Mixing Bottle and Breastfeeding

[Claire5517]

Just after a bit of advice from people who have done this... I am planning on breastfeeding DC but after BF is established I am planning on expressing so its easier for days out, DP helping with feeds etc. How has this worked for you? Did it make your DC confused or unsettled? Does it make it easier for weaning? Experience/advice from people who do this or have tried is welcomed :)

Hi Claire

Lots of people (MW included) will tell you all about 'nipple confusion'.

IMHO that's a load of old tot.

My DS was born at 27+5 weeks and was in hospital until 34 weeks (gestation). I started to bf him at 31 weeks. At 33 weeks we started to reduce his tube feeds, which meant when I wasn't there the nurses were bottle feeding him.

So here was this tiny 4lb baby, still 7 weeks away from his due date taking a daily bf plus several bottles, and he was absolutely fine!

However, after we came home I dropped the bottles altogether. Then come 6 months old when I want him to take some bottles he wouldn't have any of it!! It took until 10 months old to get him taking a bottle again.

I also started giving my first baby an occasional bottle at 3 months and she didn't get 'confused' either.

Based on my experience, and what others have told me, I definitely think its a good idea to introduce bottles sooner rather than later. Before they work out how to play the system!! ;-)

However, expressing might not be as easy as you think. I never managed to successfully fit in expressing around feeding a newborn. If you're feeding your baby every 2 hours, your baby empties you, then by the time you've got full boobies again, it's time to feed the baby again - when do you express?! I never really got my head round that. I only expressed when DS was in hospital.

I would highly recommend a Medela electric pump, and if you can afford it a double pump (so you do two boobies at once).

Plus, I wouldn't do more than 1 bottle a day otherwise you really might mess up your supply.

Good luck!

Thanks for your reply :)

Would you recommend, for example, as long as BF goes well, introducing bottles at around 2 weeks old? Or sooner?

Nipple confusion may well not exist - but the effect on supply of skipping feeds is definite, and it's not a good idea to introduce bottles of ebm in the first weeks. Using a bottle of ebm still means going hours between feeds and it's a real risk to supply.

Not sure why you think it would be a great idea, Claire - nothing could be more convenient than bf for days out, and why does DP have to use a bottle to help??? There are loads of things he can do which are far more useful with a young baby :)

What's the rush? Why not leave it for a couple of months when things have settled?

Well, my pre-term DS was 3 weeks old and mostly tube fed when he started bottles. So I guess in theory it's possible, from the baby perspective.

BUT I don't know a single mother who has managed to express and bf a newborn. Seriously, when do you think you'll have time to express? As soon as your boobs are full after one feed your baby will want to empty them again. If you've expressed and you haven't got anything for your DC you are going to have one seriously pissed off baby on your hands.

The only scenario I can imagine it working is if you're expressing every day, at the same time, for DP to do the bottle shortly after. So, if at 3 months your DC is feeding at 7pm bed time and sleeping through for another feed at 11pm you could express at 9pm and get to bed, leaving DP to stay up (or get up) for 11pm feed. Then at least you've had a good sleep before the 1am-3am feed.

But, I honestly can't see how it would work with a 2 week old.

Also, if you're thinking about stocking up and the giving DC random bottles as and when, at different times and maybe more than one feed a day, tiktok is right, you could really mess up your supply.

I had a very scary episode when DS was in hospital. I was doing really well expressing, I had a stock in the freezer and had enough to give to my 2yr for her bedtime bottle. But then we had a really busy weekend and I let my expressing slip down from 5 times a day to 3 times a day. Buy the 3rd day I could only express 50mls, when I had been doing 250-300ml. I had to work really hard at building it back up again and actually I never did get my full supply back until DS came home.

Another point to make is that I think you're expecting too much. I promise that in those first two weeks you're not going to be thinking about expressing and bottles. You're going to be barely surviving!!

My honest advice would be to just get the first 2 months out of the way, then think about expressing so you can hand over a night feed.

PS when I said 'sooner rather than later', I meant before weaning on to solids!

Having struggled to get my DC1 to take a bottle at all when I returned to work, we were keen to introduce a bottle with DC2 early on and did so when he was less than a week old. One bottle a day, at bedtime when my supply was low. Not even every day, only when DH was home in time to do it and I felt I needed a break.

We continued like this to 15mo when I was forced to stop bf'ing for medical reasons.

The early bottle was a godsend for us because of the medical issues I started having after DC2 was born. If he had been exclusively bf it would have been impossible.

It worked brilliantly for us and I also believe that nipple confusion is a load of old toss.

There is a misunderstanding here about how breasts make milk... Breasts are never "empty" - they are not like buckets that are emptied, they are more like rivers. Breast milk is made continually as your baby stimulates your breast by suckling. You get the "full" sensation between feeds as your breasts store milk that is not removed by your baby. When bf is well established you no longer get the fullness between feeds but you are still able to produce plenty of milk. My ds is 1yr old now and I don't get engorged at all now, but he is still able to feed from me.

My point is that you can perfectly well express if you need to without having to wait for engorged breasts. However Tiktok is correct that skipping feeds can easily affect supply, and some babies do get nipple confusion. My ds certainly struggled to bf after being given bottles in SCBU and it took a lot of hard work to get to 100% breastfeeding as a result.

I would also agree that bf is way more convenient than bottle feeding when out and about. No equipment needed and no delay when baby is hungry. My DP was also able to help me by supporting me to bf - and by doing the bulk of the nappy changes during his paternity leave!

poppywearer were you given formula, or expressing?

'giving' I mean

exbrightonbell I'm not familiar with the exact physics of breast milk but I think most mums who have tried to feed a growth spurting baby an hour after the last feed would say that they were 'empty' (not literally, but certainly not full) and struggled to satisfy them.

We gave a mix of expressed milk and formula, tending towards more formula as he got older. But some formula early on too, on days when I was exhausted.

I've mixed expressing with BF very successfully.

For the first few weeks I only fed direct as it were. At about five weeks, DD was feeding every 90mins-2hrs,
So DH would give her EBM while I had a few hours uninterrupted sleep in the morning or afternoon. When I woke, I'd express the equivalent of what she'd drunk. (it probably helps that DD pretty much only ever wanted one side at a feed, so I could always express from the other)

I found it very useful, to get some rest. Another important aspect is that I was feeling a bit overwhelmed by the responsibility/burden of feeding: only I could do it, and had to do it. So even though I had lots of support, it weighed on me a bit, but that stopped when I knew that if I really needed to just take a break, I could.

We used to do a bottle a day, maybe five days in seven, never had any issue with preferring a bottle - DD always goes for boob if there's an option! But now she's older, I can go out, away for a day, without having had to battle to get her to take a bottle.

She's now ten months, and I've never had to use formula, because we have that flexibility.

Oh, and I would never express for when we're out an about - a hassle to keep it cold, warm it up etc, why bother when it's on tap?!

I'm not an expert (Tiktok is!), and I understand what you are saying about frequent feeding. But bf is a supply and demand (or should that be demand and supply?) model, where babies increase supply of milk by feeding more frequently. When a baby is trying to increase supply you will always be playing catch up for a while and you are bound to have to feed frequently as a result. I'm just attempting to say that you can fit in expressing around feeds if you need to (not saying it's easy though) and you don't have to be engorged to express. It was a big help for me that my DP would be in charge of getting the equipment ready for expressing so that I didn't have to.