Best way to combination feed

[Woodso100]

My DS is 4 days old and I am combination feeding him. I had an emergency Caesarian with a few nasty complications and ebf is too painful for now as I can't hold him for long and the after pains during bf are too intense. I am giving him about 30 ml of expressed milk at each feed, then as much formula as he wants. He's a very big boy so eating lots. Been reading about combination feeding and a lot of people seem to alternate breast and bottle or give a few bottles a day at set times, rather than top up at every feed. Is this better for milk supply? Not an option until I am stronger but want to know if I should be working towards that instead? Thanks

I have a very low supply and after working closely with the BF support group counsellors for the path 3 months I do 30 mins one side and straight to formula of which he drinks 6oz. I put him to breast inbetween when he's a bit grizzly and to help him sleep at night. I used to 30 mins a side and then top up! It was just getting too much.

My advice would be to talk to your midwife or a find a BF support group as I think every situation is different when it comes to needed to mix feed. You can ring helplines if you can't get out. Google the la leche league and NCT have one too, and there are others.

And my DS is 15 weeks now so has started to stretch out his feeds so my situation is probably not very helpful!

Thanks Shantoto. I will speak to HV or midwife. I found the midwives in hospital a bit judgemental about the fact that I wasn't exclusively breast feeding tbh but hopefully the ones that visit will be more helpful!

Woodso, no one should be judgmental :(

But the midwives do need to inform you that early use of formula is not helpful to breastfeeding. After pains can be helped with pain relief and holding your baby should be possible with a change in positioning. What you are doing now - expressing, formula, direct breastfeeding - is the very hardest way of feeding a baby, and many women would not find this sustainable, esp after a difficult birth. It's also likely that breastfeeding dwindles.

There should be a way to help you bf direct, without pain, and without the use of formula. A good midwife should help you do this :). Later on, with bf established, you can work out how to combine with formula without the effect on production that leaves you without the option to give any breastmilk at all.

Hope this helps. Don't confuse midwives or anyone else being straight with you and sharing information with judgmentalism :)

Sounds like we are in a similar position. My baby is two weeks old nearly and we are doing a mix of bfing (if she latches), EBM and formula - it's all quite messy. I'm not sure how to get back to bfing or even just expressing, at the moment I can't express what she needs and she won't stay on the breast to transfer milk. I've started a thread about my specific issues but maybe we can support each other.

I've found the judgement of other quite hard. Like they don't think I'm trying hard enough or feeding her enough even though I'm doing everything that has been said. No one saw the tears in the middle of night when I gave her the first 15ml of formula and was sobbing so hard because now I'm setting her up with an increased risk of obesity. Motherhood is difficult let alone when it's a bumpy start.

Are you just trying to hold your baby or are you using a support cushion, like the Widgey? (or one of the many others that are available so easily now, but like rocking horse shit when mine were babies!)

I ended up combination feeding DS1. I was ill for the first 2 weeks of his life - 4 unit transfusion which resulted in fluid overload and pulmonary oedema. I couldn't express more than a few drops and ended up having to give him some bottles when I was radioactive for 12 hours! Between that and my illness and the poor latch he had, I never got back to ebf. I substitued a couple of feeds a day with formula just to give my nipples and still sore arse a rest.

He's now a lanky nearly 12 year old. His younger brother was EBF, Mrswishywashy and he's the one with chubby tendencies. I think it's more down to which parent they take after than the way they were fed, as infants!

Congratulations op and I hope you're doing ok.

About the after pains. I had awful afterpains with dd and the good news is that they peaked at 3-4 days and were more or less gone by 5-6 days. Keep yourself constantly topped up with painkillers- I alternated paracetamol and ibuprofen using the maximum doses I was allowed.

I mix fed ds (22 months) and am currently mix feeding dd (16 weeks). With ds he was incredibly sleepy (I had diamorphine) and jaundiced at birth and then it turned out he had a tt. Bf was incredibly painful and he was still losing weight at 10 days so we started to top up with f. By the time he had his tt snipped at 18 days we were topping up every feed. I then gradually reduced the f but never got rid of the f (we got down to around 12 oz a day and fed him until he was 6.5 months).
TBH I really wish I'd had better advice and had got myself better informed about how to deal with the very early days. I don't think looking back that f was essential and it damaged bf for me. I think the key is to find a way to bf directly and do that as much as you possibly can. The trouble with f is that you use a oz here or there, so your boobs make less, then your baby gets fussy so you give more f to combat the fussiness, so your boobs make even less.... and so it cycles. At the time of ds's tt snip a lovely mw told me to go home, take him to bed with me for 3 days and just feed. My nipples were bleeding and emotionally I was just shot to pieces so I said I didn't think I could face it, the mw then said that ds would most likely be ff within 2 weeks. I don't think that she was being judgemental (I did at the time)I think that it was just her experience.

With dd I ebf her for 3-4 weeks and then started to introduce very small (1oz a day to start-we've increased it gradually since) amounts of f once a day at the time that I wanted a ff to be, so bedtime for us. So now at 16 weeks she's bf most of the time but has a bottle at bedtime. I might start giving her the occasional daytime bottle if I want to go Christmas shopping in the next month or so.

It might be worth giving one of the bf helplines a call. I called the nct and LLL ones with ds and found them very helpful. The LLL was very geared towards returning to ebf (the nct was perhaps more open to mix feeding)and some of the things they said looking back now I wish i'd done. It is certainly much easier to mix feed dd than ds so I wish I'd established ebf first then given f.

I combination feed, DS is 4 weeks, i also had an emcs.

I started off ebf, but DS lost too much weight, mw suggested f top up to get his weight back up this was at 4 days old.

Once i started adding f DS refused breast as a bottle teat was easier for him, so i was expressing, this was the hardest part especially at night when OH was back at work, every 2 hours it was a routine of change, feed, settle which took upto an hour, then start setting up to express, expressing, washing out equipment then sterilising. Some nights i would only get 15 minutes of sleep each 2 hour session. You have to be prepared for this, it is hard work, what made a difference was lending the hospital industrial dual pump, it was quicker and boosted by supply by 10 ml.

But the thing that made the biggest difference was the feeding support midwife, who was amazing, she suggested nipple shields, and now DS feeds from me no expressing needed, i still combination feed as he's still hungry after feeding from me (for 8 out of the 10 daily feeds) but this saves so much time and crying, as soon as he starts rooting offer one breast when he starts coming off but still wants more do same with other breast, then whilst he is chilled sort out bottle and change nappy, offer the bottle if he takes it, the amount can vary i make a 60 ml (3 oz) sometimes he doesn't want any sometimes just 20 ml and the last feed before bed he always wants it all. yes it is a waste of formula, but i am hoping that by going through both breast I'm boosting my supply and eventually he'll be back on the breast, then i just have to work on getting rid of the nipple shield.

DS2 is 7 weeks and has formula at bedtime (10ish) and in the night. He only wakes up once between 2-4am. I bf for all other feeds and I've had no issues with low supply. Was quite engorged/leaky in the mornings in the early weeks but this has now settled down.

We always intended to do a 10 pm formula feed (DP does this one) but the other night bottle feed came about because I also had a c section with complications and was too immobile to hoik myself about in the night to get into a feeding position.

What we do works well for us but I also think I've been lucky that DS is very chilled and happy to take a bottle and that he is a very efficient feeder from me too which has kept my supply at the right level.