Advice on combi feeding for first time mum?

[Lalarosex]

As a FTM I find the information on breastfeeding, pumping, bottle feeding so overwhelming it seems like you need so much equipment.

I hope to initially breastfeed my baby but express so my partner can give him bottles too. Potentially looking to combo feed with formula but again, it’s hard to plan

can anyone give me any useful tips on this? And what equipment I will actually need

thank you mamas!

We found a combination approach worked well for us as it gave us options. Majority of the time was breastfeeding, with an expressed feed when I needed to go out during the day or if I was too tired at night, and a formula feed (Neocate due to a cows milk protein allergy) overnight.

It can be a hassle to get established - I spent a couple of weeks in a horrendous cycle of feed-pump-clean on repeat every 2 hours. But it was definitely worth the investment for us

My top tips:
Have a supportive partner - they should be as invested in feeding as you and willing to bring food, clean equipment, etc.
Get a comfortable chair to sit in - ideally a fairly upright one (reduces the risk of falling asleep) - and put it somewhere with good wifi signal, the remote for your TV and a table for snacks.
Get several cups with lids on for your drinks, so you don't accidentally spill them on yourself and baby while trying to hydrate mid-feed.
Hire or borrow a medical-grade pump for a few weeks at the start, as it makes a big difference to establishing supply (some hospitals can lend these out, or try your local NCT or breastfeeding support services).
Once supply is established, try a few different pumps to see which one you like best. My absolute favourite is the Elvie range, which are hands-free - you can just pop it in your bra and get on with your day.
Nuby RapidCool is hands down the best formula feeding system my DH and I tried. It's simple, portable and easy to clean.

You need:
a breast pump. Electric is best. It is time consuming and thirsty work.
bottles
for the formula we used a tommee tippee prep machine
steriliser to clean bottles

that’s it. I agree the info is absolutely overwhelming and made far more complicated and daunting for first time mums.
I breastfed for 2 weeks before it was too much for me mentally, so we then went onto formula. X

Pumping is tedious and a pain in the arse. Along with trying to train a bf baby to take a bottle and tje whole washing bottles etc it isn't worth the hassle.

That's my opinion anyway. I'd not worry about it at all in the beginning. Get bf sorted which makes everything easier if it works then think about pumping after a few months.

I did it with DC1 for the sake of going out for one day long hen do. Couldn't be arsed with the hassle at all with DC2 and gave away my pump when she was about a week old

Don't feel forced to exclusively breast feed. I did with my first, my (ex) DH stopped me giving her a formula bottle, saying I'll regret it. I was sore, both nipples were split and feeding was agony but I stupidly listened to him and carried on breast feeding. Lasted 6 months before I dried up. I found it exhausting and draining as I literally didn't get a break, felt i couldn't leave her go out by my self etc as she'd need feeding and I was her only source of food. I didn't make the same mistake again with my second, and combi fed from day one. It was so much easier and it meant others could help out more (until COVID hit)

If you do breast feeding, you can get nipple guards which helped when I was super sore, nipple cream to help prevent the splitting and heal if they do, also breast pads as you'll leak. Breast pump if you want to express for others to feed, bottles for the milk, and then if you plan to take formula into hospital it has to be premade, can get this from supermarkets, it's little bottles with sealed teats.
Good luck and just follow your gut instinct, don't feel pressured into anything. Fed is best.

It is a pain in the arse. I was adamant I was going to with my second but was too knackered looking after a toddler as well. Wasn't to bad with first. Much easier to just breastfeed.

For me, pumping was a nightmare and stressful. If combi feeding I would rather mostly breastfeed with the occasional bottle of formula but this never worked for me unfortunately. DS1 ended up having a bottle preference and went on a complete breastfeeding strike so our journey ended much sooner than I felt ready for. With DS2, I didn’t want the same thing to happen so I didn’t give him bottles regularly enough and in the end he refused them entirely, so we were stuck breastfeeding for what felt like an eternity.

I have had friends who have exclusively breastfed and just given the occasional bottle of expressed milk by a husband/partner whenever they were out for the evening and it worked well for them. Unfortunately it didn’t work for me but everyone’s journey is different.

Don’t feel any pressure to exclusively breastfeed, but after a while it’s so bloody easy. And cheap. Formula is extortionate these days. All you need is a boob (and some nipple cream, breast pads and muslins for the first couple of months). If combi feeding you’ll need a breast pump (for me the manual tommee tippee one was the one that got me the most milk, about £20), bottles and teats, and a steriliser. The Tommee Tippee perfect prep machine is a godsend for formula fed babies too. I found pre-made formula easiest for when out and about.

I know it all sounds overwhelming but you’ll find your way, I promise. If you want to breastfeed (long term or not) I would always advise to build up your milk supply for the first 3 weeks by solely breastfeeding (no formula) but if you want to introduce bottles then get your partner to give them a small bottle of expressed milk every couple of days from about 3 weeks onwards. Then after about 6 weeks if you feel like you want to introduce formula then go for it. I think they say that it takes 6 weeks to get your milk supply well established so I would avoid formula until then if you wanted to continue to breastfeed so it doesn’t affect your supply. That’s just my advice and experience! Xx

They advise you not to but I got both DC to take from a bottle as well as the breast around ten days. No issues at all.
It paid off as time went on if I simply needed a break from bf or wasn't around. Massively beneficial both practically and psychologically and no great faff.

Concentrate on breastfeeding first. Your body responds to your baby, so your supply will build up nicely with responsive breastfeeding. Introducing a pump and bottles before 6 weeks may interfere with that and will certainly be a faff. To maintain your supply in the early weeks, you’d have to pump at the same time husband is giving the bottle anyway, so it’s not worth it imo.
You may find you have breastfeeding difficulties (latch issues, baby not regaining birthweight etc.) and need to pump to keep your supply up. But don’t plan for it. Trust your body and yourself. Snuggle up, feed on demand, get your husband and family sitting everything else out and try not to worry.
Then once breastfeeding is established, you could start to pump a little after some feeds and husband can give a bottle.
Le Leche have a good website and fab volunteers who you can speak to. Check out your local infant feeding team too and be as informed as you can. Eg. so many mums think they’re not producing enough milk bcos baby is cluster feeding/being fussy at the breast. But this is totally normal to build up your supply.
You’ll do great mama! However you decide to/end up feeding, baby will adore you.

Bambino ( the breast feeding support) will tell you not to pump for the first six weeks because you’ll begin to over supply. Honestly you need to figure out yourself what works for you. My sister recently had her first baby and her head was cabbaged with the amount of different Information she was given by bambino, the midwife’s and the health visitor ultimately she ended up switching to formula so that her partner could help with night feeds and so that we could give her time away from the baby.

I had a manual pump to begin with as the electric ones can be pricey and I wanted to see if expressing and giving bottles worked for me. Breastfeeding is probably the most difficult but most rewarding thing I've ever done it might be the most natural thing in the world but it's also a skill that has to be learned so go easy on yourself. I know people say to wait to give bottles if you want to breastfeed but I also know so many people who breastfed and then babies refused a bottle so I introduced small bottle feeds round week 3 just 2-3 ounces of breast milk and then tried to make sure baby got a bottle at least once every 3-4 days to keep them from refusing. You'll know what's best for both you and your baby when the time comes follow your gut and go with what your comfortable with what works for one person/baby might not be the best way for you

We've been giving one bottle of expressed or formula milk a day. With DC1 I has a manual pump but found it difficult to fit pumping into the day. With DC2 I have an electric hands free one (this Pippeta one) and it has made it much more convenient. But it depends what works for you! I've been lucky in that both babies have slept well, when I wake up in the morning my boobs are FULL as it's been a long gap - I feed baby on one side while I pump on the other and I often get a full feed into a bottle. If I get extra out it can be frozen and used on a day that I don't get as much.

I’m 10 weeks into combo feeding, it has been quite the learning curve. My key learnings that I will share:

My baby was a hungry baby, she was starving after being born, she spent hours on the boob, so eventually I have her a ready made bottle (Kendamil to be exact) and she was awake and perky so I could finally see her face and also DH could hold her.

I then started with boob and finished with bottle because she never ever seemed satisfied

My nipples hurt for 2 weeks, it was excruciating, I couldn’t bare it. I started to not give boob for every feed so I could give my nipples time to heal. Instead I give formula.

Maam compresses and lanisoh are a godsend those early days.

I personally didn’t have a supply issue or an establishment issue doing it this way. I had so so much milk (big boobs) so not feeding at every feed did not in any way impact supply (again this is my experience not everyone is the same).

I didn’t pump this time as I did with my first baby and I had constant lumps and engorgement which hurt insanely. I personally would rather give formula than ever endure a pump again. But given its your first time, try it. I used a hospital grade pump and in hindsight, it was too powerful, which lead to problems. So maybe try a regular one from a store?

My little one came home as a good night time sleeper, with feeding at 3am then 7. On the evenings and nights I fed with boob, she didn’t sleep well, she was awake and hungry. Even if I gave a full feed from both sides for up to an hour. This is likely an unpopular opinion, but having tried multiple approaches, I can safely say that breast milk does not fill my baby as much as formula. So at night, I give formula, as it’s working well and I’m getting much more sleep. Happy mum - happy baby.

DH has bonded wonderfully with my baby as he can help wjth feeds but is equally very supportive of breastfeeding and does everything he can to help.

My little one falls asleep at boob constantly which makes feeding take so much longer. So I try to mix up both formula and boob at the feeds I give boob

My boobs responded well to my feeding and milk production once I was consistent every day. No lumps, no engorgement and no mastitis, unlike when I was pumping.

Some of my new found wisdom.
Fed is best.

Formula is ok to give and I have zero regrets introducing that bottle in this early hours and keeping it up.

my supply was not impacted by not giving boob at every feed to allow my nipples time to heal, despite what I was told by midwives and lactation consultant. feeding was established by 2 weeks and milk production responded accordingly (it produced what I used and the times I use it)
Breast milk is not as filling as formula (which meant more feeding, less sleeping and a cranky hungry baby and an overwhelmed me) So I do both at each feed it just formula.

My baby gained weight appropriately and I never had any concerns about jaundice, it went down quickly. Unless DD1 who was readmitted in day 5 and my doctor asked me to give formula to wash it out.

My mental health matters and if I was struggling I wasn’t helping myself , my baby or my family. I didn’t martyr myself like I did the first time with feeding and pumping.

Washing and sterilising bottles is not as big a faff as let on, and I would rather do that than be buried night and day under a baby who is never satisfied. I do have another DD to think about so it’s not really feasible.

I am happy now 10 weeks in, but I was from early days with my approach. It works for us.
I think combi feeling is a brilliant idea. Best of both worlds.

Combi feeding is fantastic and I don't know why it's not recommended as standard!

In my experience:

Expressing was a huge faff, uncomfortable, unproductive, and not necessary. We used ready made bottles of HIPP organic formula instead.

Introducing one bottle a day from a few weeks old does not interrupt or harm the establishment of breast feeding.

Equipment you need:
A few bottles (MAM were easily accepted by my otherwise breastfed DC).
A steriliser - I found microwave to be easy.
A bottle brush to really get in the nooks and crannies of the bottle.
A few bottles of ready made formula.

That's it! No need to over complicate it.

Just go with the boobs to start. The best investment if you have spare cash is a £10 haaka and transport to your local breastfeeding support group.

Agree with this.

We introduced a bottle of formula for the midnight feed at 12 days old, just so that I could a couple of hours of unbroken sleep and it was a lifesaver for my sanity. I still bf 11 times a day, but having the option of DH being able to do a feed as well was wonderful.

Good luck with whatever you decide!

Just a note on the Tommee tippy perfect prep machine - I've seen they're not great as they don't heat up the water to the correct temp so bacteria growth can be an issue (they haven't been regulated basically).

I was going to combi feed in the beginning and ended up EBF because it was way easier (luckily for me) but would recommend having some formula handy anyway for the first few days while you're getting the hang of things and your milk is coming in...

I'd also recommend speaking to an IBCLC, who can help with any anxiety around combi feeding and answer any questions you might have on bottles / machines etc

I agree with some others about focusing on getting breastfeeding going first. I then started pumping first time round about 2 weeks in because I was going to a wedding (with baby in hotel nearby) and wanted to be able to give a bottle if I couldn't dash back. Worked fine.

Second time round I didn't really bother pumping.

Combi feeding from the start almost always results in full time formula feeding due to the differences in feeding styles on a breast vs an artificial nipple, and the disruption it brings to breastmilk supply. Also, combo feeding may feel like it'll make your life easier by allowing others to do some feeds, but the reality is you're complicating your life by adding in bottles to be sterilised and pumping/making up formula.

If you do want to breastfeed, get that established first. After a few weeks you can start pumping or giving the occasional bottle of formula if you like, but for the sake of keeping your life as simple as possible, don't rush to bottles until baby is latching well and your milk supply is established.

If you're considering combi feeding so that your partner/family can bond etc, please know that feeding is only one way this can happen. Babies need lots of care, skin to skin, contact naps, baths, nappy changes, playtime, massages, all lovely ways for others to help and bond that don't mean you have to spend time pumping and sterilising.

I'd say your essential equipment is a couple of good nursing bras, a haaka type pump (good for catching leaks even if you're not pumping regularly) a nice soft carrier/sling (not a structured baby bjorn style, a wrap, ring sling or Ergo type) and some nice cushions (I'd go for old style v-shaped ones as opposed to the c-shaped boppy type) so you can get comfy, and the contact details of your local breastfeeding support group.

I had a similar plan (mostly breastfeed with my husband doing some feeds of expressed milk). However, when it came to it, expressing didn't work for me. Both times my babies wanted to feed almost constantly and there was too little time between feeds to express. If I did try to express it was too close to the previous feed for much milk to come out. The only times successfully managed to express enough milk was when they were older and started to sometimes sleep through the night. Then my body would have made enough milk to feed the baby one breast and express the other.
What ended up working for me was that I exclusively breastfed for 3-4 months then switched to a system of all breast fed except for one feed. I would do all the daytime feeds plus bedtime. Then I would go to sleep soon after my baby's bedtime. My husband would stay awake watching TV until the next feed (which was usually sometime between 10.30 and midnight). He'd give a bottle of formula at that time (or expressed milk of there was any) then come to bed himself. I'd then do the other night feeds.
It was a great system! I highly recommend it, as it gave me a few hours unbroken sleep. Before we started doing that I hadn't been able to get more than 1-2 hours sleep at a time which is so tough!
Best of luck.

As others have said PLEASE don't buy a Perfect Prep. They aren't safe.

https://www.firststepsnutrition.org/making-infant-milk-safely

Personally i would recommend getting breastfeeding established first then decide if you want to pump or just give a bit of formula when you aren't about. Buying all the equipment in advance is not necessary. I found pumping was a faff as was washing bottles so I simply breastfed mine using the small readymade formula and bottle if absolutely necessary, I just put the bottle in the dishwasher then sterilised in boiling water as not frequent.

Obviously if formula is being used frequently or you decide to pump you can buy the equipment then

Get signed up to online support groups ahead of the birth and find out in person support in your area, both professional (paid) and volunteers etc. I've sat with new mums helping with positioning and giving reassurance, often this is what you really need. My second dc had no bottles at all because it was so much easier to breastfeed with a toddler around than make up bottles

I personally disagree strongly with the 'get bf established first' advice.

I'd first of all choose which you'd prefer to do if you had to pick only one. If it's breast, then yes, put lots of effort into that at the beginning, if it's bottles, then introduce it as soon as possible!

And even then, frankly it's your baby's choice, not yours, which you'll end up doing.

I wanted to do 50-50 mix feeding. I did it from birth (first bottle within a couple of hours of birth, strictly alternating). I didn't want to risk waiting and baby rejecting the bottle.

I didn't wait to introduce a bottle

I tried to jepardise breastfeeding (I really really didn't want to EBF, so when it was headed that way, I tried to scupper my supply) by giving more bottles and trying to dry up my supply

Guess what, baby rejected the bottle anyway and I ended up breastfeeding for over 2 years 😂

I know many more people that waited, and their babies rejected a bottle, than that that rejected the boob. There's no guarantees either way, but the longer you wait to introduce a bottle, the greater a risk that you won't be able to.

Combi feeding from the start almost always results in full time formula feeding due to the differences in feeding styles on a breast vs an artificial nipple, and the disruption it brings to breastmilk supply. Also, combo feeding may feel like it'll make your life easier by allowing others to do some feeds, but the reality is you're complicating your life by adding in bottles to be sterilised and pumping/making up formula.

1. Not in my experience, and most women that I know who tried to introduce one after a few weeks, baby said a clear no!
2. why would mum be making up bottles, sterilising, washing up etc? Wouldn't it usually be the dad that would deal with bottle admin? And it means mum can have freedom to go out places, get more than an hour's sleep at a time. Certainly bottle feeding (my first) was a lot better for my happiness and mental health, and a lot more 'balanced' between parents than EBF.