Can anyone offer any advice on combination feeding until my milk comes in?

[CremeDeSudo]

I’m currently pregnant with DC2 and hoping for some hits/tips/advice on combintation feeding until my milk comes in.

I tried to BF with DS, but it didn’t work out. When he was born, I raised concerns that he wasn’t latching properly as he was stuck on my boobs for 3+ hrs at a time. The MW’s told me his latch looked fine, however when they tried to discharge us we noticed that he had a slight shiver and it turned out his blood sugars were low. We were kept in a bit longer and in the meantime I tried to master BF’ing. I was visited by the local BF’ing expert, but by the time I went home I was in tears whenever he came anywhere near me.

My community MW was much more helpful and told me I had flat nipples, which was part of the reason we were struggling and also pointed out that my milk hadn’t come in. (He was born on the Monday, home on Thursday, I first saw her on the Friday, and my milk didn’t come in ‘til the Sat). We agreed I’d give it one more shot using nipple shields however I ended up having a huge panic attack on the Sat and promptly turned to formula!

This MW also told me that she’d have recommended I combination feed until my milk came in as part of the reason nipples get so sore is the baby trying to get milk that isn’t there yet. So I’m thinking that might be an option this time. Does anyone have any advice on how to approach this please? I know the baby needs to suck to stimulate my milk, but I also want to give this the best shot I can and I think this might help.

TIA wise MN’rs! X

It does sometimes happen that the baby gets hungrier at a faster speed than the milk comes in....best way to stop that is to hand express as soon as you suspect the baby needs more. This encourages the milk to come in and of course you give the expressed to the baby 😀.
Using formula is an option, but it does not support the establishment of a good milk supply.

Hope it goes well this time!

Hi
I am combination feeding my baby after a rough start. I would consider the following, rather than combi feeding as I found it impossible to move to ebf after adding in formula.

Maybe express some colostrum abs store in syringes I’m the freezer for the first few days while waiting for your milk.
Get lots of irl help ASAP. Go to your local breastfeeding group/la Leche group while still pregnant to get to know them. If possible, get a Lactation consultant on board who can visit you in hospital/at home ASAP after bath is born.
Check out the Kelly Mom website and also the Jack Newman videos online to get as much info as possible before you start.

I have limited experience but if I have a second this is what I will do. Obviously if baby needs the supplement on advice of the experts then so be it. But if you’d like to ebf I think it’s best to do all you can to avoid the formula if possible.

Good luck x

The Kelly Mom website does have a page on combination feeding for info if you choose that path. x

I would harvest colostrum antenatally to offer him. I had weight loss and low blood sugar problems with my first, which led to being admitted to hospital for 5 days. If was a nightmare.

With my 2nd, I didn’t want to go through this again so expressed colostrum from 37 weeks pregnant. I had 5 syringes full each about 2-4 ml (you don’t need much!). I bf but then 1-2 times a day for the first 5 days I topped up after a feed with the harvested colostrum. Worked a treat, he only lost 5% birth weight and gained it back quickly, no low blood sugar or jaundice this time, all fine. There’s no reason you can’t just offer formula (in small amounts, so baby still encourages your milk to come in), but I found that harvesting colostrum really boosted my confidence and it didn’t feel this time like my body wasn’t doing enough if that makes sense, because I was still offering my own milk. The effect was a psychological one really for me.

Thank you everyone.

I find the harvesting colostrum thing a bit difficult to understand though. Is there guidance anywhere you'd recommend I read?

How long can I keep 'topping up' a syringe before it needs to be stored/frozen?

I feel like I'd find it incredibly frustrating how little you get when you do it.

When can you start trying?

I had inverted nipples. It was a challenge with my first. Nipple shields can work for some but I have a feeling for me they would have made the toughening up of my nipples take longer. That might not be a plan for you if you experienced such panic.
Combination feeding might take the pressure off if you are happy to let the milk take longer to come in. It is also popular in some countries to stick with one non boob feed a day. Funnily enough nipple confusion doesn't get mentioned there!
Pumping just before a feed used to get my nipples to form a better shape for my newborn to latch onto. Would you consider that? You don't need to worry about how much milk etc just getting a more nipple bit.

Don't worry about collecting any colostrum or milk. But you could start pumping before birth to get your nipples to take shape more readily.

Thank you @Dangerous that sounds more doable and less daunting!

I used to joke before having DS that my nipples wouldn't come out no matter how cold it was! And even though I only managed a few days, they've been less reluctant since then so hopefully I won't find it so difficult this time.

D'you think a cheapish hand pump would suffice?

Hello,
I had flat nipples too, and struggled a lot even with nipple shields. My milk came in faster than yours, but I would add to the other poster's concern that if you supplement with formula you will actively be reducing your own supply. Every feed the baby doesn't have is telling your boobs they don't need to make more. The first 7-10 days are when your milk glands establish how much to make, and this is then boosted over the next 6 weeks. But that first week's sucking by the baby impacts your entire breastfeeding- their action is what stimulates the glands to develop. They are doing a really important job by nursing a lot. Of course, health is a concern, but monitoring nappy output over the first few days will help stop dehydration.

If you had a panic attack last time, it sounds like you will be very worried this time- totally understandably. I would second the suggestion that you get your support network established now- both for the latching and positioning, which can make an enormous difference, and for having people there to monitor and reassure you that the same thing won't happen as did with your first.

You absolutely can do this, and I would advise avoiding combination feeding unless it's medically necessary as you will be making your own situation harder. But I understand how massively stressful it is when feeding is going wrong.
Good luck

I had a great deal of difficulty with DD1.

With DD2, I did 36 hours of skin to skin after she was born. She just wore a nappy. The midwives were quite uncomfortable with both the bedsharing and extended skin to skin. It worked. My milk came in much faster, her latch was much better (we did laid back bf) and I did not get engorged at all.

My suggestion would be put LO to the breast, let him suck for 15 mins each side, then hand off to your DH while you pump for 10 mins each side. DH can give LO a bottle with some formula while you pump. Rinse and repeat every 3 hours until your milk comes in and then maybe cut back on the pumping and increase time on the breast a little each day. If you always breast feed first, then the formula will just be a top up and LO will take less and less as its tummy is more and more full from breast milk. The pumping should help to stimulate your production even if LO isnt sucking enough to get it going.

Hopefully if you have a timed amount for having baby on the breast and pumping at each feed, it might not seem so overwhelming and more managable.

Thank you so much for all the advice and suggestions all. I'm daunted and nervous after my experience last time - I blame the BF'ing drama on my struggling so much in my first week with DS. I was miserable until we switched to formula, so much so that DH is concerned that I want to try again!

So my plan is to visit La Leche in my area and speak to my MW about possibly colustrum harvesting in case they can give me a kit. I'll also get a cheap hand held pump to get my nipples out and things moving.

Ridiculous as it sounds though, I'm worried that by putting so much effort into it that I'm putting too much pressure on myself again!