39+3 preg and thinking ahead... What's so bad about mixed feeding?

[Bellyrub1980]

Obviously in an ideal world EBF would be the way I'd go as there are so many benefits. However, from speaking to friends and family about this it's really not as easy as just getting your boob out! Infact I know far more women who have given up after a few weeks than not. In almost all of these cases they switched exclusively to FF because they were warned against mixed feeding. I haven't discussed this in too much detail with them because it seems like quite an emotive subject and I really don't want my questions to appear judgemental... I'm just genuinely clueless!!

So my question is... What's so bad about mixed feeding?

From what I've read the main issues are:

• it can reduce your supply (due to reduced demand)
• it reduces the 'immunity boosting' effect of breast milk
• nipple confusion
• more work in terms of cleaning bottles etc, and more expensive.

So I have some questions about the first 3 issues in particular...

Can you overcome the first issue by expressing when you give them FF (to maintain the demand)? I appreciate this is extra work, but besides this would expressing maintain the demand sufficiently?

And as far as the immunity issue... EBF is the recommended option but if this doesn't work women are advised to switch to EFF. Why does it have to be one or the other? Surely a bit of both is better for immunity than no breast milk at all?

And as for nipple confusion... what's the point in expressing if mixing the nipple and bottle is so bad? Or is this frowned upon too?

From a complete novices point of view (and I appreciate every baby is completely different and I won't be able to make a decision about this now) mixed feeding breast, expressed and formula is the best route to take (provided there's no nipple confusion) because they get the benefits of breast milk, the DP can be involved in feeding (either with the expressed or FF) and you can give them a big FF bottle before bed and stand a better chance of them sleeping through.

I imagine a thousand eyes will roll reading this post because of my total lack of experience. I know I've probably over simplified things. But I guess what I'm asking is, is there another reason why mixed feeding is so frowned upon? Because it only seems like a good option to me....

(Please don't look at this post as trying to provoke a debate or stir up an argument... I'm clueless and all the midwife said to me was that you should try to EBF and if this doesn't work EFF, and all my questions about mixed feeding were met with 'we just don't recommend it'.... No real explanation was offered)

I don't know much about mix feeding but I would assume it's preferable to eff. Strange response from your midwife. However if you can ebf without problems then I can't see why you'd mix. I'm sure someone with experience will come along with more advice soon.

I ebf and have found it to be the best option for me.

Don't worry about being green - it's a whole new world this baby lark!

Just to add, it's possible for ebf babies to sleep through - all babies are different, as you said

I struggled to BF my daughter due to a very busy job which affected the milk supply. I found I was able to manage a couple of feeds a day ( night ones were the easiest) so I gave her a bottle of formula for the other feeds. I did this for eight months and DD was a happy and contented baby. Good Luck whatever you decide . I am sure your baby will be fine

The longer you EBF the better your supply will be

If you give an occasional bottle because you are away from baby for some reason it is a good idea to express for your own comfort and to retain supply.
If you give a regular bottle at say 6pm everyday you only need to express if you want to give expressed milk in the bottle. If you plan on giving formula I personally wouldn't bother to express (especially if your supply is established) as people usually choose to give a regular bottle to give themselves a break and if you express you wont have this break. Also if using a bottle I would only do this if it gives you a break (ie someone else does this feed, prep, and clean up, sterilise), if you end up doing all the work you may as well continue EBF as in the longer term it is easier.

I know people that have mixed fed long term I also know people that after introducing a bottle feeding starts to diminish as they then swap to 2 bottles, then 3 etc until they are fully using formula. This may because they wanted to stop and are reducing gradually or may be they prefer the break they can have if giving bottles, or find baby more settled after bottles.

I wouldnt plan too far ahead and go with the flow or what works for you and baby (one feed at a time).

ohand midwives and HV are a mixed bag - generally not the best place to get BF support.

If in doubt, speak to BF advisors, LLL, BF peer supporters, google and forums for support.

The advice i have heard form HV really varies and sadly isn't always correct..

I mixed fed both mine. Never had any issues what so ever.

Both my dc's were ebf for the first 4 weeks and then mixed fed until weaning. I expressed rather than bf. There was no advice given with my first (now 6.5) and I had to find my own way. I made my choice after a very difficult 4 weeks trying to feed my son who was losing weight rapidly despite breast feeding support from all corners. I felt very close to PND.

Both my dc are happy, thriving children who rarely get illnesses. Ds has had 1 tummy bug in his life (on my 40th birthday - thanks).

The choices I made regarding feeding were my choices to make. There was no advice and support from HV or midwives regarding any feeding other than breast. When I made my decision I was then finally told "What's best for mum is best for baby, you have to look at the bigger picture. But we're not really allowed to talk about anything to do with formula". I was told this by my community midwife who I happened to bump into at my 6 week check.

I then also discovered that nearly all the women I knew through NCT groups gave at least 1 bottle of formula per day. But many were reluctant to admit it let alone whip out a bottle of formula at a coffee and cake meet up.

So OP, my message to you is definitely try bf and for as long as you can but not at the expense of your health and well being. And don't expect advice in formula from NHS professionals. This may have changed since my baby days, but I doubt it.

Both mine were ebf and both slept thru 12hrs from 3 months. Filling up with formula for a good night's sleep is a myth.

It's a completely personal choice. For me, after the initial few weeks, bf was easy and no hassle, couldn't have been bothered with making bottles! Also, bf poos smell quite nice, formula nappies stink, IMHO.

At the end of the day, you do what works for you. With regards to nipple confusion dd1 had expressed bm in a bottle from very early on and didn't affect anything. With dd2 I didn't try until later and then she would never take one. Not sure I believe in nipple confusion.

Good luck, you'll make the right choices for you and baby when she arrives

Nothing wrong with mixed feeding but it is generally advisable to ebf for the first 4-6 weeks to establish supply and avoid nipple confusion.

Bf supply is a matter of demand, the more the baby sucks the more milk is produced. If you substitute a lot of bf feeds (especially at night) with ff your supply will dwindle. You could express for every ff feed but can't imagine finding the time to do all that.

Bottle feeding is not recommended until bf is established because the bottle teet is a lot easier for the baby who may then give up on sucking which in turn affects bf supply.

Thanks for those quick replies! Answers all of my questions!

Goes to show every situation is different and it's good to hear many do mix feed with no problems. I think I'm probably under estimating how much work is involved with expressing.

EBF will definitely be my preferred option. But I'm almost anticipating it not working because it hasn't for so many ladies I know. But recently I went along to a breast feeding group and they were all BF all different ages and were so positive about it I realised it is possible (with plenty of patience and perseverance at the beginning)

I'll be sure to seek advice outside of MW and HV. It's a shame mine became so shut down when I asked about mixing it up. I guess they have to tow the party line. But to say something like 'there is no right or wrong, go with the flow and do what works best for you and your baby' would have been reassuring enough for me. Which is the message I have got here.

Right.... I just need to get this baby OUT now!!!!

I think nipple confusion is over hyped. I'm sure it happens to some babies, but both my DD were fed bottles of expressed milk for the first few weeks (one just wouldn't latch and the other the other had a medical issue) and both went on to be expert breastfeeders.

I will also say, if you really want to EBF, give it time! The first few weeks are really tough but then it gets much much easier.

Thanks Josie. I did wonder about nipple confusion so it's good to know it's not a dead cert for all babies.

Mixed feeding, if introduced before 6 weeks, can be tricky to manage - most mums who introduce a formula bottle before then end up stopping breastfeeding earlier than they wanted to. (as in, if you ask them, they say 'I wish I'd been able to feed for longer.')

There are things you can do now, and when your baby is born, to increase the chance that breastfeeding will work out for you.

1. Find out about local BF support. Are there groups? Are there home visits? What options do you have? There are always the phone lines, but local in-person support is better. You can go visit this support now, and get to know them, so that if you need help after the baby is born, there are fewer barriers between you and the support ('where is it? maybe they won't be nice?')

1. If you are finding things difficult in the early days. If you are in discomfort. If you have concerns. Seek help early. The phone lines are great for answering those niggling worries. Breastfeeding largely shouldn't hurt. If it hurts, seek help. I gather, for labour, that being brave is a good thing. For breastfeeding it isn't good. Please please, be delicate and complain early, and complain often. If it hurts, it's not working properly, and you need some help.

1. If you are suffering doubts, look at your baby. Your body made her, your body can feed her. Give your body a chance.

That's great advice thank you.

I mix fed from day 2 with ds4 with no problem, he stopped himself at about 10 weeks when he became a bottle refuser, hes still bf at 20 months.

I fed him with a cup the first few days to avoid nipple confusion but it was never a problem with him and it helped me avoid cracked nipples and a screaming hungry baby

Hi belly, just a couple of things from my own (limited) experience. Firstly, dd is 11 weeks and ebf, and sleeps through the night on breast milk alone. So it can happen!

Secondly, I had hoped to express so dh could do the occasional feed if necessary. However, we tried introducing a bottle of expressed milk at about six weeks and have tried a number of times since then, with no luck. So things don't always go as planned! Maybe I should have tried earlier but was also scared by the talk of nipple confusion.

Good luck and come back and let us know how you are getting on

Don't worry about not really knowing much about mix feeding. I thought bf was all or nothing when I was pregnant and DS was new born. In reality very very few babies are ebf until 6 months (around 3-5% I think) and most Mums I know mix feed/fed to some degree (bottle at bed time or when out and about in a place that is inconvenient for feeding). I mix fed because of various issues with DS (won't bore you with the details) and I think that there are 3 main problems, baby gets used to the relative ease of bottles, your supply dwindles and you get used to the ease of bottles. I think these can be overcome with planning but as other posters said bf needs to be properly established first.
It's a very strange thing for your mw to say though "we don't recommend it" is very wooly (though more or less the reaction I got too!). She can't possibly be suggesting that if, after say, 4 months someone wanted to give the occasional bottle they should give up bf???

I mixed fed almost form birth and still am now at 6.5 months. It wasn't by choice, EBF was my first choice, but due to a combination of milk not coming in and bad advice re breast feeding I was left with the choice to FF or mixed feed when DS lost too much weight and was admitted with dehydration. (I did try to re-establish EBF and spent several miserable weeks doing so but it just wasn't happening for us and it was more important that DS got fed! I mention this only to point out that sometimes perseverance isn't enough, and if not don't get down on yourself.)

Anyway, my experiences:

I also had no issue with nipple confusion, DS easily swapped between bottle and breast.

For me the bottle feeding was also easier than breast as we had issues with latch, positioning etc, and I was never comfortable enough to try it out and about. We have a perfect prep machine so milk is made up in about a minute, and bottles are bulk sterilised about once a day which really isn't that big a deal to me personally. Drinking from a bottle is also considerably faster than a breast feed, and doesn't restrict me as much as anyone can do it.

Expressing is a bit of a pain, but I invested in one of those hands-free bras so I'm not confined to the sofa while I do it.

My supply is now dwindling, and we're down to one BM feed a day. This was in part a deliberate choice though, as FF was for me is so much easier, and gradually switching meant we were free to do other things.

To me it's the best of both worlds and I think I'd try and do the same again with future children, except that I'd try to get my supply a bit more established first to try and take some of the early stress out of it. I genuinely don't understand why a HCP would recommend EFF over mixed feeding - the data are quite clear that some BM is better than none in terms of immune protection etc!

Sorry for the mammoth post!

I agree with Josie, nipple confusion is exaggerated as a problem. I've never known any baby to have any problems and there are a lot of mixed fed babies in my cohort of mums.

It's so ridiculous that MV aren't supposed to talk FF and I think this all or nothing approach to bf does a lot of harm. Mixed feeding, properly handled can help mums keep up bf for longer

I did it from birth to nearly 8 months and probably would have gone on longer had my supply being fucked up due to spending 3 weeks watching my DM dying .

It can be done.

You sound like you have a really open mind which tbh is the best thing.

And yy to not underestimating how difficult those first weeks are.

Come on baby - come out soon!

*my supply NOT being fucked up.

Re nipple confusion (sometimes called flow preference) - this is more likely if you don't have a strong let-down reflex. I don't, and I noticed a difference very quickly when I was bullied into giving bottles in hospital (I wanted to use a cup but apparently that wasn't 'scientific' enough). In the end I used a lactation aid (sort of like a long thin straw) at the breast and mixed-fed for 6 months.

On the other hand I know a few people with a very fast let-down who used bottles (for EBM/formula) and didn't have any trouble keeping their babies interested in the breast. So if you try bottles, keep a close eye on how the baby reacts and it's always worth using a type that has slow flow, especially when starting out.