Mixed feeding help

[psychgirl]

Hi there

I would be so grateful for anyone's advice about this...I hope this is the right section for this thread, but please let me know if I should be posting somewhere else. I hope this isn't too long...

My baby boy is 18 days old. I had quite a traumatic induction which ended with an emergency c-section. Baby didn't latch on for first few days and I was physically a bit out of it myself. By day 5, baby had lost quite a bit of weight and had quite bad jaundice and ended up back in hospital, and under the doctor's advice, we began feeding him formula, which made a huge difference to my sanity and most importantly to baby's health.

Anyway, since then, he has managed to latch on with the help of nipple shield but each breastfeed will take about an hour and then baby will cry a lot out of hunger, so we have been topping him up with formula or anything I have expressed. He's doing well health-wise - has put on lots of weight and jaundice has cleared up

It's all been quite stressful for me, I've been feeling so guilty for not being able to fill him up with my own milk and i feel like i've failed him My anxieties about feeding I believe has been getting in the way of me enjoying my time with my baby, but I just can't stop worrying about it all.

Obviously my main concern is that he is healthy and does not go hungry, and that he has a mummy who is sane and happy, so I am tempted to give up on the breastfeeding altogether and just stick with formula.

But i'm not yet at that point and would like to try a mixed feeding system. The system I have at the moment (breastfeeding and then topping up each feed) is not really working as it takes so long and it often involves him working hard at my breast and then crying out of hunger. So, my question is as follows:

If I breastfed him for, say, 3 feeds of the day (e.g. first thing in the morning, late afternoon, and middle-of-the-night - since these seem to be when I have most milk) and then formula fed him for the rest of the feeds, would I need to express at any point to keep my milk supply going? If I did this system and didn't express at all, would my milk dry up?? Is there anything else I need to be considering before I implement this?

Like I said, I hope I have posted this in the right section and I hope someone can help me. I'm so stressed out about this, it's keeping me awake at night when baby is sleeping (and therefore when I should be sleeping!), and I just want to enjoy feeding my baby rather than be consumed by guilt or by confusion or by fear that anything I do will ruin my milk supply.

Thank you in advance, and I really appreciate that you've read this far!

G.x

 

[Kristin52]

Hey mama! Congrats! and I have no clue, but my best advice is to copy and paste this over to the breastfeeding section and I'm sure you'll get a few tips and some help! Good luck!

 

[kat2504]

Eventually a mixed feeding system might work for you. Right now you clearly need to get your supply going if you want to continue breastfeeding so feeding frequently during the day, even if topping up is still needed (gradually you can phase these out) is so important. If your breasts don't get frequent stimulation they don't get the message more milk is needed. To get your supply up, frequent feeding and perhaps even adding some pumping sessions is crucial.

Once your supply is improved, you can then work out about replacing feeds. Many breastfeeders give one bottle feed at bedtime so that their OH can do the bedtime routine. That might be a good place to start. If you wish to BF for more than a short while, I think going down to 3 feeds a day in the first 3 months could be damaging to your milk supply, which is still hormonally driven in the first 3 months. there was a lady on the BF section who was told it was ok to just do 2 feeds a day by her health care professional and guess what, she ran into problems with her milk supply quite quickly. when you have a very young baby your breasts are expecting to get used every couple of hours.

I personally believe that since you have done so well in getting his weight up and sticking with the bf, you should persevere with it a bit if you can and perhaps pick one feed of the day such as the evening feed to replace with a bottle. Once your milk supply gets better you will find the feeds less time consuming as you can make the top ups smaller and then get rid of them altogether. If replacing one feed with formula works, then you can try it with a second feed and see how you go with that.

 

[NotNic]

A lot of what Kat says is right, though given your bfing struggles I can see why you might be happier with combi-feeding. I combi fed, starting with one/two bottles a day of formula. At the risk of frightening any pg ladies reading, my nipples became so severely cracked I was told by midwives to stop feeding and express instead. My son's 90min feeding sessions took its toll big time. After expressing solely for 72hrs we got back to bfing with shields, but it took a long time for me to heal and a while to wean off the shields. By 6 weeks feeding was down to a more manageable 1 hr each but we had introduced three bottle feeds as his colic made feeding a challenge and his weight wasn't going on as much as we'd like so we were advised to give him an extra feed.

If you want to continue you do need to allow your baby to suckle and any skipped feeds in the early weeks you should try to express if possible, because as much as you'd like to supplement you wont want to rush and jeopardise your supply as it makes it harder to produce milk and more frustrating bfs without the stimulation. (It doesnt need to be for as long as a normal feed. 30 mins was enough for my supply). You also should try to reduce feeds extremely slowly. When F naturally dropped a feed by sleeping through I would express before bed. I also swapped one feed every 2-3 weeks for formula and stopped bfing at 20 weeks as F was on solids and he became less interested in feeding. If you swap to three feeds really early there is a good chance combi wont work (sorry). Also it was possible for me to 'up' the feeding when he was ill or going through a growth spurt, by allowing him to snack through the day. Very quickly I discovered I could produce enough by stimulating the supply. Also something I didn't know is that it takes a while for the breast to get used to expressing initially. With practice this will improve and it will become less time consuming. Remember it can take 6 weeks for your body to regulate milk supply.

The early weeks are tough but by 6-8 weeks I found bfing easier and almost enjoyable A good vitamin can help you stay in good health and eating and drinking regularly helps with the milk.

Also (sorry for the waffle!) it's helpful to get a HV's support (or a fellow combi-feeder) as it can be harder to work out how best to approach combi-feeding as not everyone's experience is the same as mine. I was very lucky that my HV was on board and was very supportive with supplementing and keeping the bfing up, as she knew the feeding issues we had. Too many people give up bfing when supplementing (if done properly and slowly) can really help you bf until your child is weaned or it no longer suits you. Good luck!

 

[NotNic]

Another thing (I will shut up soon I promise ), topping up directly after a feed might be the problem for your lo. If he knows there will be a nice easy bottle afterwards he might not be so enthusiastic to eat. Finishing a feed, then an hour later offering milk might be more successful. Also a slower teat or one that mimics breast flow might help him improve his feeding skills. Bfing and bottle feeding need different actions from the baby to get the milk. If he's a less enthusiastic bfeeder, then a faster flow teat will be easier and less frustrating for him, and he's likely to get upset from bfing. You need him to practice at working for the milk!