Can we talk combination feeding?

[michaeljacknnugg]

I've been meaning to ask you ladies about this for a while, and imagined telling you all the reasons why I want to combination feed. And then I caught myself -  no mother should feel the need to justify they way she feeds her baby! So I am just going to say that I really want to combination feed this time, as it will make a great difference to my whole family.

But I have a few questions:
When to start?
How many feeds a day works best? Ideally I'd like to bottle feed two-three times a day and breastfeed the rest of the time. I can be pretty consistent with which feed is which,
If I want to change things up occasionally, eg use the bottle for a later daytime feed instead of an earlier one, what impact would that have?
How much can I expect to put in a bottle?

I only ever expressed before - and don't intend to this time - so never really got my head around all this!

[kayra]

I did a combination this time round, but I bf'ed at first and then we topped up with the bottle at each feed. I think that if you want to be at all I'd have thought you'd need to be more frequently initially and then you can go some feeds without nursing once your supply is a bit better-but I may be wrong.  After about 2 weeks I think I stopped bf at night b/c it was just taking too long but during the day I'd always be first. It would take really long tho-esp with 2! I think I was afraid to go a feed w/o bf'ing since I didn't feel that I had that much milk anyway I didn't want to endanger my supply iyswim? Being able to have someone else help-esp at night- is wonderful though

[michaeljacknnugg]

I think we might be opposites there! I had huge amounts of milk last time, to the point where one night (early on) I expressed a whole bottle before I could get comfortable enough to sleep. But yes, you're right about letting things settle a bit before using the bottle. I'm thinking six weeks or so, if we get a good start?

[Emami]

I'm going to go against conventional wisdom here as I know the general advice is to avoid bottles until breastfeeding is established. Obviously I am not any kind of authority on this but I gave both my girls bottles from day 1 and it did not have any negative impact on them being able to breastfeed. It seems to me that mums I know IRL who waited to give a bottle often had a difficult time getting their baby to accept it or they never did at all.

You helped me when I wanted to cut down breastfeeding Annabel and start combination feeding, so thanks for that and I hope I can help you too. Here's what we did -

My milk took 5 days to come in despite skin to skin and lots of bfs, so I hand expressed colostrum and syringe fed her as well as bfing on demand, pumping for a bottle (at first I could barely get an ounce but still gave this to her).  When I could pump enough for a whole bottle she had that for one feed a day. At some point (can't remember when) I stopped pumping and she had formula once a day. I didn't always do the bottle for the same feed as I didn't want to lose supply at a particular time of day. I gave her the bottle whenever it was most convenient in the day depending what we had going on. Then increased the number of formula feeds until I was just doing a BT breastfeed. Hth x

[michaeljacknnugg]

Thanks Emma! Bottle avoidance is something that does worry me,  as that's what happened with DS. I'd kind of come to the conclusion that it was because I couldn't manage to express and then bottle feed him every day (he took it at first but then refused), but maybe I am wrong?

[kayra]

We used the bottle early on too, and never had issues with them refusing either. Sorry what I meant with the supply being established was in bf'ing frequently enough to keep supply going, so kind of like what you were saying Emma about not always doing the bottle at a certain time to decrease the supply for that time. But if you don't have supply issues maybe that won't be an issue for you. How old was ds when you introduced the bottle, maybe it was late? Or maybe b/c your supply was good and you had a door flow ghe bottle seemed to slow???

[michaeljacknnugg]

We introduced it fairly early, maybe at three weeks or so? It was after that that we got the refusals, when he was more awake and aware I guess.

I want to regularly bottle feed at certain times (when I'm most likely to be out and about, mostly), so I'd prefer not to be engorged and uncomfortable at those times!

[MasynSpencerElliotte]

Helen your supply sounds a lot like mine was - very abundant (lol my milk has just finally dried up 11 months after stopping bf this time!). I combination fed all three kids - with Masyn I waited until 6 weeks but in hindsight did not really need to, Spencer started at 2 or 3 weeks maybe and Elliotte not until 5 months (with two much older kids I found I liked the excuse of bf to take frequent breaks and even though we tried ebm in a bottle from very young she was the only one of my kids to not take to a bottle well). 

I replaced specific feeds - with M & S it was the bedtime feed first so DH could do it. With E I did the opposite and changed the am feed as she was more hungry and likely to accept the bottle (once I finally found one she liked!). My body adjusted accordingly.

[*Ali*]

I'd definitely wait a couple of weeks before introducing formula as ff in the early days tends to stretch the stomach and make it difficult to get full from the tiny quantities of colostrum/milk which are all that is required. It can then delay the milk coming in if baby isn't feeding frequently enough.

Ideally in the early weeks you don't want to go too long between BFs so I would try to make sure you don't have more than one FF in a row to start with until your supply is established.

One bottle a day should be enough to keep him/ her taking a bottle if you start in the first 6wks. More than that and you run the risk of bottle preference so it might be good to start small and build up to more FFs if refusing the breast is something you want to avoid.

[michaeljacknnugg]

Yes, once a day will be plenty to start off with!

[lauradj]

No hijacking of your post but thank you for asking this question!!!