Negatives of combi feeding

[Usedtobechilled]

My LO is not gaining weight as quickly as expected through EBFing. We had a 28g a day weight gain this week purely because I constantly expressed and fed this on top of BFing. This is unsustainable and I'm knackered. I'm hoping I now have more milk that I don't need to top up however even if we do a 28g a day weight gain again this week, my LO will have dropped to the 9th oercentile which, considering he's on the 91st for length isn't great and he started on the 75th for weight.

I'm super close to supplementing with formula to boost his calories intake, question is - what actually are the negatives to combi feeding?

@Usedtobechilled ive literally just been going through this. Did your baby get checked for tongue tie? Mine had one and had faltering weight as he just wasn’t transferring much milk. We had it snipped but it reattached to which point the constant decline in weight being put on was just giving me anxiety and I moved to fully formula

I was in the exact same situation as you, started supplementing with formula and it was absolutely brilliant. He immediately drank so much I realised he hadn't been getting enough just from me.
No negatives at all and I breastfed to a year old. Did this with two babies, so the second that was the plan all along.
Just make sure even if breastfeeding gets easier that you keep giving at least a bottle a day because if not then the baby can start refusing it and that's a complete nightmare. I found that so long as you carry on with both the baby will accept both happily.

The main risk to you if you're combi feeding is that you don't get appropriate support and it affects your milk supply. Having a mix of formula and breatmilk is fine for baby.

I combi-fed and had excellent breastfeeding support, but know others who didn't have the appropriate support / were surrounded by people pushing the "just give a bottle, fed is best" arguments and ended up stopping nursing before they really wanted to.

If you can have baby assessed by a decent lactation consultant/IBCLC as a starting point, they might be able to advise. Also see if they need assessing for tongue tie as that can affect feeding. Definitely aim to get some feeding support from someone who knows what they're talking about. There's an IBCLC called Lucy Ruddle who did a combifeeding book. It's quite recent but people have said good things about it.

I loved combi feeding. But my DC still went gradually from 75th to 2nd percentile. It turns out he’s just very slender, still lives on air at 5.

I combi fed to 9months. DD was 75th centile for length but 0.4th for weight after being SGA / IUGR and then had GBS sespsis on top. We introduced formula top ups because we were not going to be discharged from the neonatal unit until she had two days of weight gain and i was determined to make it work!

Presumably you are planning on top ups after each feed rather than swapping one whole feed for a bottle. In which case, I found that i had to be pretty militant about ALWAYS offering the breast first (even when knackered, doing all the nights etc) to keep my breastmilk supply up and running. And be militant about not offering too many top ups / only the min ml needed / paced feeding / slow teats etc so that DD didn't develop a preference for the bottle over the breast.

I also pumped 6 times a day until 12 weeks and did a 3am pump until 20 weeks old to try and boost supply. But i appreciate that isn't sustainable for everyone and i think certainly contributed to my PND.

Have you looked at the kellymom website? She has some good tips for combi feeding and keeping up your supply.

I combi feed for 3 months, i was told overnight breast milk. Is the best for them .... i let him get what he could from me then topped up on formula.. you have to do whats best for you as well if you are tired and stressed it wont help milk production or quailty.. and combi offered best of both worlds.

To add to my comment above, DD is now 19months and on around the 75th centile for both weight and height (she took really well to weaning!😳) so seems to be much more in proportion now!

Combi feeding saved my sanity with both children ... I'm really not a BF only til they're 27 years old kind of mum though

It can cause problems with supply and also nipple confusion leading baby to reject the breast.

If at all possible get the help of an IBCLC who can also check for tongue tie. They are often missed by other professionals. Failing that talk to your local La Leche League. They can help you figure out if the issue can be resolved, and if combi is the way forward support you in doing that in a way that preserves the feeding relationship.

Something else you could try in the meantime is wearing a Haaka pump on the opposite side to the one you are feeding on to passively collect the letdown and feed that too. You'd be amazed how much you can get.

Just to add, I didn't top up each feed, I did one or the other. As far as I can recall anyway. Would be quite a pain to make up a bottle for every single feed if you are breastfeeding too long term but perhaps there's a good reason to try that for a bit.

I'm pretty sure I did the breastfeeding and my husband did the bottle feeds so I got more sleep at night.

Combi feeding from 1 month and breast-fed till 3 years. It is absolutely possible. However in the first year I still often pumped as well in order not to lose supply. But all babies are different so check if your baby will take both breast and bottle. Good luck

So LO had a tongue tie which we got cut around 1 1/2 weeks and from the look of it and his tongue mobility, it doesn't appear to have reattached (he can stick his tongue out a wee bit whereas before he couldn't at all) although he does unlatch himself a lot when feeding so i guess its a possibility. He sounds like he's gulping and the HV has assessed his latch as has a breastfeeding support person at the hospital and everyone was quite happy with it. I'm feeding on every cue (mostly when no cues) but it's not been enough and after pumping constantly and giving him top ups with that it's only just been enough to scrape a decent weight gain for a week. People have said breastmilk is enough for them but I'm not sure in my case it is or else why has it been such a struggle? It's incredibly disheartening so I think we'll move to combi. Thanks for everyone's input.

No negatives for me. I had low supply and had to top up. I was pumping around the clock, then just switched to breast and formula. Saved my sanity. We introduced a bottle early on and there was no nipple confusion. Husband did night feeds so I could rest. Best decision we made. Now have a strapping 20m old!

From everyone's replies, I'm assuming there are no negatives in regards to their health then as they are predominantly still breast fed?
I'm not against it but I almost feel like I'm doing something bad if I combi feed and I don't understand why I feel like that. Also feel a bit like I'll be letting my health visitor down and again, I've no idea why I feel like that either when I should be thinking what's best for my LO

They would be no negatives to their health even if they are 100% formula fed, so I really wouldn’t worry about that. It’s a difficult time the newborn stage and please do anything you can to make things easier for yourself and the baby. The horrendous schedule I had with constant bf and pumping was exhausting and towards the end I started to resent my baby as it felt like a constant drain. Switching to combi feeding then fully formula fed at 6m was the best thing I ever did for my baby and my mental health.

My baby was like this. Born on the 91st and dropped weight like a stone despite responsive feeding and topping up with formula as directed.

I combi fed him with 2 bottles of formula a day but still pumped those feeds (not sure why I didn't give him the milk I pumped)

For us there was a negative to combi feeding. My son is allergic to cows milk. He was fine on my milk, but after formula he'd cry and scream and projectile vomit. He basically threw up the extra he was getting so it didnt help at all with his weight issues.

Thankfully we got to see an amazing dietician at 16 weeks ago diagnosed him, gave us prescription formula AND was pro breastfeeding and my continuing. So many doctors will wrongly tell women that you cannot breastfeed a CMPA baby.

Even with the special formula he would be fine with my milk and vomit up his formula. It was however a lot less and he started to gain weight. We also weaned at 4 months on medical advice.

Partly I think his weight issues were just him though. He's 6 now and is the definition of lanky, he's super tall but has a six pack! He eats like a horse although he still cannot tolerate milk.

For me there were negatives to combi feeding and I didn't do it with my second child.

Hi OP, we supplemented both of my kids; current little one was 2 years old at the start of this month and is still on the boob several times a day - whenever he gets the chance! :)

So in my experience combi did not shorten my BFing journey - in fact it extended and supported it, by removing the panic and fear I felt when his weight wasn't going the right direction.

Both of mine are fit as fleas and it did them no harm at all - in fact no doubt in my mind that formula helped massively when they needed to get weight up in the newborn days.

One of the big things I wanted when we began combi feeding was to feel less stressed - I felt I wasn't recovering as well as I could from birth due to feeding anxieties.

For that reason I did very much 'baby-led' combi feeding, didn't write anything down or do any maths - all of that fed my anxiety!

So I would offer the boobs, one after the other, and then after 10/15 mins if bub still seemed hungry I'd offer a reasonable-sized bottle of formula - 4oz or whatever seemed 'about right'. If bub chugged that down and still seemed hungry I'd offer boobs again and potentially make and offer a second bottle.

I'd always offer feeds whenever they seemed upset or hungry, never timed them or limited anything, but never woke them to feed either.

It's amazing when you stop hearing that 'hungry cry'! And they just get all relaxed and full and sleep really well... It did wonders for my post-natal sanity and recovery.

Wish you all the best <3

I remember I felt like I was totally failing if I gave my baby formula. It was a few weeks in and he was hungry and I was exhausted with bleeding nipples.
First I used a bottle of excess milk from a friend who unlike me had tons to spare. Constantly leaking, freezer full of spare milk.
Baby gulped it all down and fell asleep for ages. Realised he just needed more and started with formula for some feeds.
Although I felt so guilty initially I look back and it was ridiculous. But I was so tired and hormonal and stressed. With some distance it all seems logical and clearly the right way forward.
Good luck!

I EBF and expressed with my first.

Subsequent babies I combo fed and was sooo much better. Babies didn't loose massive weight in initial days after birth. Max would be 2 formula feeds a day to not disrupt my milk supply and also easy for baby to take feeds should I pop out.
Win - Win