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Infant feeding

Mixed feeding from birth (almost)

23 replies

GingerDoodle · 10/10/2012 19:19

Hi all

I wonder if anyone can offer some advice / encouragement.

Our little girl was born 2 weeks ago tomorrow (at 11:24pm); and was ebf for the first week, however she lost 8% of her birth weight, didn?t poo for 4 days and was very unsettled so we started to top her up with formula on day 5, que much happier baby which after a day started to poo each day (big poo?s once or twice a day seems to be her norm now).

She now takes breast happily (prefers it) for 10 - 20 mins each side every 2 ? 3 hours and then a bottle of around 60ml each other feed.

She is now back at birth weight. HV came today and she is apparently on the 9th centile for height and weight (neither me or her dad are very big ? I am 4ft 11 so this is not surprising) but she has not yet started to pile on weight which she said they would be looking for.

HV did stress that to continue mixed feeding would affect my supply, which I know and accept. For me, I would rather top up and have a happy satisfied baby than one screaming with hunger chewing my nipples off.

I enjoy breast feeding and am hopeful to be able to keep it up for 6 months but mixed feeding has proved to work for us all so the comments about not gaining weight in bounds and supply have made me feel a bit emotional about it all?.

  • Is it normal to just be back at birth weight and not yet climbing?
  • Is there anyone here that has mixed fed from this sort of age?
  • Any tips for maintaining supply?

    Many thanks

    GD
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MigGril · 10/10/2012 20:40

mixed feeding from this early on will effect your supply. It's not an exact science but supplementing this early could lead to you not feeding for ass long as you'd like. Are you expressing at all?

Have you been given any breastfeeding support at all?

8% weight loss is within normal and the best way to get more milk into a baby is to breastfeed more often. The still slow weight gain would suggest that you need help with breastfeeding.

Ask your HV if there is a local support group in your area or give one of the breastfeeding helplines a ring.

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Kalisi · 10/10/2012 20:43

Ok this is probably not the best advice as I'm not a health professional but I would just like to reassure you. From my experience HV's will push exclusive breast feeding AT ALL COSTS even if it goes against what is best for you and causes a great deal of stress. Every baby is so different and I genuinely believe that if combined feeding feels right for you, you should continue. If you are small, you are likely to have a small baby so as long as LO has a healthy appetite I really wouldn't worry (remember 9th centile is still on the chart so not in the danger zone)
With my little one I stuck exclusively to BM for the first 5 months out of pressure and fear that if I gave him even one bottle of formula I would stop producing milk. It was hell!! When I finally started topping up it was like I had a new lease of life and a new baby! Because of this ,I continued BF up untill nearly ten months which I would never have done otherwise! I didn't feel like I produced any less milk but it certainly made it easier to wean completelty ( no engorged breasts) Anyway as I said I'm in no way a proffesional but if you express when you can and always try to top up the same feeds hopefully it should work out for you.

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Kalisi · 10/10/2012 20:51

Although Migril does have a point, maybe at this young age it would be beneficial to atleast wait until DD is in a regular feeding pattern so your body can get into more of a rhythm.

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PoppyScarer · 10/10/2012 20:54

I've mix-fed from around 1 week old with my DC2 due to nipple pain on one side. I have breastfed from one side and topped up with a bottle, usually the last feed of the evening. Although more bottles during the day if we have been out or if my DH is looking after the DCs.

As my HV said to me, some women breastfeed twins (in fact I know one who does) and so topping up isn't always necessary, but I chose to do it with DC2 in order that he would take a bottle and we could avoid traumas experienced with DC1 in this regard.

I am still going with this mix-feed method at the 14 month mark. He's a very happy, 75th-centile boy.

FWIW, I occasionally squeeze my other breast to check and there is still milk there. I believe from experience that the body can produce more milk very rapidly. For example when my DCs have been sick and don't want solid food, they breastfeed more and the milk appears to be there for them.

I love mix-feeding and wish I had done it with DC1. Please don't feel guilty, it sounds as if you have found the best solution for your baby and your family. Good luck!

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MigGril · 10/10/2012 20:56

kalisi - you had an established milk supply so adding in bottles at 5 months would have been fine. this is not the case when a baby is so young and there is very good reasons why they recommend not introducing bottles before 6 Weeks. Documenting this early most often ends up in mum fully formula feeding before she wants to.

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SarahJinx · 10/10/2012 21:01

I mix fed from week one to 8 months. For the first five months, it was one top up after bedtime feed, started as an ounce. I really had no choice, my milk took ten days to come in, I had a 9,2 baby and I desperately wanted to bf. It probably dif effect my supply, but having said that my baby started on and stayed on the 91st centile, and I managed to feed him myself for longer than I hoped.

At five months I introduced a second bottle and I did that because he was trying to drpp feeds, one day he I tried a bottle instead and he downed it. To be honest I was hugely naive, I did what felt right and it helped me to continue when I would have stopped, I couldn't allow him to be hungry initially and I won't lie, I did get to look forward the 8pm break where dh took over.

He didn't ever sleep brilliantly and I fed through the night until five months, it just seemed to help him settle.

You do what works for you.

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aamia · 10/10/2012 21:18

We've mix fed since about day 4. DS had tongue tie and was screaming in pain (from wind) and hunger. After hours and hours of this, we tried a bottle to see if it was something to do with bf, and in desperation because we couldn't stand to see our tiny baby so upset for so long. He calmed and slept. So from then on we gave a couple of bottles a day to give him and us a break. I spent days feeling terrible every time I bf him as it always led to terrible wind (infacol helped) and he fed and fed yet was never satisfied. He lost 8% by day 5, then a further 15g by day 10, at which point we added in a bottle every other feed, and began to wake him to feed every 2 hours without fail. By the time we had the tongue tie cut I'd given up on bf and was expressing and ff only. I just couldn't bear to see him scream when I KNEW he'd be happy and content drinking from a bottle.

After the tt was cut, he bf without problems (no crying afterwards) for the first time since my milk had come in. He has continued to bf happily and my supply has increased somewhat, although we're still alternating bf and ff. He's now taking 90ml from a bottle and is content after a bf, so must be getting about that from me. I can now express 60ml where I was getting 30-40ml before, and my breasts are starting to fill between feeds. MW did say that eventually my supply might dwindle, but if that happens it happens. My baby needed to eat, and formula gave him the nutrition he needed. If the tt had been found earlier then our story would have been different.

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Kalisi · 10/10/2012 21:19

Migril, Im guessing you wrote that before my ammendment Grin
All the while you can cope gingerdoodle ofcourse bf as much as you can. We all know the statistics. Exclusive Breastfeeding is the best course of action ( health wise) for mum and baby etc.etc. the danger is when the going gets extremely tough and Mums end up disliking breastfeeding to the point they stop completely whereas taking the pressure off by combined feeding makes many mums (including myself) go for much longer than intended.

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mumblecrumble · 10/10/2012 21:31

We mix fed. And found it was a good comprimise between DD getting lots of lovely breast milk and having flexibility of bottle if needed.

DD prefered breast mostly and she had breast milk aprox 6am, 10 am, 2pm, then lots from 5 - 10pm. She sometimes had a small bottle at 10 and if I was absolutely knackered DH would give bottle at night. I fed from only one breast too.

We found DD's growth was always normal, she was happy etc and I felt conforted by the bottle. I know that might sound daft but I also have chronic pain in arms and hands so sometimes breastfeeding didn;t go well if I wasn;t in my comfy spot at home.


My suggestion would be that while you are on maternity leave to breast feed as much as pos, knowung that there is formula handy if needed. Often babies, after the first difficult few weeks, have leanr tthe tricks to boobie feeding and will feed well without needing formula. Mayeb she was getting to hungry adn tired to sort it out?

ANyway, not an expert, just did dsome peer support and breastfed for 18 months. Found everyone concerned for my mixed feeding..... we would do it all the same again.

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mumblecrumble · 10/10/2012 21:32

Also, breastfeeding gets much easier as you go along. I started feeling like we had both got the hang of it around 5/6 weeks.

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ceeveebee · 10/10/2012 21:37

I mix fed my twins from 3 days old until 10 months old. Up to 6 months old I guesstimated that it was about 50:50 bm and formula. After weaning I dropped most feeds (gradually) except morning.
I did lots of expressing and took fenugreek to try and increase supply in an attempt to drop some formula feeds, I did manage to drop a couple but never managed to get to exclusive bf.
It had its pros and cons- other people (DH) could do some feeds while I rested, they slept for longer stretches after a ff, and its easier to bottle feed in public then tandem bf! But obviously bm is best, and also bottle feeding is a real faff, all that sterilising and making up bottles from fresh.

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GingerDoodle · 10/10/2012 21:42

Hi all

Thank you so much for your input.

I've tried to express but as yet have not had any joy with the advent pump I have; will continue to try and am going to borrow a friends pump (diffent make).

If we had had no other issues the 8% probably would have not prompted intervention but it was the combination which suggested that she was not getting enough fat / nutrients from my milk (MW, NCT Breast feeding counsellor and our thoughts).

The midwife and health visitor who have seen me feed have both commented that she is latched well and everything looks in order.

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beancurd · 10/10/2012 21:46

It is rare that your supply will allow you to continue to mix feed if you add in much in the way of ff in the first month.

If you have never bf before, don't bf mainly for the first month to six weeks then most mothers would find their supply dwindled rapidly after a few weeks.

The more bf and expressing you do then the more robust your supply will be. After two weeks most babies will put in 4oz to 8oz a week, up to 10% weight loss is normal in the first week and a return to birth weight at the end of the second week is expected.

I would imagine the best way to carry on mix feeding would be to get bf support in real,life from a baby cafe or bfc so they can help you boost your supply with either direct bf or expressing.

Good Luck:)

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SarahJinx · 10/10/2012 21:49

I think the point Kalisi makes sums it up for me If I hadn't been so determined to do it (four years ttc, wanted everything perfect, obvs) I would've given up.

I had a lot of comments from women suprised at what I was doing because it had never occured to them at the point they stopped bfing that mixed feeding was an option. It hadn't to me either, I went to a bf workshop at 37 weeks, planned to do it, stocked up on Lansinoh and breast pads and thought that would do it. Cluster feeding hit me like a train, my milk wasn't in, my baby screamed from 5 - 10 the first few nights (which I now know is normal but didnt at the time) and I was gutted to be thinking that Iwould be forced to give up.

A midwife advised I top up for a couple of nights. She probably should'nt have, actually all hell broke loose when I spoke to the bf coordinator midwife, asking me to name her and all sorts. The lack of support was pretty shocking, and I guess its the same for lots of new mothers.

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Yika · 10/10/2012 21:50

I mix fed from birth as my milk didn't come in for yonks (anaemia). I tried to get back to ebf but try as I might I never got my supply up (but that's because I didn't get enough good advice support in the first few weeks and didn't have a clue what I was doing or how bf works!). To my absolute amazement though I managed to keep on bf till DD was about 21 months, and then it was hard to stop! Breast feeding is great but I didn't half agonise about it, and I admit it was hard to maintain supply. I pumped every day for a year.

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MigGril · 10/10/2012 22:06

has anyone watched a full feed from latching on to baby coming of, just watching a baby while feeding doesn't tell you enough to determine if it's a good latch.

Expressing can be difficult to start with, google hand expressing as a lot of women find it more effective them using a pump.

I think you do need more rl help with this. Did you mean the combination of 8% loss and lack of poo?

I'm surprised a breastfeeding councillor world recommend formula. there are normally lots of things you can do with breastfeeding before you need to resort to formula. but maybe we don't have all the details hear.

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GingerDoodle · 10/10/2012 22:25

Didn't get to finish the post - baby work so now typing one handed.

It was the weight loss, poo and being unsettled.

The NCT bf lady did not suggest topping up but did say it sounded like baby was not getting the enough fat from my milk and suggested using the biological nursing approach. Thishas been helpful to an extent but tbh she just put the fear of god into me about getting sent back to hospital if baby didnt poo the next day which i did not find helpful at all.

I will look up hand expressing; as it sounds like this would be helpful to keep up my supply.

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girliefriend · 10/10/2012 22:34

I mix fed my dd as necessity (she was in scbu for the first week of her life and I was in hospital for the second!!!)

I never found it to be a problem, I would bf dd pretty much on demand but if I fed her and she still seemed unsettled or hungry would top her up with an oz or two of ff. This esp seemed to be the case in the evening.

I found also that naturally the need to top up dropped off and by the time she was 3mos she was exclusively bf but happily would take a bottle when I went back to work several months later.

If its any help I managed to bf in all for nearly a year Smile

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girliefriend · 10/10/2012 22:37

oh and also I found to increase my supply it helped to drink loads esp when I was feeding (not Wine unfort Wink )

I also kept the calories up for the first time in my life I put sugar in my tea and on my cereal!!

I know in theory this shouldn't make a massive difference but am convinced it helped my supply!

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MigGril · 11/10/2012 07:58

the unsettled baby is not to much of an issue to be hoist. you only need to be cencerned when they are sleepy and won't feed.

I've help mums turn round feeding with much grater weight loss without the need for formula. I'm not saying you shouldn't have given it if that's what felt right for you. but you may end up not feeding long term if you don't try and increase your supply. a lot of these mums who have shared there stories with you have been the lucky ones who have been able to carry on mix feeding after starting so early. there are a lot more who will have had to give up.

It depends on how you would feel if you ended up fully formula feeding. if your happy with that idea then carry on mixed feeding and see how it goes. if not then you need help in increasing your supply. could you get in touch with the breastfeeding conciler again?

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Rusulka · 25/02/2013 17:48

I expect this is miles too late, but just wanted to add in my experiences.

I was in hospital the same week I was induced (for an abscess on my coccyx)- a combination of not being able to eat or sleep, then antibiotics which prevented me from eating when I needed to, then a difficult back to back birth with MASSIVE episiotomy and heavy blood loss meant that my baby had lost 12% of her birth weight when they came and weighed her- she cried and cried, and I continued to struggle on, they suggested I express, which was really difficult, and then I was told not to worry about it- I think I saw every midwife in the damn team- anyway, she went down to 14% loss and I was strongly advised to top up every feed with formula. I just wasn't producing enough milk, my body had too much on its plate.
Nearly 6 months down the line and she's doing absolutely fine, still combination feeding. Every feed she has both boobs followed by a bottle, which we have increased at 1oz/30ml behind what an exclusively bottle-fed baby would have.

I'm happy to have made it this far. There were times where I wanted to give up breastfeeding. I wondered what the point was. But I'm sure I've managed to pass on my concrete elephant constitution so it was all worth the perseverance.

I beat myself up for ages about giving her formula, I really didn't want to. But I have to say it's worked out just fine for us. And I cold water sterilise, so it's not really that much faff. Initially I hoped I could get to exclusively breastfeed, but it just didn't happen.
The main thing is, she's happy and healthy, got what she needed when she needed it, and is tracking at a decent weight gain at every fortnightly weigh-in.

I hope your little girl is doing similarly well. Grin

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Andcake · 26/02/2013 19:49

We mix fed from day 5 after being re admitted due to 14% weight loss and managed until 6mo. Pumping helped. Ds hated bf and despite numerous bf support and mw help just basically refused to eat. After we got hus weight up slowly by tube back in hospital. Mix feeding worked with some expressed bottles as bf was touch and go. Some times fine sometimes screaming hitting my boobs! Made me so depressed especially as he was perfect in front of so many hcp then with others would be awful & then they would trott out same advice as though I hadn't tried it before. Until I made a decision to mix feed it was all pretty hellish.
I think mix feeding gets a bad rep but I found a study which said that as little as 100mls a day can have great benefits. Ill try and dig it out.
I think with determination you can do it and produce happy healthy babies and mums in my experience. Good luck

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newcastle34 · 28/02/2013 14:49

Well my dd lost 17 % body weight by day 5. Back in hospital where dd tube fed and I continued breastfeeding/expressing. Ended up being discharged on day 8 with instrucions to beastfeed and give regular formula topups. Within a week midwide happy for me to drop formula and see how it goes. Baby back to birthweigt by day 17.and still doing well at 5 months.
In my case feeding formula didn't appear to affect my supply. However, my case was quite extreme.
So mixed feeding can work. Dd does have occassional bottles if I am out. (normally ebm but occasionally formula)

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