Combi feeding advice needed

[Jaffakake]

I think I need some advice.

I've been combi feeding from the off because I had a rubbish time with my first. I was not well after the birth, lacking in all sorts of vitamins, with milk coming in very late & seemingly never producing enough of good enough quality for my son to gain weight well. So far I've been giving a bedtime and an morning bottle plus one whenever I get truly fed up - usually after having sat there bfing for 1.5-2hrs & still having an unhappy baby.

My thoughts were by being consistent my body would adapt & still provide and that by doing an early morning (between 12am - 5am) breastfeed I'd keep supply up. I was told that by stimulating the breast over 8 times a day it would keep it going. However this afternoon I fed for nigh on 2 hrs and then offered a 4oz bottle, which was emptied. Early evening I fed again & then offered another bottle, which again he emptied. So I'm beginning to doubt my supply.

I suppose my question is, how do you all do it and ensure it works & you don't end up faffing & topping up after a breastfeed?

Anyone?

How old is your baby? Is bf painful? Has your baby been checked for tongue tie? Have you had your latch checked and an entire feed observed by a mw/feeding specialist? Sorry that's loads of questions but if your baby is, say three weeks old and having, say 3/4, 4 oz bottles a day it's very different to a 5 month old having the same!
So at the moment are you doing bottle at night and in the morning and then topping up during the day?

Yep, not enough info, sorry jaffa.

You've had a difficult time:(

My other questions apart from the ones asked by nicky would be

• when did you introduce formula? This is relevant, because early introduction of formula can mean the supply is calibrated downwards so it becomes very difficult (not impossible though) to build up to a supply which will maintain, without dwindling
• have you tried switch nursing and/or breast compression?

Sorry. I suppose I was looking for an understanding from those who have combined fed as to their approximate schedule of feeds. I'm not looking to ebf. The description of the rubbish time I had was with my older son, but the experience has left me with a nagging doubt I can't make it work.

Ds2 is now 3 weeks old. Latch is fine. No tt. No pain other than let down. Baby swallows but does fall asleep a bit. I wake him up & repeatedly switch sides.

I was topping up in hospital due to fear of late milk (hangover from last time), so every time I was feeding for more than 1.5-2hrs I'd top up afterwards. Since being at home I've basically done a morning & evening feed & everything else breast. On the rare occasions I've done another ff I've pumped as a replacement. However I'm now finding myself topping up after very long feeds (2hr+) in the afternoon. Plus I'm finding sometimes I need to give ds1 my attention & can't afford the 2hrs sitting still. It's only going to get more complicated with nursery runs from next week.

Is it possible to ff & bf this early?

Yeah, understood you want to combi-feed, jaffa, but to do that you have to maintain a milk supply...otherwise there's no combi :)

I have to go out now, but I'll give your situation some thought and come up with some ideas for you to mull over, later.

Cheers tiktok, you're a star!

I am prepared for the fact that I may just not be as committed as I need to be to make combi work.

It's just such an uncomfortable dilemma; I want the benefits of bf but for example, ds1 came home from nursery with scratchy eyes & looking appalling, (probably hayfever) so needed my attention & a bath, ds2 wanted to cluster feed. The 2 are mutually exclusive at the moment & that's even when dh is moving heaven & earth to be home early to help, cos I'm also recovering from a c-section.

I have low milk supply due to breast hypoplasia and have mix fed two babies (still going with DS, 5 months).

At that age I still offered breastmilk followed by a top up at every feed, as per lactation consultant advice. Bf was offered at every feed to ensure supply was being stimulated. A total PITA at times wrt bottles etc. I found at night I didn't need to offer formula as supply greater.

A 3 week old feeding for 90 min stints and still not satisfied would concern me.

He was 9lb at birth and is probably about 10lb now. I wonder if his large-ish size has a bearing on it all....?

I introduced f at only 10 days as ds was till losing weight. We had his Tt snipped at 17 days and even in that short time i was topping up after every feed. After the snip I gradually reduced the f until I was making up bottles and not really using them (this took maybe two, three weeks). After that I found that I wanted to mix feed so we did bf for most feeds, a top up if he was really fussy and a ff before bed- I'd also give a ff if I was somewhere I really didn't want to bf. I think that it was a mixture of some diligence and some pure luck (ds didn't seem to really care which he got).
When I saw a mw at around three weeks old she said that i should aim for ebf at least for a while to secure a robust supply then start to reintroduce f if I wanted to mix feed. At the time I just didn't want to, we'd had a horrible start and i was just so dejected by the whole thing. The mw said that if I carried on mix feed ing he'd by ff within a fortnight. I don't think that she was being mean i suspect that that is her experience. I think the main worry is that f can just gradually "take over". I think that if bf means a great deal to you it's probably best to get to ebf then introduce f. I couldn't just decide to solely bf on some days - I always relied on some f every day-which I would've been able to if I'd established supply first. I also stopped bf at six months and whilst this was ok for me as we were ttc again when ds had a growth spurt at 5 months my supply couldn't really keep up so had I wanted to carry on it would have been hard.
No idea about baby's size- ds was a tiddler 6lb 5oz.

Just read that back and it's really jumbled! Sorry. I guess what I'm trying to say is that if bf means a lot to you but you want to mix feed, probably the best way to do it is establish a robust supply first then add f. I did it the other way round and it probably cut bf a bit short and gave me less flexability.

Morning, jaffa. nicky explains that getting a good milk supply and then intro'ing formula to combination feed is usually better....when bf is getting going, formula calibrates the supply downwards, and makes the supply fragile, likely to dwindle away.

It may be this is what has happened, with what sounds like frequent and early formula supplements.

You can retrieve this, though. Best thing is not to replace any feeds with formula at the moment, but when you use formula, use it to top up only. You need to be offering both breasts at least every time, and to up the frequency of breastfeeding - hard to say how much formula to use as your baby may now need a certain amount to grow. You'd need to discuss with the Hv. You can't just drop the formula.

A call to any of the bf helplines would help explore options.

Hope this helps.

Cheers for the advice. I'll mull on it a bit & maybe call the bf support person that comes with the mw service I'm using.