Combined feeding - bottle & breast

[Zeeky]

Expecting DC2 in a couple of months and really want to successfully combine breast & bottle feeding this time. DS1 was exclusively breastfed until 6 months and then started to take a bottle. I didn't try him with a bottle until he was 11 weeks old which was too late, and he totally refused to take a bottle until he was on solids.

This time I would really like the baby to take a bottle for one feed a day, so that I have a little more freedom if I need to leave the baby with DH, and DH can get a bit more involved.

ANy suggestions as to when is best time to start using a bottle, expressing etc. Last time I was totally paranoid about messing up the BFing and left it too late.

It's taken me 2 mths of trying almost everyday with loads of different bottles and teats to get my DD2 to take a bottle. She is 21 weeks and still not easily fed with one but will take it.. Don't leave later than week 6 I say. She was fine at week 4 but I stopped because of the whole nipple confusion propaganda. If I were to do it again I would do a dream feed of BM or Formula every day from week 6.

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Forevermore thanks for your advice. I was planning to start trying a bottle at the last feed of the day (11ish), so that I could go to bed early and DH can do the last feed each night. But just wasn't sure when to start. Do you think week 2 is too early?

I too was put off by the whole nipple/teat confusion issue last time, and I'd read that it could mess up my milk supply/production.

When DS eventually took a bottle, the only one he would take was NUK with a latex (brown) teat rather than a silicone one. THe teat is much softer and looks more like a nipple to the baby (apparently!!) It was the bottle/teat he was rejecting rather than the formula. Once he started taking a bottle though, my milk supply dried up pretty quickly.

It's such a minefield!!

I think 2 weeks is too early. I would feed all the time to buildup supply for at least a month.

It's tricky. I think nipple confusion is a real thing, but not every baby seems to struggle with it. I think it's safest to introduce to start expressing, and introduce a bottle of EBM from 4 weeks. If you keep giving a bottle of EBM every day or two, the baby hopefully won't 'forget' about bottles, and will keep accepting bottles as they get bigger.

I don't think it makes a difference if you start giving bottles early or not - some babies just prefer the breast. I have even heard of babies taking a bottle happily and one day refusing it and never taking one again! I would probably leave it for 6-8 weeks to get through the first growth spurt and allow your supply to establish.

Zeeky, (hi from a fellow April threadee!) I combined breast and bottle with DS1 from 4 weeks and he was absolutely fine. When we started him on the bottle DH gave it to him (for the same reasons as you - so I could go to bed early and DH could give him a 10:30 / 11pm bottle of expressed breast milk) and he never questioned it at all, in fact it was astonishingly easy!

I'd been told 4 weeks is about right to start them on the bottle if you want to carry on BFing as they've got the hang of BFing and won't forget how to do it, but it's still early enough that they shouldn't reject the bottle in favour of the breast.

TBH in reality it probably depends on the baby, but I definitely recommend giving it a go at 4 weeks ish, and if you can get someone else to give baby the bottle then do so as that way they won't smell the milk on you and wonder why they're getting a bottle rather than the breast. IMHO I can't imagine many 4 week olds doing that though, in my experience DS1 just wanted dinner and didn't give a toss who gave it to him or how!

Another one here whose DH intro'd a bottle of EBM for DS1 at 4 weeks for the 'dreamfeed'. No problems with supply (as he was still taking plenty of night feeds) and we never experienced nipple confusion. I bfed until 5 1/2 months. Dr. Brown bottles worked the best for us.

Am due to try the same with DS2 in a couple of weeks. Fingers crossed!

We introduced a bottle of EBM at 4 weeks old for the last "day" feed before bed about 7.30-8pmish. After a couple day's of him completely refusing it I got Dp to give it to him while I was in a different room and he took it straight away.

Never had a problem with him getting nipple confusion and he still BF perfectly. I just think because he could smell me he thought he would get boob while I was there so when Dp gave it to him he didn't bat an eyelid and drunk it without a problem.

Great to hear from you guys who have succesfully done it. When did you find the best time to express?

Last time I loathed expressing. I found it such a faff and really time consuming, and was always worried that I was "taking" DS's milk from his next feed (or else he had already drained me dry and nothing would come out!) or would over-stimulate my supply! I think I was just looking for reasons to not do it! Is there a best time to express, and is it best to do it at the same time everyday? I was using an electric pump too, so it wasn't as if I had to hand-pump.

Zeeky I hand pumped last time and found it very easy really - in the early days I often had to get up in the early hours of the morning to express because my boobs were like rocks, so the 'best time' kind of dictated itself. When I was really full it was such a joy to express, took the pressure away and gave me peace of mind that I had milk tucked away for an evening / night feed.

Otherwise I'd often express after a feed to empty my boobs once DS had finished, and then just before bed if DH was going to give DS a bottle of EBM at 10:30pm, so as to keep supply going.

Doing all of that I used to average about one or two feeds'worth of EBM in the fridge / freezer every day, and if I didn't have enough I'd just top it up a little bit with formula (but that was my choice, obviously, and not for everyone if you want to BF exclusively.). Also I found that my supply dropped drastically when I went on the mini-pill at 6 weeks, despite the GP saying it wouldn't affect my supply. Have heard the same from friends to. Again, just my experience but worth bearing in mind.

Thanks for the advice Snowtiger. Not long for us to go now, so thought I'd better start thinking about some of the practicalities of having a newborn again. There were loads of things that we vowed to do differently if we had another baby, but I now can't remember what half of them were!!!

Determined to get the baby to take a bottle this time though, as definitely need to be a bit more flexible/free with DS1 around, and also able to get some rest and not have to ALWAYS be the one to get up to feed like last time. I found BFing easy last time, and very very convenient, but at times I wished I could just crawl into bed and leave the feeding to DH.

Zeeky, ime it depends pretty much on how quickly your supply settles down, and how readily your baby takes to BFing, and how easy you are finding it feeding this time around. If you are having latching issues and introduce a bottle too soon, then the baby might see that as the easy option and it might make those latching issues worse.

Similarly if you are having supply issues then there is a chance that the expressing will interfere with this, if you don't make sure you replace the feed you miss with an expressed feed, which means that you would need to be up expressing so you might as well just BF!

And as others have pointed out, it depends entirely on the baby. My DS2 wouldn't entertain bottles at all, but DD before him didn't care where the milk was coming from as long as it was coming. DS2 has been getting a cup since he was about five months old, and even then it was only under extreme circumstances that he would entertain it....he much prefered to wait until I was back from wherever I was to get it direct from the source!

It's my feeling though (as a peer supporter) that two weeks is probably too early to start missing a feed to get an earlyish night, as your supply is still settling down at that point, however depending on how things are going, four to six weeks might be a better time to think about it. I would suggest getting a local BFing counsellor on board who you can turn to readily for help and advice should you need it and to wait and see how this baby is and how things go.

forevermore, its not exactly "nipple confusion propaganda "; it does exist! And while there are lots of babies for whom it isn't an issue (my DD was one of them), there are just as many, if not more, for whom it is. Just as there are lots of women who successfully combine breast and bottle feeding, equally there are lots of women for whom mixed feeding is the beginning of the end of BFing.

Re time of day, most women find that early morning is the best time as the milk producing hormones have been most active throughout the night.

There is lots of good advice on pumping on kellymom

Zeeky - I expressed early morning (between 6-7 after DS feed) as had heaps of milk and always managed to express enough for evening feed in one sitting.

TBH though this time - am more relaxed about the whole thing and also concious that expressing will take even more time away from DS1, so am considering just going straight to formula for that one bottle a day.

My first born was BF and refused to try a bottle every day from 6 weeks to 5.5 months. My second DD is going the same way, I need her to start taking a bottle as I have to go back to work at the beginning of April, I just don't know how to make her take it. I bought the Closer to nature bottles, but they certainly don't look or feel like boobs to me! Any suggestions on how long I should let her scream when trying to give her a bottle. I usually wimp out after about 1-2 minutes, I just feel so sorry for her. It seems so cruel to try and force her to have a bottle that she doesn't want?! Heeeeeeeeeeeeeellllp...

Lolzarela - maybe try the NUK bottles with a latex teat rather than a silicone one. The latex teat is brown and much softer, so baby thinks it looks and feels more like a nipple (apparently). It was the only one that DS would take last time, at about 6 months.

Hoping to introduce the bottle much earlier this time.

My ds (now 5 months) used to have a bedtime bottle every night from 7 weeks (but he'd had occasional ebm in a bottle from about week3). Then one night before Xmas he refused point blank and wouldn't have a bottle no matter what was in it. This was the night after a set of jabs that made him feel v poorly. Coincidence?

Anyway, the other day I gave him a teat to play with/chew, and then gave him a bottle - but just to hold, I didn't try to make him drink it. Lo and behold he grabbed it and started feeding himself! he dis this again last night while lying in his bouncy chair. I helped to hold the bottle up a bit to get the milk into the teat but he basically served himself!

"I was planning to start trying a bottle at the last feed of the day (11ish), so that I could go to bed early and DH can do the last feed each night"

That is exactly what we did and it has been very sucessful.

We started on day 4! Only due to my nipples being badly cracked, but it has been a very helpful accident as she took to it straight away and had no nipple/teat confusion. We used tommy tippee bottle which are shaped rather like boobs so that might have helped.

I went through a lot of guilt as I ended up giving her more bottle from time to time and I had intended to exclusivly BF but I am now glad we started so early as we now happily combination feed every day and it has taken some of the pressure off me.
I had a few raised eyebrows from the HVs but my doctors, (I see 3 differnt female doctors at my surgery) who all have young children, have all said they do the same and have been very supportive of it.

Good luck!

Mrswee - did you use expressed milk or formula?

Can I add a question as struggling with the when to express issue too? How much do you need to express to get a full feed for a 4-6 week old?

I can't remember what I did last time around! (and it was only 4 years ago).

Hi Zeeky

I used formula and occasionally breast milk when I could express enough.

I could never express more than 1oz at a time and sometimes less from the very begining so it was hard to get enough for a feed.

So formula it was!

Our little refusenik eventually took the Breastflow bottle - apparently it's the same sucking motion for the breastflow teat and the breast, and so reduces nipple confusion. It's working for us anyway but then DD is that bit older (7mo) but still mix fed.

We did last feed at night through bottle of formula from about 6 weeks. DH did at it first so ds wouldn't get upset it was my smell but not my milk, iyswim. Usually though, he was so hungry he would've taken it from anybody!!!