Hi, we use SMA staydown on it's own, they said it would take 2 weeks to work but I noticed a difference straightaway. You make it just like any other milk apart from it has to be chilled water which you can then warm up if needed. You just need to keep on top of it and make sure you have time to chill the water, As soon as I have 4 bottles I just sterilise them, boil the water and chill so its cold in time. I get it on prescription from the Health Visitor.