Is combination feeding actually possible??

[ThisSharpNavyRaven]

My nearly 3 weeks old was exclusively breastfed for 10 days, until we realised she was still losing weight. I began 'topping up ' with expressed breast milk twice a day, and giving a bottle of formula in the evening and she's now gaining weight and is much happier. However I'm struggling to express enough breast milk for her, not because of supply but time and logistics! I've got a 2 year old and a 4 year old and it's just so hard expressing, sterilising and constantly breastfeeding. I'd love to just do formula top ups, but I'm worried about my milk supply. Last night I had my newborn and 2 year old on my own and I couldn't deal with the toddler whilst the baby cluster fed, so I gave her a bottle of formula and she slept all evening - it was heaven.

I'd love to hear from anyone who made combination feeding work from such a young age. How did you do it? How many bottles a day?

I can feel myself sliding towards her becoming formula fed, but I would like to continue breastfeeding in some capacity, especially as my older two were exclusively breastfed.

Thanks!

I've had two babies and both have needed formula top ups for different reasons from birth really. I've kept the breastfeeding going for at least 6months with them both before switching fully to formula. I was happy with that, but with both of them, I felt like my supply was really starting to decline at that point. So i suppose it depends on what would be a comfortable stopping point for you?

I do a top up after every bf - I had 8 bottles at the start (now 5 feeds a day as DD2 is sleeping through) and just do one big batch of washing and sterilising per day to try and make it easier. I was doing the whole 8 x pumping a day with my eldest and this time i just refused. I did one power pump session per day when my eldest was in bed and used whatever breastmilk I got from that, but otherwise it was formula, and even then I stopped pumping around 12weeks this time.

@CrispAppleStrudels thank you so much, this is just the advice I need. I'm more than happy with moving to only formula after a few months to be honest, so it's good to hear you could maintain breastfeeding for that long using formula for top ups. It's the pumping which is really killing me.

How did you find topping up when out and about? Did you just bring a bottle of formula with you or did you skip top ups when not at home?

Your baby is two weeks old. Your milk supply is still adjusting on your babies needs. Let your baby latch more often, then your supply will grow as well. Babies are also more efficient on your boob than a pump, they get more out of them.
I understand that that is hard to do with two other children ánd recovering from birth. Do you have help so someone can look after the older ones?

I keep a supply of the 200ml ready to drink formula bottles at home and use those when out and about. It was also handy as both of mine had reflux and ended up on infant gaviscon, which was much easier to make up with formula.

@MontblancTheSecond yes I know that! I'm pretty experienced with breastfeeding and as I said, supply is not an issue at the moment. As stated, exclusive breastfeeding wasn't working for us so I'm looking for advice specifically about combination feeding. I'm of course breastfeeding responsively and feeding her as often as she needs. I do have help at home but it's the pumping I'm really struggling with!

Hey I combi fed from birth, one formula bottle a day at the same time until 5 weeks then 50/50 bf and formula which was 3 and 3 of each alternating. Did that until 6 months then gradually swapped over to fully formula. It worked brilliantly for us and meant someone else could help and feed the baby and my husband loved doing it

I combi fed DC2 after a nightmare time breastfeeding and then ultimately formula feeding DC1.

We did one bottle per day. Almost always the same time, sometime around 10pm, so that DH could do it and I could get a block of sleep. I tried to express but it just was so much work for so little milk. I preferred to BF in the day as I found it easier than dealing with bottles.

Didn’t seem to affect supply. Breastfed until I chose to stop at around 9 months and that bottle then became bedtime bottle.

I combination fed both my kids, introduced bottle around the 2 week mark both times. They had expressed breast milk in the bottles until they were both around 6 weeks old, then my supply settled so it wasn't feasible to continue pumping as was hardly getting anything, so they had formula after that.

However mine only had about 3 bottles a week as night feeds which was so that I could rest. They were breastfed the rest of the time. It worked well for us but I can't comment on if you're planning to give more bottles than that.

We are doing combi feeding. There are days when he refuses the bottle - was full of cold - and we just breastfed. Most of the time we alternate feeds between ff and bf. If I get caught out with no formula then I do just breastfeed and will give a bottle later if he's not settling after bf. Only one problem is he won't drink cold milk so we keep needing to warm it or use the go prep when we are out and need a bottle haha.

I had to combi feed (by the time tongue tie was diagnosed and cut - twice - my supply was really poor). For a while I tried to express as well as top up with formula but as a lone parent with no other support it was impossible to keep up with. So I dropped the expressing and just breastfed with formula top ups for 8 months.

I guess your supply would drop if you stop expressing but if you want to combi feed then that might not matter so much. It will just adjust to however much you breastfeed.

Combi fed here really and stopped bf at 15 months. For quite a while was only 1 bottle of formula per day before bed, which dh would give so I could go to sleep myself. My baby fed all night long, which I think helped my supply. I couldn't express hardly an ounce...would just bf and top up with formula when needed.

Thanks for all the advice everyone. I'm going to take her to the infant feeding clinic today and push for her to get the tongue tie looked at properly. Problem is they completely lose interest in doing anything about it as long as she's gaining weight, even though she's only gaining because I'm breaking my back breastfeeding, expressing and bottle feeding all day!

At the moment my partner gives a bottle of formula at 9pm so I pump, then he brings her up at 12ish and I bf all night (every 2 hours roughly). Then I breastfeed during the day and do two breast milk top ups using what I pumped the night before plus whatever I can get using the haaka (usually quite a lot). Then if she's v unsettled in the evening I might do one formula top up, or just let her cluster feed on me until the 9pm bottle. Thing is she really guzzles the bottle top ups. Often she'll drink about 70ml and that's after bf, so I'm concerned she's just not getting enough from me, even though my supply seems fine at the moment, which would fit with her having a tongue tie I guess.

Anyway, sorry for the essay. My partner's bored of hearing about it so telling strangers is the way to go! Thanks again for the advice, I appreciate it.

Yes , people make it work all the time. Don't formula feed at the time that she's cluster feeding though. As tempting as it might be - it's essential to building supply,

Pumping is the hardest thing to do really.

@ThisSharpNavyRaven don’t bother with NHS feeding team. Go private. I can’t speak for all but my hospitals feeding specialist is literally a midwife with no infant feeding training. She said my baby didn’t have a tongue tie, my lacerated nipples said otherwise! I persevered for 7 weeks then got a private consultation, actually she had poor tongue function, had it snipped and am still bf now at 9 months.

I did breast in the day and formula at night. At 3 months I was just formula as this was best for our situation.

If pumping is an issue have you tried the hands free pumps that fit in your bra? I haven't but I want to for my second as it took me so long to pump very little and it felt like time wasted

@HamSandwic oh that's interesting. I'd love to just do formula in the evening but not sure what that would do to my supply as I know cluster feeding is quite important...
Yes I've been considering an Evie pump. They are just so expensive and I feel I'd really be committing to continuing to pump then, when really I'd love to be able to just do the bottle top ups as formula ultimately. It's so annoying when I go up to bed and my partner gives a bottle that I have to spend 30 minutes pumping and sterilising, when I could be sleeping!!

@ThisSharpNavyRaven i only pump on my kit days but have a momcozy s12 which is much cheaper than an elvie. It fits in my bra.

I combination fed my third. With 2 older kids I wanted some flexibility and for him to take a bottle and I had no time or interest to pump. He had a bottle of formula every day from birth. We had no problems switching between bottle and BF. In fact it probably made it easier when I stopped BF at 6 months and moved exclusively to formula.
i remember being told that it wasn’t an option and wouldn’t work, but it worked fine for us

I've been combination feeding since my baby was born 4 weeks ago. Didn't plan on it but she was so badly jaundice I was told I had to top up with formula after every breastfeed. Plan was to just breastfeed once the jaundice was under control but I lost a lot of blood in my emergency section and was very unwell and very anaemic from the blood loss. Long story short, my milk never came in properly ( this is my 4th baby so know what it feels like) despite constant feeding, pumping and skin to skin I'm just not producing enough and midwives and HV think it's probably the blood loss and anaemia which has caused this. Anyway the point to this post, is combination feeding is working well. I find my supply is better in the morning and mainly breastfeed her but by the afternoon/evening she gets quite distressed and is constantly looking for milk so top her up with formula. I always start a feed with a breastfeed and then judge whether she needs a top up or not. No real routine or anything at the moment so couldn't say how many BF or bottles she's having I'm just going with the flow. I will say, most evenings when she's fussy I declare I'm stopping BF but I wake up with a changed mindset every morning and still going 😂

The lactation consultant I saw said that in her opinion, a pipetta is a good cheaper alternative to elvie. I have the elvie double stride and it is a bit annoying to sterilise as it has five parts. If I was going to buy one again, I'd probably go for the new medela hands free as it only has 3 parts i think.

@autumnmum123 haha I know exactly what you mean about declaring you're stopping breastfeeding. My partner reminds me every day that each baby I've had I regularly say I'm giving up breastfeeding. I'm giving myself a goal to get to 6 weeks with this baby! My combi feeding situation sounds similar to yours, just bf in the morning and then increasing top ups in the afternoon and evening. I often start as a bf, then bottle top up and then bf at the end to get her off to sleep ...

I might be being totally stupid here, but do you need to pump at all? Both my DS lost too much weight and were on a mix of formula and BF for a while - Ds1 only 10 days or so, DS2 a couple of months on two and then one formula feeds. Ended up back on EBF in both cases. I can't pump, literally get nothing, so although I had the Evie and was using it to stimulate supply I gave up fairly quickly cos it was so pointless. You say supply is okay so could you try just giving the evening formula and BF the rest of the time? Especially as you're BF at night won't that keep supply up?

I would see a private tongue tie consultant to get that confirmed or eliminated as quickly as possible.

There is no definitive answer because some babies will accept combo feeding, and some women will be able to manage with supply etc. others won’t. Problem is you don’t know until you do it, then if you’re one it doesn’t work for you wreck your supply and often ends your bf.

i will say combi feeding ebf is an utter mess. As you’re experiencing, it’s twice the work and still affects your supply.

my advice is always if you really want to bf, bf. Expressing, topping up etc is not helpful and can affect your supply. The only thing that increases supply and positively helps bf is more bf.

if you are happy with a move to formula and aren’t that invested in bf, and you want to top up or give bottles, give it a try. I would just give formula though, don’t put yourself through the expressing and bottle feeding ebm when it’s so much easier just to bf.

I did breast and bottle with both mine dc. Both over six foot tall, so can’t have done them any harm.

@Howmanyusernames123 well I definitely do need to top up using bottles as due to her feeding issues (possible tongue tie) she is burning too many calories with inefficient breastfeeding and not getting enough milk that way. I'm aware exclusive bfeeding is easier as I did it with my older children. Fact is, she's only gaining weight due to the bottle top ups she's getting at the moment. Supply is not an issue for me at the moment, I'm able to get 3-4 ounces easily in a pump session and that's in between constant bf sessions, and my boobs are gushing milk all over the place! The reason I'm feeling the need to pump is not to maintain my good supply, not boost it. If I just supplement with formula then I think my body will adjust to not making enough milk for her. This way, I'm still producing nearly all the milk she's drinking in a 24 hour period, she's just getting some of it from a bottle, which seems to be necessary for her health at the moment.

It's v v useful to hear the experiences of those who have successfully mix fed their babies! Thank you all very much :)