mixing formula with breast feeding

[Lucy123]

I have a 7 week old breast fed baby and though I would like to continue breast feeding, I find expressing a complete faff (and can only ever get an ounze or so), but would like the flexibility of getting someone else to feed her every now and again. I'm a very laid back mother generally (gave up dairy, but not milk in tea - mum thinks I'm acting like this is my second child!) and don't see why I shouldn't give her a bottle of formula every now and again. Is this OK??

I mentioned it to the pediatrician, but he told me to give her a particular kind of formula (that no-one round here sells and that I'm reluctant to order in case he was simply visited by a salesman that morning) and to give it to her for the last two feeds of the day. I should have asked why, but he was very impatient. Anyway, I'd want someone else to be able to feed her for other feeds too. What do other people think? (no problems with milk supply so far - don't think that would be an issue).

Fionn, mixed feeding can suit some people, but the idea that Lucy should just give 'as many bottles as she wants' is not helpful if she wants to continue breastfeeding...and she says she does. Any intro of bottles has to be done in the knowledge that more than the occasional one is likely to have an impact on her breastmilk supply; she could end up not feeding as long as she planned to.

Please don't take this the wrong way - I know you feel very sad about not breastfeeding as long as you wanted to. No one has suggested Lucy is depriving her baby of anything, and she is not under any pressure, as far as I can tell, to breastfeed. The paediatrician is quite the opposite, it appears

Tiktok - I take your point. I know that the intro of formula will have an affect on the supply of breastmilk. But in my experience mothers are either totally committed to breastfeeding and wouldn't dream of using formula at the same time, or they're flexible and want to use both for whatever reason(I'm not condemning either type!). If Lucy123 wants breastmilk to be the main source of nourishment then yes, she might end up in a situation she didn't anticipate by giving more than the occasional bottle. But the fact that she wants to use a bottle suggests to me that she would be happy with a combination of breast and bottle. OK, I concede that saying "as many as bottles as you want" was not a scientific thing to say, so Lucy123 don't take my advice literally if you want breastmilk to be the main source of milk! But whatever you do don't feel guilty about it. And don't be swayed by NCT/La Leche League etc literature saying that mixed feeding is always a bad thing.
Tiktok - I do feel that comments about asthma etc (whilst I know they're right) do constitute a subtle form of pressure. But I do understand that for mothers who have successfully breastfed exclusively, it seems a shame for others not to attempt the same, but not everyone can or wants to. I agree that the Spanish doctor is talking bs though!

Fionn, where does NCT literature say mixed feeding is always a bad thing? I don't think you will find it anywhere! There is a new factsheet called 'Bottles for breastfed babies' which gives information, to allow the mother to choose.

You highlight a quandry - if mentioning asthma and so on is seen as pressure, yet you concede these aspects are correct, how are mothers to be informed about their feeding choices?

The answer (as I see it) is to place information at people's disposal, keep it as information and not a personal judegment. But if even the information is seen as pressure or interpreted as saying something is 'always a bad thing' , then bf support people really are stuck, aren't they?

Tiktok - I really do not mean to undermine bf support people, I think what they do is very important.
I assumed that Lucy123 already knew of the asthma connection as it is so well documented, but as she is in Spain maybe she doesn't (sorry to talk about you Lucy123!).
I no longer have the breastfeeding literature I used over 3 years ago. I read an NCT breastfeeding book which gave the constant message that using just one bottle was the thin end of the wedge and that if you breastfed "properly" there would be no need to do so. I'm delighted to hear that there's an NCT leaflet on using bottles whilst breastfeeding - I wish I'd seen it 3 years ago. What I objected to in literature I read was that everyone could breastfeed successfully and you should keep at it no matter what. I obviously couldn't as my baby was failing to gain weight after 2 weeks of feeding him, and I have met mothers who had exactly the same experience, just as many as mothers I've met who were successful breastfeeders.
I agree that people need to be able to make informed decisions and that the facts must be given, but I think it is scaremongering s to give the odd bottle.
This is why I never join in breastfeeding threads, wish I hadn't started...!

But 2 weeks is an incredibly short time. Many many people have babies who fail to gain weight for 6 - 8 weeks despite what feels like constant breastfeeding.

Ffion you raise an interesting point though.... You share with us what you remember having read (and I do that too a lot ) but is what you remember 100% accurate ??? How much is selective memory particularely on an emotive subject at an emotive time!
I am only too aware of the feeling of guilt that some women have for not having bf or bf for "not long enough".... I am also conscious that when you have a tiny baby (particularely a first), a woman will be emotional, hormonal, tired, worried, anxious... and so some things they read are misinterpreted to be far more authoritative or prescriptive than they actually are.

It is important for women to make an informed choice on BF and ALSO to get the right kind of support once they start bf and it doesn't go as planned.

What is an informed choice though ? I use to think like you ... scare mongering ! Well now that I am training as a bf counsellor I have access to info I didn't have access to before (at least I have a lot more info)... and it spells the case for BF in even bigger letters. My own mother was "against" bf... certainly past the 3 months stage "He'll be too clingy!!!" and that sort of thing. I have asked her recently if I could share with her some of the pro-bf argument... she was gobsmacked by all that info and now supports my bf my 11 mo daughter !

I am not having a go at you at all BTW but I suspect what you feel is scaremongering might just be your defensiveness towards a choice you made and for which you are not 100% convinced or at least wished people would all reassure you that it is absolutely fine for you and baby. (I am making assumptiojns here)
I hope this comes across in the right way... I am myself attempting to understand where we draw the distinction between info and scaremongering....

Does any of this make any sense?

I mixed the two successfully for 3 months after going back to work. I really struggled with expressing and must admit I felt a bit let down with the help I got from this angle because if I had established the expressing I might have been able to not bother with the formula. As it was all the precious ounces that I tediously expressed and froze got wasted because I had such a job getting DS to take the bottle. Another issue which I wasn't warned about at ante-natal classes - and I made it clear that I was going back to work at 15 weeks so it was obvious he would need some kind of bottle.

All the emphasis was on establishing breast feeding not continuing it.

I won't direct this at Fionn - not fair! Speaking more generally to, um, anyone , I agree with you, pupuce, that sometimes reading stuff, we can read too much into it, especially if we are in exactly the situation the book is. If you know what I mean...

Giving one bottle can be the thin end of the wedge...it doesn't have to be, but it can be. It is certainly the end of exclusive breastfeeding (even if it is only ever one), and that may be important to some people either because they are concerned about allergies, or because they really felt it was crucial their baby only had breastmilk. Or both reasons.

It can, but doesn't have to, lead to an early cessation of breastfeeding...yes, just that one bottle. I have spoken to a mother this week for whom that happened....one bottle, which led to a lack of confidence, which became one bottle a day, then a top up every so often in addition, and then more bottles, until her supply of breastmilk really is on its way out.

Babies do need to be fed, and of course there is a place for formula..but its place should not be taking up the room where bf mothers should expect decent info and decent support.

I was advised (by pro-BF HP's) to introduce a small bottle of formula with two of my babies, when they were a month old and still nowhere near their birthweight. I never had all that much milk and have since learnt that a thyroid condition I have could have been at the root of it. However, the one bottle never became more than that and they dropped it when they began solids.

I'm not trying to say anything, one way or another, just relating my experience!

Oh, forgot to add, I went on to BF one DD for 14mths and the other for almost 2yrs.

I just add my experience too - DS was very difficult to B/F at first - in fact we were not allowed out of hospital as he lost so much weight - anyway, after 3-4 weeks of really struggling I did give him one bottle of formula most days (sometimes two if necessary) and, quite honestly, just doing that enabled me to carry on b/feeding for 8 months. I know everyone is different but I am so sick of the 'politically correctness of b/feeding' - I personally hated having to faff around with sterilising (and yes, it would have been worse to do 8 bottles a day instead of the odd 1) and, call me an uncaring mum, but I needed time to get out & do my own thing & if leaving a bottle was the only way - so be it. Expressing was a nightmare for me.

I think mixed feeding can work really well - it did for me, and DS went very happily straight on to cups, no more bottles!

I think the point is that for some people, giving a bottle can help them, and even enhance the whole feeding thing...but mothers need to be aware that the end result may not be what they want.

I don't understand why saying this implies that mothers who give a bottle are 'uncaring' - huh? Or that saying exclusive breastfeeding is something some mothers want to do is somehow being 'politically correct' - huh again?

There's nothing especially virtuous either way! Do what suits you, and as long you know what's what, and that either approach may have drawbacks for you and/or your baby, and that you need to know what they are, what's the problem?

Just a wee comment re weight gain. I believe that we often get too hung up on weight gain and growth charts.

My ds went through a long period of not gaining weight - dropping from the 91st centile to, for a few weeks, just underneath the growth chart. He never actually lost wieght - he just gained weight EXTREMELY slowly. If it hadn't been for the support I got from the bf support group at the hospital and from dh and my parents, it would have been easy just to "top up" with formula. Instead, I "topped up" with plenty of EBM - and I was able to produce a good supply. Ds still didn't gain weight, although he was obviously thriving, happy and alert. Having been checked by the consultant paediatrician, we decided that he was just following his own growth curve and that he would be skinny like his parents (or at least, like we were as kids!). The consultant even told me stop with the "faff" of expressing and just to continue with the full bf (although by that time I had got used to it - and it was useful to continue so that I had a good "stock" for wehn I went back to work, and ds was used to the odd bottle)

If I had been less confident/determined to breast feed and/or had not had the support that I had, it would have been easy to be go down the formula route unneccessarily.

I went on to bf for over a year (introducing solids at 4 1/2 months), expressing during the day from 4 months, when I went back to work full time.

Yeah... weight charts are really a problem IMO... First they were designed in the 50 or 60s (Tiktok might be more precise), second they are for bottle-fed babies... and they are averages !
I know that at the Association of BF Mothers we are looking at more appropriate charts in a way to re-assure mothers.
DS was never a problem (though he did drop at 8 weeks or so for 3 weeks) but DD is 2 centile... but she looks absolutely fine, she is smiling all the time,... She feeds 1 side at a time and for maximum 7 minutes. If it had been my first child I would have been worried because of these charts because she feeds so little, etc

At 11 mo - still bf 3 times a day and eating (now) massive amounts of solids, she is getting fatter but has not been weighed for 4 months...

So let's keep things into perspective !

Suedonim, your story mirrors mine, as in I gave bottles of formula while still b/f for many months afterwards. Unlike you, one started I never stopped the bottles. I only started giving formula when my son was a few months old, so my milk supply was well established. He had bottles of expressed breast milk when tiny.

How I looked at it, and still do, was that those bottles of formula ENABLED me to carry on breast feeding for longer.

I simply couldn't express huge quantities of milk. How I tried! I could do 2 oz but not more. That was OK for a younger baby, but not OK for a baby of 5 months. Yet I had to get my baby to take bottles so I could do the odd bit of freelance work. By organising mixed feeding I was also organising life around bottles AND breast/feeding.

If I had said no to mixed feeding, my baby would have gone onto formula only from the age of 4 months. As it was, he had breastmilk until he was approx 10/11 months.

I am glad there is now more info around on mixed feeding. 7 years ago, I got all my info from a kind friend.

I agree with you, Tigermoth, that for me, giving one bottle a day enabled me to BF for as long as we wanted. The choice for me was between one FF a day or total FFing, not between one FF and total BF. Not doing something wasn't an option, unless I could have had a wet nurse! I never managed to express anything more than a teaspoon, during BF four babies.

It wasn't that my child was going down the centile charts, it was that she was losing actual weight. Although I wasn't aware as such of the 'slippery slope' aspect of a FF a day, I knew enough about BFing to realise that if I introduced any more, my supply would decrease. She used to have the formula in the late evening, when she had been feeding on and off for about 4 hours, still wasn't satisfied and wouldn't settle at all, despite co-sleeping.

It isn't something I'd recommend to anyone else, and it was something I would have preferred not to do but I think my medical conditon definitely had a bearing on the situation.

Pupuce - thank you for the belated breastfeeding support ! No offence taken by your comments, I found them interesting.
I agree that too much store can be set by constant weighing of small babies, but the slow weight gain was accompanied by my ds being obviously very hungry after every feed for the first 2 weeks. After a very easy pregnancy and labour I thought bfing would be a doddle, and was shocked that it was so difficult. One regret is that I bowed to subtle pressure from my mum (with whom I have a very difficult relationship anyway) who lives locally and pointed out that if I gave bottles she would be able to look after him to give me a break, which was very tempting. I did get the constant What time did you feed him? and I would always lie as I was embarassed about him crying with hunger an hour after a 20 minute bf! Ridiculous I know, I should have told her I was determined to bf and ignore her implication that I was starving him. Ironic too, as she was a midwife in the 60s and breastfed me and my brothers.
But I wasn't the type to sit on the sofa for 4 months doing nothing but feeding, as all my breastfeeding friends seemed to have done. That would have got me down I think, so I probably did what was right for me but things may have been different without by that pressure from my mum.

Just a point of interest re: the weight gain charts.

We now live in Switzerland and when we had our dd now 10 months (bfed until 6 months, now mixed fed)I dug out ds'UK red book (1998), copied the Girl weight page and plotted, what appeared to be her gradual descent towards the grey zone. However when we visited the paediatrician he used a different chart and, apart from one blip at 8 weeks,he has seemed largely unconcerned by the fluctuations.

It seems that there are alteratives in operation and the two over here of which I have copies are each sponsored by Nestle and Milupa -hardly independent in these matters!

At the end of the day so long as a baby is feeding well and thriving (healthy, alert,developing, gaining weight and sleeping well) should these charts be allowed to dictate matters so much ?

Fion - just saw your message - well if you have a second child - you can try again - no 2 experiences are the same
As for my own DD.... she finally went to get weighed and is an impressive 2 centile.... which means that 49 weeks (so 1 yo in 3 weeks) she weighs 16.9lbs !!!!
I am NOT worried she is as happy as can be, she eats well, smiles, sleeps, crawls,...