Combi Feeders please read!

[Monalissa]

I'm still not producing enough for LO to actively nurse most feeds even with pumping 8x daily, domperidone and fenugreek to boost my supply. I've been using the Medela SNS starter most of the time which I hate. If I don't she's hungry again anywhere from 5 minutes later to an hour. I've had to give her a bottle myself a handful of times when we couldn't get it going. I was surprised she took it from me, but I guess being hungry...

How do you make Combi feeding work? What's your routine? I am really struggling with giving up BF and am very depressed over it. I have to find a way to make this work as stress free as possible. We also end up wasting a lot of my BM that I do manage to pump or formula because I never know how much she actually gets from me.

I'd also love to hear from anyone who uses a Lactaid or full size Medela.

Thank you!

 

[Celesse]

Its actually quite normal for a baby to want to be back at the breast soon after "finishing" a feed. They don't just suckle for food, they suckle for comfort and to be close to mummy and just because they are little. They don't think "oh I'm hungry I want a boobie" They think "i feel wrong I want to suck something". Baby wanting to be back at the breast 5 minutes later doesn't mean you are not producing enough milk. Its just normal newborn baby behaviour. Breast milk is easily and quickly digested, babies only take small amounts and their stomachs are tiny.

Hourly feeds are normal, wanting to be at the breast all the time is normal. It doesn't last forever and after the 6 week growth spurt feeds begin to get shorter and more spaced out. If baby is giving you wet and dirty nappies and gaining wieght then the milk is there.

https://theleakyboob.com/2011/08/baby-explains-normal-newborn-behavior/ << Please have a read of this which explains normal breastfeeding behaviour.

If you decide that you are not happy feeding this frequently the first thing to try would be to soothe baby in other ways. Skin to skin, using a baby carrier, rocking, giving a dummy. If you are still unhappy with this and want to give milk via a route other than the breast it is possible to make combination feeding work. The best way to combi feed without effecting supply is to FF to a schedule and BF on demand in between. Limit FF to 2 or 3 bottles a day that are well spaced out.

When I was combi feeding DS when he was little (he was unwell as a newborn, then I was hospitalised) he would have bottles every 8 hours. After the bottle he would probably go 3-4 hours before wanting a feed, then hourly after that until bottle time.

 

[Cheska]

Why do you end up wasting pumped bm?

What did you want to do, exclusively breast feed?

My lo was prem so I started expressing for him when he was in nicu. I was managing to supply what he needed then. Since he's been home I've carried on expressing (have medela swing) feeding him through bottles not breast. I try to give him the breast once a day as I feel it will help my supply also he knows how to suck. He is now 7 week old and demanding more and more every week. I occasionally top him up with formula but feel this will have become a more regular thing. I started doing this mixing breast and formula in the same bottle now I make up two bottles give him the breast milk first and then formula as I would rather throw away formula.

Don't feel bad she will thrive and grow on any x

 

[Monalissa]

I should have given more background details. My daughter has a lip tie, tongue tie, high palate and her chin is receded more than usual. All of which were preventing her removing milk efficiently for weeks, hence the low supply. I've been seen by two lactation consultants and the pediatric ENT who snipped her ties almost two weeks ago (she breastfed all of her children and deals with nursing mothers daily). I do agree that she will take the boob almost anytime but that's not only what I am dealing with.

I have no issue with the work involved and haven't for almost 9 weeks. Since those visits I have been paying attention to how much she swallows and it's only the first few minutes of the feed and then she is actively nursing without swallowing for minutes on end. If I don't use the SNS she will become frustrated at the lack of flow and it's impossible to continue. If we manage to successfully nurse with the SNS and she gets 1-2 ounces of breastmilk or formula she goes much longer to her next feed because she is satisfied.

Although I love the added benefits of breastmilk, I love breastfeeding and the closeness with her. She seems to love it also. Having given her bottles I can say its not the same for me. I was FF myself and turned out pretty ok so that's not what I'm worried about. But knowing she is not satisfied after nursing is not ok and it's only gotten worse.

She goes back and forth between bottle and boob ok for now but I don't know if she will continue to especially if I am giving the bottle.

 

[Celesse]

Poor baby, sounds like she has had a lot to deal with. I must admit when I first read your post I thought baby was a 4 week old (I got confused with the US dating in your signature and misread). Apologies for the irrelevant advice. However my experience with my first baby would be quite relevant.

My daughter had poor milk transfer and slow weight gain and was therefore combi fed until around 4 months. Her poor milk transfer was due to her birth and got better following CO from 7-12 weeks. So at 9 weeks I was giving 2 bottles a day. I gave them at set times of the day, one at lunch time and one at bedtime (around 7:30/8pm). The rest of the day I BF on demand. I had no issues with switching between breast and bottle. They were different things to her, she liked both.

From what I remember my day went something like: Wake up 8am with DD in bed feeding (we co-slept so no idea what time that feed started). Get dressed have breakfast ect and be sorted around 10am then start with feeding every 1-1.5 hrs with sleeps on my knee/at the breast. Give lunchtime bottle then she'd sleep for a bit. Start again with frequent feeds about tea time, then give bedtime bottle then she'd settle for a few hours sleep. I remember watching a lot of Law and Order re-runs.

At some point I went down to just the night time bottle. And at around 12 weeks I was giving a morning bottle just before first nap of the day and bedtime bottle. I think as long as they are spaced out and fewer than 3 a day you can probably manage to continue breastfeeding. If you think a fully FF baby has 6 feeds a day you need to keep a good proportion of the milk as breast feeds to maintain your supply, so thats why I'd suggest no more than 3.

 

[holymoly]

I've combi fed since day 5 when it found LO was losing too much weight (born at 36 weeks).

When ever he is hungry, I breast feed for as long as he wants. When he's finished (comes off the breast and won't go back on again) I offer him a bottle, sometimes he takes it all and sometimes takes none. I make up about 60 ml of formula, if he takes that and is still hungry (rarely happens) I put him back to the breast, if only to stimuate supply before I'll give him more formula. If I have time I'll also express what I can once or twice a day. He's 9 weeks now and doing really well. Now I know him better I don't always offer him a bottle after breast feeding if I think he's had enough (we've dropped the bottle at night and in the early morning which is great!).

I don't think we'll ever be exclusively breastfeeding which was my aim but I'm happy with what we're doing now.

Good luck!