Anyone combination fed from the start/v early?

[snowydrops]

With DD1 i EBF for 8 weeks with a couple of top ups from a cup during early days before milk came in. At 8 weeks we were both very poorly and I stopped producing milk so she had formula and then I pumped for the next 4 months, I did as much as I could and as my supply decreased I upped the formula. It was draining and very time consuming (the expressing) but I felt the breast milk to be the best option.

I'm expecting DC2 now in two weeks, I would ideally like to breast feed exclusively for at least a month to establish supply a bit but then start to combination feed (just one bottle and then increase to 50/50) hopefully for 9 or so months.

I am going back to work at 5 months and also have DD1 (3) to look after so am trying to work out how this might work in reality! I have support for the first two weeks from DH but that's it as then he's back to work from 7.30-7pm every day. I am worried how I might establish a routine having a very active DD1 to consider as well...

Has anyone gone or combination feeding from early on and if so how did it work for you?

Thanks

Also should say I am happy to express again especially early on if that might help!

I haven't done it, but my concern would be that you're doubling your work - expressing and bf will take up twice as much time as either bg or ff and will give you less time with your dd than one or the other.

Bg? Should be bf!

I have friends that have done this. I think the crucial thing if you want to bf a bit to 9 months is to make sure you bfeed more during growth spurts rather than offer more formula.

Is combination the same as mixed feeding or is it exclusively breast milk? .

I can't exactly remember the details (15 years ago ) but it was very difficult to breast feed my DS in hospital (EMCS, serious health concerns and kept in for a week) so my DS did have some formula in hospital and then we got home after a week I established breast feeding but also gave a bottle of formula (carton - no mixing) most days. Seemed to work perfectly well and I (mainly) breast fed until DS was 8 months.

I did but not through choice!! Dd was very poorly in scbu so was being topped up with ff and I bf as much as I could.

Did they work out why your supply dropped so much the first time? I would go into it this time with an open mind, I am amazed you were able to pump for 4 months - you deserve a medal for that

From 2 weeks I gave DS a bottle or two of ebm a week. From 6 weeks he had a bottle or two of EBM or formula a week and from 8 weeks he's had a bottle of formula with DH for his late night feed each night so I can go to bed earlier than him and on a couple of occasions when I've been out. Otherwise he's bf as it's easier if I'm with him. He's had no nipple confusion and switches between the two quite happily.

I also have an almost three year old. The current routine is survival, particularly when DD decided she didn't want to wear nappies anymore when DS was four weeks old. Poor boy got used to feeds being interrupted as I wrestled with a potty and knickers.

I chose mixed feeding with both mine, and it worked extremely well. I made sure bf was established by feeding on demand (took about 4 weeks) and then got into a routine of giving one bottle per day as well as BF. I used to BF about 8.30pm ish and then go to bed, and DH used to give a bottle around 11.30. It was lovely for DH as it was some quiet time with him and the baby, and I used to get to sleep 8.30 until about 3.00am when I used to start BF again.

Basically I was well rested, DH and babies happily bonded and I had no problem transitioning them to bottles once I stopped BF at about 7 months.

I can work! My HV was full of doom and gloom about it and said my supply would dry up and BF would fail, but I just produced enough milk for the feeds I was doing.

Good luck.

did both from day 1, mainly breast
gradually changed to formula

Yes combination is a mixture of breast milk and formula.

Sorry pressed post too soon...but I could express a bit in the early days to introduce the bottle just with breast milk and then swap for formula after a few weeks

I did from day 2. Big baby + csection + hypothyroid = not enough milk. I never leaked, never got engorged, couldn't express. We gave DS a bottle at 8pm and one as a dream feed.

I did, with dd1 it was enforced, she was sent to special needs at 24 hours old due to low sugar levels the midwives decided she needed a bottle (they have little bottles of made up fomular very easy to use) anyway we left the unit and i then ebf for a long time and expressed from an early point because i was returning to workmat four months. When ds arrived i decided that bf and bottle might work so it did the same and used the little bottles and mostly bf from an early stage. Again i started expressing also from an early stage, the more you,do the more you produced... Worked for me, might not for everyone.

I have but it does depend on the baby as to how well they'll take to it.

DS has been largely BF (currently having some unrelated issues) with one bedtime formula bottle with DH. Apart from that bedtime bottle he hasn't had any other bottles (even EBM) because I noticed that more than one bottle a day & he tended to fuss at the breast. We introduced bottles quite early on and it worked well as long as just one a day and only given by DH.

My two nephews, by comparison, were different again. My sister mix fed, BF both, for 9 months and 1 year. Nephew 1 switched between bottles & boob no problem; nephew 2 was tongue-tied & bottle fed EBM for first 6 weeks - then BF-ing clicked and he refused to take a bottle! Go figure.

I think mixed feeding should be encouraged a lot more, it enables the father/another carer to get fully involved, gives mum time to rest/do something else ............. I've heard though that HVs don't like encouraging mixed feeding as they feel people will 'give up' on b/feeding and just switch to FF.

I also think there are some mothers who just won't allow anyone to feed their PFB and like to feel that only they can provide for their baby - my view was always 'what would happen if I dropped dead' - a bit harsh but I am pragmatic about most things .

Same as littlebearpad. Bottle of EBM for the dream feed by DH from about 2 weeks, switched this to formula at about 8 weeks. BF until 15 months, no nipple confusion. Was very handy for nights out or GPs babysitting that she would take a bottle of formula when required

I don't know what happened first time around. If honest I don't think my supply was ever brilliant, DD1 was at the breast for ages, frequently but often was unsettled and we would top up with a cup. I stuck with the BF for 8 weeks though because I felt A LOT of pressure from midwifes and family even though I never felt she was getting enough. I never leaked at all, my boobs never got engorged, I didn't know when my milk 'was in' and I have big boobs so I always felt this a bit weird...when DD1 and I got sick I carried on BF as instructed via NCT helpline. She was distressed (hungry) but they told me i would still produce plenty of milk (I had gastro flu) then eventually the midwife visited and DD had lost a fair bit of weight, we hadn't been able to tell and so she was very swiftly given formula (in a bottle) and she never went back to the breast. I think she was starving poor thing!! Anyway I then started to pump and took a supplement (from the Dr then, no longer allowed now apparently) which upped my milk supply. I know I never had much because even at top production (without the supplement) I would only get 1-2oz in 20 mins expressing . I was so under pressure though I took the supplement and that increased to 4-5oz so I expressed 5 x a day until 5 months then ran out of the tablets. DR wouldn't prescribe more and my milk instantly dropped to approx 50ml in an expressing session. Personally I don't think I had much milk, why I don't know but I'm concerned it may happen this time.

This time around my boobs haven't changed at all (37wks now), I am the same bra size, nipples the same and no leaking. I am hoping it's because it's my second and that things will kick in when DC2 arrives! I am seeing my midwife tomorrow and will mention these things because this time I want to feel prepared mentally that it might be tricky. I will at the worst try to do combination feeding but hope to establish my supply (as much as I can get!) first!

I would agree that expressing + direct bfeeding + formula is the most time consuming of all the options, as you're doing all of those things. Wouldn't it be easier to either just breastfeed, mix feed using formula, or fully formula feed?

I had to mix feed with my DS for the first few weeks as we were both ill after my EMCS. He was given formula in SCBU whilst I was too ill to feed him. We went home mix feeding and then gradually dropped the formula until fully breastfeeding. I found I had to express a lot to try and catch up my supply, and I found organising the expressing around feeds and everything else to be a pain. Just my feelings on it, others might find it not too much.

Ragwort - I don't think it's helpful or accurate to promote the "breastfeeding mother as a martyr and also possibly slightly unhinged" idea. If I had dropped down dead whilst EBF then my baby would have had to have formula. That would probably be the least of my DPs worries if that were the case.

I agree it's annoying it's a bit taboo...my midwife is actually quite supportive so I'm hoping when I speak to her she actually listens to what happened last time and has some constructive advice...not just 'feed 24hrs a day and you'll be fine' which is kind of what I felt they did last time.

I have never had success expressing, so I think expressed milk is a slightly misleading indicator of supply. I breastfed with ease for a year. BUT I also mixed fed.
On day 1 DS (now 3) was given a few top ups because of low sugar.
Came home on Day 3 and slowly weaned him off them by Day 7.
Day 7- Week 5, was EBF. Then I had a job interview in Week 7 (jobs in my field are rarer than rare so I had to go). I reintroduced one bottle a day from Weeks 5-7 (usually mid day). And from then one we stuck to that, the one bottle a day, usually after waking up from the post lunch nap.
When he was 7 months old he went to a childminder as I went back to work. He had 2 bottles of formula when I wasn't there, sometimes 3. I fed him in the morning, at bedtime and once at night. My supply adjusted. We kept this up for a year (although by then he had dropped the 7 am feed, so we were down to 7 pm and 5 am). And then moved to cow's milk at 12 months.
So it is more than possible, but I would second the advice above NOT to use the bottle too much during growth spurts but to persevere with the breast. I also managed without expressing at all, so if you are happy to use formula then I would do that.

Yes I don't mind using formula this time from earlier this time really. I think the tip about growth spurts is good, best to know you will be a feeding machine then ;-) so you can keep up supply.

I agree that expressing can be misleading...that's why I never really knew if I had enough milk or not. What I would say though is when I expressed whilst taking the tablets and got higher volumes DD was satisfied with just breast milk at a feed, we didn't need to top up BUT when I was exclusively breastfeedjng before taking the supplements she wasn't satisfied and would get very annoyed and frustrated. I never knew why, people checked her for tongue tie and her latch and all seemed fine. The only other thing I always wondered was if my boob / nipple was just possibly too big for her to properly stimulate (she was a small baby and my boobs were an H cup) so it could have been to do with that but I'll never know now! Hopefully this time around will be more successful!

DS first had f at around 11 days old. He was still losing weight and I was advised to top up so I did. After having a tongue tie snipped feeding got easier and I increased bf and could probably have got up to ebf but mix feeding really worked for us. I really enjoyed the freedom it brought and I'm aiming to do the same with this baby (still only 21 weeks pregnant!). I think it depends on the baby to a certain extent but most mums I know who want to mix have had no problems doing so. I was strongly advised to get back to fully bf by the mw as I was told that ds would be ff within a fortnight, to be fair to them that may well be their experience. I think that the worry is that if you start to early it's easy for ff to "creep up" and bf to scale down but in all honesty most mums I know have been fine.

I think back in the 80s it was often the done thing...I know both my sister and I were combination fed from two weeks on and that was what the midwifes advised my mum to do (she was going back to work quite early) but it seems these days it's often assumed the mum will fail and just swap to formula!

Kewrious I'm interested/encouraged to hear that you mix fed from 7 months, I may be going back to work when DS is 6 months (v rare part time role I'd be mad not to take if it's offered) and I would like to keep up a bit of BFing - (if I can keep DS on track) - ideally some combo of the 7am, early evening and or/the dreamfeed til we phase it out, and the middle of night feed if he's still waking up for it (which I'm sure he will be...)

DS def has a bottle prefernce but I can usually trick him into the sleepier feeds!