Combining breast and bottle-feeding can be very useful if you’re returning to work or if you want your partner to take over some of your baby’s feeds. Your baby will still get the nutritional goodness from your breast milk, but can still feed when it isn’t convenient to offer a breast.
Combining breast and bottle feeding: Timing is everything
You can use infant formula or expressed breast milk for one or more feeds by bottle. If possible, midwives recommend that you wait until your baby is at least six to eight weeks old, as combining breast and bottle any earlier than this may affect your milk supply. Bottlefeeding a breastfed baby too early could also affect their ability to suck at the breast properly, as milk flows faster out of a bottle than from a breast.
Supply and demand
Your supply of breast milk is driven by frequent breastfeeds, where you follow your baby’s feeding cues. Feeding your baby formula can affect the frequent feeds that are required to make the right amount of milk, particularly in the early days of breastfeeding. The less you feed, the less milk you produce. However, if your baby is older and breastfeeding is established, it is possible to maintain your breast milk supply combined with formula feeds, as long as you continue to breastfeed every day.
Do it gradually
If you substitute a breastfeed with a formula feed, it will take around three to seven days for your breasts to adjust to missing that one feed. Your body needs time to reduce the amount of milk it makes. Gradually reducing breast feeds can prevent your breasts from becoming uncomfortably engorged and/or developing mastitis. Let your baby have a few days (or weeks, if possible) between each time you substitute a breastfeeding session with a bottle. It’s a good idea to express a little milk from your breasts, to your own comfort, if you become engorged. But don’t express a whole feeding’s worth of milk; just take enough to make you feel comfortable. Your body will get the signal to produce less milk over time.
Getting baby used to bottles
If you’ve breastfed your baby from the beginning, do not be too surprised if the bottle is rejected at first. A good time to introduce those first few bottles is during the second feed of the day, when your baby is hungry but not starving, and likely to be in good spirits. It can also help to have your partner or a grandparent feed your baby the first bottle.
Take your time
According to breastfeeding.ie, it’s important to be patient and allow baby plenty of time to learn how to drink from a bottle. Sometimes it can help for someone else to try the baby with a bottle. If baby reacts against it, stop and try again when the baby is calm. Trying to force the baby to feed from a bottle is not recommended.
Paced bottle-feeding is a great way for the baby and carer to get used to bottle-feeding. Here’s how it works:
- Baby sits up on the carer’s lap.
- Hold the bottle almost level and teat is offered in the same way you would the breast, tickling the top lip and allowing baby to take the teat into the mouth and suck.
- Tilt the bottle slightly towards baby, and when baby pauses you can tilt the bottle down to allow baby to rest for a moment.
- Repeat until baby has taken the full feed.
If your baby is over six months and doesn’t like a bottle you can use an ordinary or sippy cup with handles on it. Babies at this age are usually able to manage a cup. Only put a small amount of liquid into the cup so that any spills are easy to clean. This works well because your baby can control the milk flow. See more at www.breastfeeding.ie
How to treat breast engorgement
Breast engorgement can make your breasts feel swollen and painful. Warm flannels applied to the breasts will help the milk to start flowing before you feed or pump. Cold compresses applied to the breast after a feed or pumping session can be very soothing. Before feeding or pumping, massage the area, starting behind the sore spot. Use your fingers in a circular motion and massage toward the nipple.
Combination feeding essentials
- bottles of your choice
- different sized teats with different flows. Your baby’s feeding speed will change as they grow
- a breast pump – if you plan to express
- formula milk – if you are not expressing
- a sterilising system
Mum’s story – Combining breast and bottle-feeding
“I exclusively breastfed my daughter for six months before attempting to introduce some formula feeds. She was due to start with ther child minder at six and a half months, so I planned to breastfeed in the mornings and nights and give bottles of formula during the day. She had happily taken a few bottles of expressed milk at around at three months, but I didn’t persevere with the bottle feeds. This was a mistake, as she simply refused to take a bottle later on. I began to panic, as I was due to start back at work in a matter of weeks. It took a lot of experimenting with three different types of bottles and also the discovery that I should have been using a faster flowing teat until she finally took the bottle a few days before I was due to return to work!” Lucy Smith.
Making the transition
It is now recommended to fully breast feed your baby for six months, but if a mother decides she cannot continue to fully breastfeed, rather than stop all together, she can mix or combine feed. Some mothers find it difficult to wean the baby off the breast and when the baby refuses to take an artificial feed, she may think it’s the feed that the baby doesn’t like. You will find it easier to make the transition if you recruit someone else to feed the baby for you. It’s better that you are not present.
If you bottle or cup feed the baby, he is clever enough to know that you will not refuse him the breast if he refuses the bottle! It is not recommended to mix breast and artificial feed into the same bottle. Take your time to make the transition from breast to artificial feeds. It will not happen overnight and so you could need two weeks preparation before the big day.
If you want to continue to breastfeed, you can give a morning and night feed for example, and offer the baby three feeds during the day. These can be expressed breast milk or artificial feed. The amount of artificial feed required at six months varies from baby to baby, but the average would be 180-220ml in each. The rule of thumb is to offer approx 25ml per pound of baby weight.
Midwife and antenatal educator Margaret Hanahoe set up the Domino and Home Birth schemes at the National Maternity Hospital. She is the co-author of two ebooks, “From Bump to Birth” and “After Birth”, both available to download on Amazon. http://www.bumptobirthtobaby.com/ www.womenshealthclinic.ie
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