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  1. #1
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    Default Combined feeding help?

    Does anyone have any advice or info on how to combine formula and breast feeding? My DD is two weeks old and we are struggling with breastfeeding.She lost 10% of her birthweight in hosp and by day 7 had lost a further 150 grams.


    I'm pretty devastated about all this so please no judgement. I was quite young when I had my first DD and couldn't bf her due to a tongue tie. I had no idea about expressing etc and little support so put her on formula after a week. I've carried guilt about this for a long time and I'm struggling with similar feelings now but I need to do what's best for her and I think some breastmilk is better than none right?

    I don't think I have enough milk. For example, today I fed her from both sides for 70 minutes. And she was hungry 20 minutes later. She only has 3-4 wet nappies a day and only poos every second or third day. I should add I'm taking fenugreek and blessed thistle and drinking lots of water etc.
    On top of this she doesn't latch well and I can't seem to fix it- she just has a little mouth I guess. As a result my nipples are now both grazed and red and sore. And she won't take nipple shields.


    For the last couple of days I've given her two formula bottles which she drinks very happily. But I'm not sure how to go about combined feeding, I'm struggling to find info. How many bottles do I give her? How- after a bf? Instead of a bf?
    I'd really like to hear from anyone who has successfully combined feeding.

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    You poor thing
    Babies should all come with personalized manuals.

    I don't think there is any guaranteed way of successfully combining bf and ff, many woman have but I think there are a lot of women who haven't (ie, started thinking that they could but then the ff affected supply etc). There are issues like supply, nipple confusion, baby refusing to work for milk and just wants bottle etc.

    The things I would suggest for supply is lots of water, lactation boosting cookies and asking your GP for a script for some motilium but in a higher dose (I'll try and find some figures for you). Fenugreek and Blessed Thistle did nothing for me, nor did porridge.


    Secondly, newborns can feed A LOT. My DD fed around the clock for the first 3 months of her life, the average feed lasting 4 hours. I get really annoyed when I read that "a newborn baby may take up to an hour to feed". Man, I would have done anything for her to only take an hour to feed! I coped by mastering the lying down feeding position so I could feed in bed, I took DS and DD for a walk in the morning so that DS and I got some exercise and allowed DS to watch a whole lot of TV in those first few weeks. I also used a sling and walked around with her which spaced out the feeds sometimes and she actually slept!

    For grazed nipples express a little milk and leave to air. If you don't like doing that during the day then let them out when you manage to get some sleep. Also try some different positions like football hold, this can really help!

    She will get better at latching, her mouth will grow and she will learn.

    If you want to give some ff I would suggest after a bf if she still seems unsatisfied.

    I found it really hard to work out if DD had a wet nappy so I put some cotton wool inside the nappy to see if she had weed.

    It's really hard work and you're doing so well. Don't forget to congratulate yourself for every bf you give your baby.

    I know the pain of not being successful at bf. It didn't work out when I had DS so I ended up expressing what I could. He was bottle fed but he got ebm as well as ff, that was my compromise.

    Best of luck.

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    Quote Originally Posted by ~Bec~ View Post
    You poor thing
    Babies should all come with personalized manuals.

    I don't think there is any guaranteed way of successfully combining bf and ff, many woman have but I think there are a lot of women who haven't (ie, started thinking that they could but then the ff affected supply etc). There are issues like supply, nipple confusion, baby refusing to work for milk and just wants bottle etc.

    The things I would suggest for supply is lots of water, lactation boosting cookies and asking your GP for a script for some motilium but in a higher dose (I'll try and find some figures for you). Fenugreek and Blessed Thistle did nothing for me, nor did porridge.


    Secondly, newborns can feed A LOT. My DD fed around the clock for the first 3 months of her life, the average feed lasting 4 hours. I get really annoyed when I read that "a newborn baby may take up to an hour to feed". Man, I would have done anything for her to only take an hour to feed! I coped by mastering the lying down feeding position so I could feed in bed, I took DS and DD for a walk in the morning so that DS and I got some exercise and allowed DS to watch a whole lot of TV in those first few weeks. I also used a sling and walked around with her which spaced out the feeds sometimes and she actually slept!

    For grazed nipples express a little milk and leave to air. If you don't like doing that during the day then let them out when you manage to get some sleep. Also try some different positions like football hold, this can really help!

    She will get better at latching, her mouth will grow and she will learn.

    If you want to give some ff I would suggest after a bf if she still seems unsatisfied.

    I found it really hard to work out if DD had a wet nappy so I put some cotton wool inside the nappy to see if she had weed.

    It's really hard work and you're doing so well. Don't forget to congratulate yourself for every bf you give your baby.

    I know the pain of not being successful at bf. It didn't work out when I had DS so I ended up expressing what I could. He was bottle fed but he got ebm as well as ff, that was my compromise.

    Best of luck.
    Thank you so much for all your advice, I really appreciate it. And can I say- 4 hours on average?! What a trooper you are- I just don't think I could do that!
    Im really trying to stay positive and focus on the bfs that I can manage, my DH is ridiculously supportive but I just feel so bad that she has lost weight and seems to still be hungry, and I'm so disappointed that what I can offer isn't enough IYKWIM?

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    Hugs. I really feel for you. As with pp I spent a lot of time with ds stuck to my boob in the first couple of months of his life. Are you able to take it as an opportunity to rest? Is any one able to take bubs for a few hours to give you a break? I found if I could get 3 hours continuous sleep I produced much more milk.


    are you able to get a lactation consultant to the house to help with bubs latch? I know when ds1 was little I could only get help if I went to a clinic and those first few weeks it might as well have been on the moon!

    As for combination I was able to wait a while longer because my little fatty didn't lose weight but I'd consider last feed of the day since milk supply is usually low and since the formula supposedly sticks in the stomach longer you might get that stretch of sleep. Having said that if you haven't ff before I'd give the first during the day just to check, some formulas make some babies a bit windy!


    All the best. I gave ds1 1ff a day and I went on to bf till he was nearly 2. Be kind to yourself and do what is right for you and bubs.

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    Atropos  (30-09-2012)

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    i had to comp feed both of my babies due to a previous breast reduction. i had great lactation consultants, midwives and health nurses both times with advice/counselling etc.

    i was told to breastfeed - then express, then bottle with expressed or formula.
    both lactation consultants said that babies drink most of the breastmilk in the first 10 minutes. so feeding for 70 minutes is a long time.....no wonder you are suffering with sore nipples.

    motillium definately helps - i had this the 2nd time and it made a big difference. air drying and lansinol on the nipples helps, so does expressed breast milk.

    it is a big undertaking as newbies feed every 3-4 hrs
    breastfeed, express, top up with bottle.
    by the time you finish you literally feel like you are starting all over again.

    i did it for 3 months before both my son and daughter realised it was much easier to drink from the bottle and started refusing the breast.
    i was actually relieved to just go onto bottles only but i'm glad i got as much in them as i could. speak to your health nurse and do what feels right for you.
    most important thing is that you and baby are both happy

  7. The Following User Says Thank You to halloweendee For This Useful Post:

    Atropos  (30-09-2012)

  8. #6
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    I am combined feeding my 6 week old dd.

    She had a posterior tongue tie and I had low supply. She has had her tie snipped but still has a bad/shallow latch so is inefficient at feeding and gets tired at the breast cause she's working so hard for not much milk. I'm taking fenugreek and blessed thistle, also 6x domperidone (prescription) daily for my supply. I also have raw nipples from the latch but am kinda getting used to it :/

    I have to top her up 3-4 times a day, about 80-100ml each top up. I try and give only one top up with a bottle, I use a tube like an sns for the others as I don't want her to start favouring a bottle over my boobs.

    I give the top ups after feeding at the breast for as long as I can stand. Usually about 1-1.5 hours. It's horrible feeding for so long and then watching her gulp down 100ml formula (or donor bm if we have it) but I know she's getting something from me at least. The top ups are all during the day/evening as well she seems satisfied with the breast overnight.

    I agree with pp about seeing a lactation consultant about the latch, there may be an underlying issue which can be corrected.

    Good luck, this breastfeeding journey is an uphill battle for some of us!

  9. #7
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    Hi

    Sorry you are going through this. I had a hard time with breastfeeding too. My baby was jaundice and would constantly fall asleep at the boob. I would have to keep waking him and feeding would take over an hour until he was so asleep I couldnt wake him. I never really knew if he was full. He did have wet nappies every day, but they were never heavy and he wasnt gaining much weight. He was being weighed every day and having blood tests every day, he even lost weight once at 2 weeks old.

    He went to hospital at 6 days old for phototherapy. There, I breastfed for an hour and then they topped him up with 50ml each feed which he sculled down each time. SO you can do it that way.

    A couple of weeks later, feeding with my baby got even worse and he started to refuse the boob even more. He wouldnt latch on and scream his lungs out until we gave him a bottle. I would express in tears while my hubby gave him a bottle of formula. I saw my CAFs nurse and she gave me a referral to a mother a baby unit (there may be one near you), called Torrens House. I got in right away as my baby was 3 weeks old and it was a feeding issue.

    There I found out that my supply was really low and they got me started with a supply line right away. Its a bottle of formula (or expresses breast milk) that hangs around your neck, with thin tubes that come out and you tape on to your breasts to your nipples. When your baby latches on, they get your nipple as well as the tube. So your baby then gets the formula through the tubes as well as sucking your breast milk (which stimulates your supply). In the 2 weeks I used it, my baby put on 600g and I went from using 80ml in the supply line to 30 ml. I was also taking tablets to stimulate supply. Feeds also took only 30 minutes, and I expressed after that. At first I could only express 5-10ml after each feed, eventually I could express about 30ml after each feed which was enough for the 30ml supply line.

    Even though it was going really well, I was sick and tired of expressing after every feed and feeling like I never got to play with my baby. I also suffered PND and my medication hadnt kicked in yet. My baby was doing well weight wise, but he was still frustrated at latching on and staying on. For my own well being and for my baby's happieness I switched to full time formula.

    It was a hard decision to make to switch, but I am glad that I did. Please never carry any guilt about switching with your other baby or with this one (if thats what you end up doing). There is so much pressure to breastfeed, and if your happiness or your baby's happiness gets in the way, dont feel guilty for switching. There is a lot of nutrients in formula and its come a long way in the last few decades.

    Please PM me if you want to chat :-)

  10. #8
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    Quote Originally Posted by pommiemum11 View Post
    Hugs. I really feel for you. As with pp I spent a lot of time with ds stuck to my boob in the first couple of months of his life. Are you able to take it as an opportunity to rest? Is any one able to take bubs for a few hours to give you a break? I found if I could get 3 hours continuous sleep I produced much more milk.


    are you able to get a lactation consultant to the house to help with bubs latch? I know when ds1 was little I could only get help if I went to a clinic and those first few weeks it might as well have been on the moon!

    As for combination I was able to wait a while longer because my little fatty didn't lose weight but I'd consider last feed of the day since milk supply is usually low and since the formula supposedly sticks in the stomach longer you might get that stretch of sleep. Having said that if you haven't ff before I'd give the first during the day just to check, some formulas make some babies a bit windy!


    All the best. I gave ds1 1ff a day and I went on to bf till he was nearly 2. Be kind to yourself and do what is right for you and bubs.
    I'm in the same boat re a clinic unfortunately. We've been getting a 4 hr stretch of sleep since introducing the ff at the 11-12 at night feed, otherwise she is bfing every 1-2 hours which is exhausting. Thank you so much for the advice, I hope I can bf even half as long as you!

  11. #9
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    Quote Originally Posted by halloweendee View Post
    i had to comp feed both of my babies due to a previous breast reduction. i had great lactation consultants, midwives and health nurses both times with advice/counselling etc.

    i was told to breastfeed - then express, then bottle with expressed or formula.
    both lactation consultants said that babies drink most of the breastmilk in the first 10 minutes. so feeding for 70 minutes is a long time.....no wonder you are suffering with sore nipples.

    motillium definately helps - i had this the 2nd time and it made a big difference. air drying and lansinol on the nipples helps, so does expressed breast milk.

    it is a big undertaking as newbies feed every 3-4 hrs
    breastfeed, express, top up with bottle.
    by the time you finish you literally feel like you are starting all over again.

    i did it for 3 months before both my son and daughter realised it was much easier to drink from the bottle and started refusing the breast.
    i was actually relieved to just go onto bottles only but i'm glad i got as much in them as i could. speak to your health nurse and do what feels right for you.
    most important thing is that you and baby are both happy

    Thank you, it seems motilium is a good move, I will def be asking the gp for it. Are there any negative effects?

  12. #10
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    Quote Originally Posted by felicia81 View Post
    I am combined feeding my 6 week old dd.

    She had a posterior tongue tie and I had low supply. She has had her tie snipped but still has a bad/shallow latch so is inefficient at feeding and gets tired at the breast cause she's working so hard for not much milk. I'm taking fenugreek and blessed thistle, also 6x domperidone (prescription) daily for my supply. I also have raw nipples from the latch but am kinda getting used to it :/

    I have to top her up 3-4 times a day, about 80-100ml each top up. I try and give only one top up with a bottle, I use a tube like an sns for the others as I don't want her to start favouring a bottle over my boobs.

    I give the top ups after feeding at the breast for as long as I can stand. Usually about 1-1.5 hours. It's horrible feeding for so long and then watching her gulp down 100ml formula (or donor bm if we have it) but I know she's getting something from me at least. The top ups are all during the day/evening as well she seems satisfied with the breast overnight.

    I agree with pp about seeing a lactation consultant about the latch, there may be an underlying issue which can be corrected.

    Good luck, this breastfeeding journey is an uphill battle for some of us!
    It's bloody hard work isn't it? Thanks so much for the advice. Where do you get donor BM?


 

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