, just if I was out for a few hours) bottle at 4 weeks and never had any problems with bottle refusal.

By 8 weeks DS was sleeping 7pm-3am without a feed and this didn't seem to effect my supply. However I was feeding 2 hourly the rest of the time.

I was fortunate though that breastfeeding came very easy to us and it established quite quickly.

So IME 1 week might be a bit ambitious, but if everything seems good by 4-6 weeks then I'd give it a go.

I've been watching this post with interest as I have been mixed feeding since day 10. First baby, really wanted to bf however since day 1 seemed to have trouble. Think it was more psychological rather than actual problems. The 2 days I spent in hospital put me off.. In the whole bay I was the only one bf and I was the one constantly calling the midwife as baby wouldn't latch on, my baby was the one constantly screaming because he was hungry whereas everyone else's babies seem to be calm and sleep through the night. When I got home latching improved however no one told me that on occasion he would feed constantly for hours and hours which I just didn't expect. (Although I had read up on bf beforehand maybe I was just abit naive about how difficult it is) I had to plan visitors around his feeding time and I just was not getting any sleep. My husband could see how distressed I was and felt helpless that although he was awake he had to constantly wake me up to feed. I had a go at expressing but it also got To the point where I was feeding then passing him onto my husband before expressing then as soon as I'd finished i was feeding again! So many times within those 10 days I nearly have up and was constantly in tears. It was my MW that suggested mixed feeding. She said that surely that was better than just giving up all together, I was likely to last longer bf. so from day 10 to now (tbf I'm only on day 15) baby has 2 / 3 bottles at night and I bf in the day. Apart from feeling rather engorged In the morning we seem to be doing well. I know I'm ore like to get mastitis and for my milk to dry up (which out of interest when would that likely to be if I've been doing it for 5 days??) but considering I was going to give up I feel lucky and relieved i can give him abit more.

i think we have so much pressure on us to bf that sometimes we forget the bigger picture - a happy family and for some the answer to that is ff ( still trying to convince myself of that!)

also just a thought my HV gave me all these leaflets on baby / mum vitamins I need to get whilst breast feeding and yet I'm guessing all these vitamins are already present in formula? So we are still having to supplement when bf?

Charrin, would be a good idea to start your own thread, as your situation is a bit different from the OP's.

You say, " my baby was the one constantly screaming because he was hungry whereas everyone else's babies seem to be calm and sleep through the night."

The babies sleeping through the night would be a big problem - it is just not good for a newborn to sleep through the night. It is horrible when your baby is screaming, even so....especially if they fight at the breast when you are trying your best :( But don't assume the other mothers and babies were without their own difficulties.

The feed - express - feed cycle you got into so early is very pressurising, and it's not surprising this felt impossible to maintain. Yes, mixed feeding in your situation has to be better than stopping bf altogether - with 2-3 bottles at night from day 10 your breastmilk will (probably) gradually go, but who knows when, as experience is so variable, and you might continue for longer than someone else.

Now your baby is better at latching and the pressure of expressing is off, you might feel more able to go back to full bf - your midwife could help you with talking this through.

On the vitamins thing: the vitamins are really mainly for you, not for the breastmilk, and it is up to you if you think you need them. There is some evidence that in the UK where we have less sunlight, Vitamin D (one of the Vits in the supplements) is a good idea for bf mothers and this does go into the breastmilk. Most women who go outside every day with their babies and have a reasonable diet really don't benefit from these.

Vitamin D is added to formula as an extra. You could ask your HV if she thinks you need your own Vit D as well.

Hope things get better for you soon.

Generalise like what?