Combination feeding tips please- breast and formula!

[Hjudge56]

Hi ladies,

I am due end of July with my first baby (a little girl!) and had initially decided to formula feed due to a few personal reasons.

I have now decided to give breastfeeding a go with formula feeding so baby will be both breast and bottle fed from the get go (if all is well!)

I have done plenty of research into formula feeding but nothing into breastfeeding! I’d love to hear any tips and advice on breastfeeding please. Also if there’s any gadgets, products, etc., that you would recommend to help breastfeeding I’d love to hear! Thanks! :)

With breastfeeding, you need to have your facts and your attitude towards it set in stone ahead of time. I suggest you start with La Leche League and KellyMom websites for an over view. Join Facebook groups and get the number of a lactation consultant in advance: maybe even reach out to her before you have the baby.

The haakaa breast pump is cheap and great for building up a little stash of breastmilk. Nipple shields. Some people swear by lashinoh nipple cream but it didn't do much for me. Lots of skin to skin and get baby latched on as soon as you are able to.

I combined fed my first child and had a set time that I would breastfeed, eg, morning until 6pm then switch to formula. It gradually faded out until he was fully formula fed at 3 months and was right for us at the time. My two subsequent children were exclusively breast fed for at least a year and that was harder to establish but easier in the long run.

Combi feeding is a great way to combine the best of both worlds, but be warned that uts not great for your breastmilk supply, depending on how you work it.

Hope it all goes well!

If you want to keep breastfeeding (as part of combifeeding in your case) long term then the most important time to breastfeed is the middle of the night. It’s to do with the interplay between hormones and your baby stimulating milk production by nursing. So perhaps have set times when you give of formula and then breastfeed the rest of the time. What works well for you might depend on the reasons you have decided to combi-feed. For instance, if you don’t want to breastfeed in public then planning formula for times you like be out the house may be the way to go. Or if you are worried about not getting enough sleep, lots of mums try getting dad/someone else to give a bottle of formula at about 10pm which means mum sleep from maybe 8til midnight. Although that routine might not work with a tiny newborn because they tend to want lots of feeds in the late evening in the first few weeks. The longer you breastfeed, the more stable your supply gets and the more you can mess with routine without any negative effects.

I fully breast fed mine then just gave them formula at lunch time from 3 months . In those days we went back to work alot earlier so I was getting them ready for when I went back to work. Which worked well because the breast feeling was fully established and I only dropped one feed . But if needed they would then have one bottle per day . The hardest thing is finding a teat for the bottle that they will use you have to try loads of different ones to get the right one - it needed to kind of curl upwards in their mouths !..Good luck !

If you give formula, you risk losing your breastmilk supply, especially in the first couple of months.
Breastfeeding works by baby stimulating your breast each time they feed, so if you give a bottle, the breasts gradually shut down production.
Why do you plan to give formula? It's better not to if you can beastfeed.
You can always express (pump) milk so that someone else can give a bottle, but try to wait until you've established breastfeeding first.

I know plenty of people who combination fed. My first would take a bottle from anyone else but me. It meant I could go to an exercise class while my mum had him and his dad could give bottles evenings and weekends. I had planned to do the same with second, but hecwas a bottle refuser. Read up on breastfeeding beforehand and try not to get too hung up on the theory. Neither of mine ever latched like the instructions said, but gained weight fine!

Thanks for the advice so far!

I’d like to just add I have purely started this thread to ask mama’s of their breastfeeding advice and experiences! Just a gentle reminder, I don’t wish to be questioned as to why I intend on combination feeding :) so no judgement please! Just kindness between mama’s giving their top tips.. thanks!

I loved combi feeding with my first and will do it with my next baby too.

Ignore the 'why would you give your baby formula?' comments. Eye itroll inducing.

I know plenty of people who also combi fed and had absolutely no issues. Personally I find these hard line breastfeeding stances are part of the reason so many people give up. The BF community is so unsupportive of anything other than 100% breast milk.

OP I would personally advise you to fully BF for about 2-3 weeks to establish your supply and let your boob regulate a bit. Then pick one time to introduce a bottle and only do that one bottle for a few weeks. Pick a time that will be convenient and beneficial, imo no point doing the middle of the day. Either do the early morning feed or something around 10/11pm and that way your partner can do it.

It is better to work on a schedule with the bottles and BF whenever around that. I also think it works best to have 2-3 bottles and the rest breastfeeding. Its better for your supply .

I agree with PP that exclusively breastfeeding for the first few weeks will really help if it’s something you hope to keep up for a while along side the formula.

It takes around a month to 6 weeks for your nipples to get used to breastfeeding and for your supply to even out a bit and your breast feel more comfortable. Baby also needs to learn how to latch and effectively feed from the breast, these are all skills that might take some practice. I think it would be really difficult to keep it up if you only breastfed part time in the first few weeks as your body wouldn’t have as much chance to get used to it or build up a supply.

It’s much easier to scale back breastfeeding and increase formula later on once breastfeeding is already established than it is to increase the feeding after a slower start.

@Sissynova and @PinkPlantCase very good points! I can completely understand the importance of establishing supply before introducing the formula. I want my partner to be involved from the get go so I would like to pump into bottles for him to help with feeds. Do you have any recommendations?

Agree with leaving it until around 3 weeks, as those first few weeks are full of cluster feeding. I believe between 3-6 weeks is the ideal time to introduce a bottle but it definitely can be done from the get go, just not as easy I believe.

Be prepared to try a few bottle brands to see what baby will take (ie don’t stock up on a huge set before baby is born!) if you’re expressing breast milk you’ll probably need a very small flow on the bottle teat as the milk is thin compared to formula.

But don’t stress about it, as they say fed is best and even if baby just gets those first few days of colostrum that’s great. There’s loads of support out there when baby is born too

We used a Hakka and just had it on the breast that baby wasn’t feeding on at the time. The morning wa seaways a good time for this, that would be enough to collect a few ml to get baby used to a bottle. Not really enough to replace a full feeds in the early days (though feeds then are short and frequent) but enough for DH to have in a bottle for baby to get used to.

I had a Lansinoh double electric pump when I went back to work but I think that would be difficult in those first few weeks when to blunt my nipples really hurt and it’s best if the supply early on is very much lead by the baby. Some women especially early on struggle to get much from a pump. It was also over £100 so was only worth the money because I used it so much.

The Hakka was about £15 and more of a gentle collection device than a pump and did the job well
for the first few months.

I used the hakka too but I found that although my baby was happy to breastfeed she wasn't satisfied with a bottle of breastmilk for very long which is ultimately why I used formula along side.
I think if you're only going to pump for 1 or 2 bottles a day or even less often if you're going to use formula too I don't think its worth spending big money on a pump.

I combination fed my baby for 4months but with a combination of expressed milk and formula so he was 100% bottle fed. I didn't want to risk a bottle refuser as I went back to work fairly early and it was essential that he took a bottle. Plus my DH could help out with the feeds.

For me that was a nice compromise between directly breastfeeding and formula feeding but because I didn't try to exclusively feed with expressed milk I didn't feel the pressure to pump or feed around the clock. I would pump once in the middle of the night whilst bottle feeding the baby then every 3-4hrs during the day.

A bit different but we had to give DS1 formula top ups at first so some experience of combi feeding in early days.

Tips I would say be very clear on formula volumes and start off low. A bottle teet hits an automatic swallow reflex on a baby so you might think they want 100ml as a 3 day old whereas in reality it's much much less (about 40 ml) and if you over stretch their tummy you will be on a up hill battle then trying to breast feed.

Get very very slow teets the best we found were mimbi bottle xs so there is less issues of baby having to work at the breast. All others we found way too fast so Tommy tippi, mam bottles etc. Google and learn pace feeding for a bottle in advance too regular breaks and watch their hands. If their hand is completely open it's a sign they are full and don't need anymore so simply stop. You will be throwing away formula we found the 200ml premade bottles of hipp handy as could keep in the fridge for 24 hours.

For breastfeeding I suggest finding your local support group or a local lactation consultant as they will be able to assist but basically baby will need to cluster feed to boost your supply so try not to replace too many feeds in the early weeks and not back to back.
It does take time and is a rollercoaster to begin with but it does get a lot easier after about week 6 I promise!
Lots of skin to skin time kangaroo tops are great for this and have multimam compresses and lansinoh on hand.
Read into harvesting of colostrum before birth it made a huge difference with my second can be done from 37 weeks. Also get a hakaa so you can relieve your boobs whilst feeding the other side then you can either use this for a feed later on or freeze. If you squeeze foe more suction will also help supply. Try to avoid engorgement even if you planned next feed to be bottle just feed to get comfy.
Do not use cabbage leaves!!! They contain an enzyme which dries up milk and do not use cold remedies as the decongestant also dries up milk. Paracetamol and ibuprofen is fine.
Know that you and baby both need to learn let the midwives help you with positioning on and ask them to check for tongue tie as this can effect feeding. It's a myth it doesn't effect if purely bottle fed it's just later but you can get this snipped at 5 days either privately or via your infant team.

This is all really great thanks ladies!

If pumping then get a double pump as it massively reduces the time and a pumping bra.
Different women get on with different pumps I found spectra S1 to be brilliant (you can usually get them hardly used in your area either on a bf Facebook page or similar). I never gor on eith the very expensive elvie pumps!

It's a fine balance with pumping of not creating a oversupply so 1-2 times a day should be sufficient.

Your boobs create more milk at different times of day......so morning is usually best. If bottle feeding overnight then you need at least 1 pump between midnight and 3amish if not feeding at this point.

Pumping is hard work to fit in with a newborn though so be kind to yourself about it! Exclusively pumping women have the determination of a herd of Ox its incredibly hard as the pump doesn't stimulate as well.
I found putting socks over the bottles helped as I relaxed but also remember not all women respond to a pump and it is not a sign of your milk levels whatsoever!
My friend would get about 5ml in a 20 min pump......her exclusively bf baby was 98th percentile for weight!

I combi fed bf/expressed with DC1 up to six months and then bf/formula from six months on. Agree Haaka for expressing, I would bf first morning feed in bed with haaka on other side, got a reasonable amount that way although only gave a bottle a couple of times a week

Second child, two under two... Not a chance I was going to faff about expressing!!

Both times waited until about four to six weeks for supply to establish before introducing a bottle. Both times kept them on "newborn" bottles for longer - smaller with slower flow test seemed to mimic bf better. Personally I think there's a "golden window" to introduce bottle - super early might affect supply, trying later might lead to bottle refusing.

My biggest tip would be get someone else to do bottle feeds, at least to start with. If baby is being held by you and can smell your milk, less chance they'll want the bottle.

Good luck - once your supply is established I found combi amazing - I went camping with a 9 month old, decided I couldn't be arsed with sterilisation so just fed fed fed for the few days leading up to the trip, supply increased, fully bf for the holiday. When we came home, just gradually tapered the bottles back in 😅

Congratulations on your pregnancy OP!

If combi feeding is what you want to do then that's absolutely fine, don't let other people tell you otherwise. At least you have an idea of what you want to do! A plan! It might not go to plan, you may end up fully breastfeeding or fully formula but, you seem confident in your choice and that's what matters most.

I breastfed my first DD for 6 months (she had the occasional formula top up) and I'm currently breastfeeding my 3 month old DD2 (I'm also giving her occasional formula top ups) when she was born I was producing so much I froze 95 ounces! Didn't happen with my first. I bought a cheap hand pump when my first was a couple of days of and did a mix of pumping and breastfeeding until I eventually just breastfed (doing the same now with DD2) that breastpump was the best investment I have ever made!! I would also highly recommend the haakaa milk catcher I think it's about £15 maybe? The midwife recommended it with my DD1 and it's great when you're either breastfeeding or pumping because you can catch the leaking milk from the other boob! Oh and the Lansinoh nipple cream is brilliant imo!
From my experience, don't be too hard on yourself, try to relax and not stress about breastfeeding because I did a lot with my first. Just go with what is best for you and baby. Overall breastfeeding is a wonderful experience. Enjoy every moment of your journey with your baby. I wish you all the best of luck with it OP 😊

Also it's great you want DP involved but there are so many ways they can help in those first days - burping, nappies, dressing, baths, pram walks. They don't need to give baby a bottle to bond, and you will have just pushed a human out of you or had a human exit you via major surgery. Do whatever feeding is best for you and baby, don't stress about expressing just so "it's fair" or DP gets a go - just if you want to x

Pumping can be great. It can buy you some extra time out without your baby, it can help you go back to work while still breastfeeding, and it can help increase your supply. The one time I really would not encourage a friend to pump would be as a way of getting their partner (or any other family member) involved with feeding, especially very very early on. The reason is that pumping sucks. It’s far less satisfying for mum than feeding directly from the breast (no cute cuddles! The hormone release I found less good), and it takes longer and involves the extra work of washing and sterilizing the bottles and the pump parts. And if you are in the house when your baby is crying for milk, then your let down reflex is going to start up and your body will be screaming at you to breastfeed. Let down is when all the milk in your breasts just gets ready to come out. It happens fast, like within seconds. If your breasts are out then they might start leaking milk (which can be quite dramatic, especially in the beginning) and most significantly, your boobs will suddenly feel rock hard and if you don’t feed or pump immediately then they will feel sore - like the day before your period or in the 1st trimester of pregnancy but more intense. I really resented it when my husband sometimes took it upon himself to feed our baby expressed milk at 1am because he thought he shouldn’t wake me up. I was always already awake from the crying, plus I would have to pump instead of feeding. You can feed a baby lying down in bed half asleep. You can’t pump lying down and then you have to go wash everything in the middle of night before you can go back to sleep. So my advice is, only give expressed milk or formula at times when you will get some benefit. Don’t do it at times where the benefit is entirely for your partner. It will piss you off when you have rock hard boobs that need sorting at 1am and your baby is asleep and full of formula/expressed milk.

Learn a bottle giving technique called "paced bottle feeding" (that is giving baby a bottle while keeping baby upright and the bottle horizontal and doing regular breaks), so that your baby doesn't get used to a high flow of milk and there is less risk of him/her rejecting the breast (which is a slower flow). It's also better for them physiologically as they are more in control of the amount of milk they drink.
Also, the best advice I could give regarding breastfeeding in general is to research/read/watch educational videos as much as possible beforehand. The more educated you are about breastfeeding, the easier it will be to establish. I can recommend the Kello mom website and this free short course : https://www.coursera.org/learn/breastfeeding .

Don't listen to anyone changes why you aren't planning to exclusively breastfeed. It reminds me of the time a lady put a post on a forum asking advice about her elective c section and people started asking why she wasn't having a v bac. It's so inappropriate!

I combo fed by accident with my ds. I intended to breastfeed but when ds was born the hospital were concerned about his birth weight and didn't want him to drop too much after birth. I was therefore advised to breastfeed him and top up each feed with a small amount of formula which worked really well for us. When his weight was no longer a worry I then dropped the formula for a while to try and really establish my supply but have started introducing formula back gradually and he now has a lunch feed and nighttime feed of formula. This also means dh can share with some of the feeding. The tricky part is to make sure you establish your breast milk supply otherwise it won't work.

My advice would be to try to go with the flow if you can and not get too hung up on your ‘plan’ for feeding your baby. It may not work out. Some women cannot physiologically BF for example due to pain (I couldn’t with DS1), for some women pumps produce next to nothing, for some babies formula is the absolute business and the boob isn’t or vice versa… it varies massively, even between siblings.

My advice would be to be kind to yourself and try not to let it become a point of stress for you at an already stressful time when your hormones are going crazy. I remember sobbing hysterically in a lactation consultant’s office after 2-3 weeks of really trying and ‘failing’ to BF - if wasn’t here fault but I had built up BF to be this thing I just do and I just really really struggled. I’m still pro BF and will try again with DS2 (due in July) but I’ll also try to take a more proportionate and relaxed approach.

Good advice above on the hakkaa - brilliant piece of kit.