Mixing breastfeeding and formula - some of each at every feed - advice please?

[Pempe]

My DS is nearly 2 weeks old. I intended to BF from the start, and tried to do so, but my baby was so hungry even after hours of BFing, the hospital i was staying in for 1 week after the birth recommended I supplement with a bottle of formula after every feed. I'm sorry to say that I followed their advice and now I am home we seem to be stuck into this routine. I have also started to express milk and feed him this instead of formula, partly to try and keep my supply up, and partly to make it one less bottle of formula a day he is drinking.

The paediatrician has encouraged me to carry on with this BF/bottle method, he is gaining weight and seems very healthy. She says once he gets stronger he will be able to feed more efficiently from the breast and will not need a bottle, but I am not sure he will give up bottles so easily.

Has anyone successfully mixed bottle and breast in this way? I am worried that I am teaching him that he needs a bottle after breastfeeding, and before going to sleep. Also, he seems to not settle so well after taking a bottle of expressed breast milk.

I am so worried and upset about this - am I confusing him, should I be trying to cut out the formula now before it's too late?

Pempe, can you give a bit more info? What is the weight? How much formula are you using? Formula after every feed is a lot and just dropping the formula may not be an option, and you may have to plan, as you suggest.

Cut out the formula now. I did, I was in the same position as you albeit with a slightly older baby. Mix feeding in 99% of cases compromises successful bfing.

The danger is not only putting your supply at risk, but that baby may refuse the breast in favour of the much easier to drink from bottle. Mine did, which is why I decided to ditch the bottles. DD's paed was not impressed, but than I have a suspicion that most paeds are undercover formula reps anyway. I got loads of support from the baby clinic instead.

You do have to be consistent and determined, putting baby to the breast as often as possible, even every hour to get your supply back up. You might have to wake baby up in the night, if like mine he sleeps through, as night feeding further stimulates prolactin production.

In my case we were sorted after about a week, after initial resistance from DD who had come to prefer bottle teats. I'm still bfin now, 3yrs on and at the time I didn't think I'd make it to 6 months.

Thanks for coming back to me Tiktok - he was 8lb5oz at birth. He lost about 1lb over the first 5 days, but has now regained most of that (he is 10 days old).
He is taking about 60ml on average from a bottle after breastfeeding.
I have no problem with sitting for longer to get him to drink more from me - I have tried this - but he just falls asleep and even after me pestering him to stay awake and drink more, he still gulps it down from a bottle.

It's never too late to cut out formula. Sometimes you have to do what works for you both at that time. There will be plenty of people here who can advise you re improving your supply, and there are wonderful support groups that you can go to for face-to-face advice (contact the NCT or BfN to find groups near you).

But, in the meantime, here is a bit of my story to encourage you, I hope. I too was supplementing ds1 with formula after each feed from 2w. At about 6w I decided to try and relactate. Every morning I parked myself on the sofa with ds, the phone, the TV remote, a blanket, some books, a jug of water/juice, a fruit bowl, a pile of sandwiches etc, and did nothing but feed and rest.

The last ff he would have had was at about 10pm the previous night. I followed his lead and fed him when he wanted, but would first play with him, let him suck my finger or a dummy for 10-20minutes to extend the gap between feeds. Within a week he went from feeding every 2h to an easy 3 - 31/2h gap between feeds. I didn't give him any formula until I could no longer pacify him in any way and he wanted to feed continuously.

By 10w he was sleeping through from the 10pm feed until about 6am, perfectly contented and not needing any top up until about 1 or 2pm, at which time he only took half a bottle (about 3oz IIRC). For the rest of the day he would have breast, with two bigger top-ups one at about suppertime and one a dreamfeed at my bedtime.

I was really chuffed and pleased with myself. I'm sure that with good advice and support I could have relactated further, but I didn't know how to access that at the time, and felt good about what I had achieved in any case.

I hope this helps!

I don't know personally about this, but a friend of mine had something very similar to this, and was prescribed something to increase her supply, would this be a viable option?

Think there are a lot of foods that can increase supply to (oats?), but I'm sure someone more knowledgeable than me will be along in a minute

Curries are pretty good. I used to positively brim with milk after a generous portion of aloo gobi.

(Brangelina - this advice is not helpful and could be risky, sorry - cutting out formula 'now' could compromise this baby quite seriously. What worked for you with an older baby cannot be generalised).

Pempe - thanks for the further info. It's clear things were not going well at the start, and you were given poor help and info - not your fault, but theirs

Your baby is having a lot of formula - if he is averaging 60mls a time, then at a rough estimate he is getting more than half his calories from formula. You cannot (sorry for bossiness ) simply drop the formula and expect your supply to double straight away - your baby could become ill. Instead, with the midwife's help , you can work out a plan of action to

• preserve and save your milk supply
• ensure your baby is happy and growing well while this happens

This might involve expressing, lots more skin to skin, co-sleeping, attention to the way the baby positions and attaches, switch feeding (going from breast to breast and back again and again), breast compression (google it)...anything that increases the effectiveness of bf and your supply.

Meds to boost your milk supply will not work unless this basic stuff is sorted.

The sooner you start all this, the better. At the moment, breastfeeding is deffo at risk.

Helplines will give you support as well, but I do think you need to work out a plan with someone who is able to see your baby and assess his needs. Good luck

Brangelina I meant the 'drop the formula' advice was not good....the curry advice is fine, but a bit unscientific

Prettycandles you say that you put off giving formula until you could no longer pacify him - how long were you giving him at the breast before you topped up with a bottle?

Pempe - whatever PrettyCandles did may not be right for your baby, who is a lot younger than hers was when she did this.

Nothing can be a substitute for careful, individual planning, sorry.

In your case, you should be supported to breastfeed for as long as your baby is actively feeding, so it's not a question of time but of his behaviour. You can extend his behaviour with switch nursing, breast compression.

With a difficult situation like yours, it's important not to totally exhaust the baby so he then refuses the formula/ebm. In a baby of 6 weeks, this may not be so much of a concern.

It was the advice I was given Tiktok, but then as I said my baby was a bit older and never had such a large proportion of her feeds as formula. Apologies if misleading or inappropriate in this instance.

The curries might have been a placebo effect, but they were nonetheless far more pleasurable than those awful galactogogue teas I was prescribed.

tiktok, your advice is so helpful, thank you. However, I am in Greece, there are no midwives, no NCT breastfeeding counsellors and my only official support - the paediatrician - is encouraging the formula/breast method (as I said, she claims it's only for the next few weeks).

So would you recommend I keep him at the breast for longer, switching from breast to breast (every 20 mins?) and see if he takes less formula? I have read that babies drinking from a bottle are unable to guage when they have had enough and will just drink and drink....this may be an old wives tale, but I am concerned that he will take so much he will upset his stomach.

another anecdote to offer without expertise

• I weaned off the bottle by guessing when my baby had not had a "proper feed" from the breast and adjusting top ups accordingly. Gradually I phased them out and moved from a routine to feeding on demand. There was no science involved, only guesswork but it did have the desired effect!

No probs with curry advice or with placebo effects, come to that - all good

But as you say, advice for an older, different baby may not be right for others.

If you google, you can find a recipe for lactation cookies! I followed a recipe I found on another site using the cookie ingredients to make a "lactation shake" - not sure if it worked but I used the wrong kind of yeast and it fermented inside me - weird!

Pempe:

www.llli.org/Greece.html

Give them a call

Pempe, if you follow what the paed is saying, you will have no milk...this is already happening. I can be pretty sure you will not be able to drop bottles in a 'few weeks' - you will have had to switch to full ff long before then

Pempe, I gave you my story not to say "this is what you should do", but to show you that it can be done. To encourage you, I hoped. I don't know whether what I did then (8y ago) would necessarily be considered the right thing to do nowadays. Maybe there would have been better things to do. For example Babymooning. Have you tried that? It's bliss (I still do it from time-to-time with my 2y ) Undress baby down to nappy, get naked yourself, and snuggle up in bed together, cuddling close, letting the baby feed as much as they like whenever they like. There's truely nothing like it . Another pleasurable way of feeding is to feed in the bath. The intimate, skin-to-skin closeness in these activities encourages milk production.

I don't recall how long I bf before giving formula. I do remember that an entire feeding session - breast, burp, bottle, burp - could easily last 1.5 - 2h.

Tiktok, by the way, is the bee's knees. She has been fantastic for me whenever I have had concerns with my children's feeding. (And for other mums, too.)

Aw, PC, nice of you to say

And yes...babymooning is just luffley

Pempe, you could certainly try it

If you can't get a response from LLL Greece, then post again. 'Cos I have contacts elsewhere who might be able to help.

Thanks everyone for all your useful advice, I'm feeling a bit more positive today.

I also spoke to the La Leche League yesterday. Unfortunately, they don't have a support group where I live, but it was good to speak to a (lovely) lady who understood how different/difficult it can be out here in Greece with the vastly different culture....

From yesterday afternoon I have tried feeding him for longer at each breast and he actually took a lot less from each bottle afterwards. It meant that last night I was up for nearly 2 hours each feed, but it's worth it

And then this morning, we had an hour of baby mooning. Fantastic.

I guess I keep doing this until he takes so much more from me that he doesn't need the bottle at all? Is that the way forward?

Hello Pempe,DS1 was just bf from birth. However, DS2 was combined fed for the first 3/4 days after birth (he weighed 10lbs 14 ozs) and would just cry after each feed. In the end the midwives said he was probably still hungry. I started to give as much formula as he could take immediately after each breastfeed.

I stopped this when my milk came in, by only offering the formula if he came off the breast and cried or seemed to still be hungry. It may take much more frequent feeding for the first few days, but see how he reacts if you start gradually cutting down the amount of formula he has after each feed and then just try without. Good luck - and try not get stressed any breast milk is better than none. You are doing really well even if you prefer to stay combining.

Good to hear you're feeing more +ve, Pempe

mumoftoby - the risk in Pempe's situation is that staying with combination feeding is not going to work for her....it will almost certainly lead to full formula feeding.

So Tiktok, how long do you think is reasonable to carry on with the formula until I really need to be cutting it out completely? He is still having a bottle after each feed, should I limit how much he takes, then cut out one bottle feed a day? Over what sort of time scale?

Pempe, you are right about cutting down over time....but better to work out what is appropriate with someone like the LLL person, who can have a proper dialogue with you.

Sorry - it's not something I think is sensible to work out on a talk board.

Pempe, I would say 2/3 days. But play it by ear - see how your baby reacts.