Hi everyone

I would love to hear from those who have successfully combined breast and bottle feeding (using EBM and/or formula). What sort of a routine did you use? Did you feed one baby the breast and one a bottle at each feed then swap at the next feed? Did you feed both at the breast and then a bottle at every feed? If you expressed, how often did you do this? I need to combine feeding methods somehow, as my supply is insufficient. I am trying out different things to see what will work best for us. I would like to get them as much breast milk as possible- but obviously need to work out a sustainable routine.

Thanks everyone
:-) Lindy

Hi Lindys,

I combined breast feeding, and bottle feeding with EBM. It is a little different in my situation because I was feeding three, but my feeding routine went like this:

I always tandem fed, and at the same time the third baby would get a bottle of EBM. Then, for the next feed, the baby that was on the left breast for the last feed would have the right breast, the baby that had the right breast for the last feed got the bottle the next time, and the baby that was on the bottle last time would get the left breast. So basically I rotated that baby's so that they each got a turn on the bottle and a turn on each breast so that they didn't develop a prefence for one breast if that makes sense? Then as soon as I had finished feeding, I would sit down and express with the electric double lactiset. I was always able to express off enough for the next feed for the baby that was on the bottle. I was very lucky that I had a huge supply so was able to meet their "demands".

Have you tried calling the breastfeeding association, or a lactation consultant? You can also take herbs that promote you milk supply, and there are prescription medications that you can get to increase your supply.

Good luck.

Thanks Nee

Sounds like a great routine. I wish I had the milk supply that you did! Happy to report that my supply is increasing though- much expressing and also taking 'Motilium'. ATM I am able to get enough breastmilk for 1/2 of my boys' requirements, so I am pretty happy with that. Unfortunately neither are very good at the breast- Hayden attaches poorly and Jackson is too impatient (he has worked out that it is much easier to get milk out of the bottle than the boob!).

Cheers
Lindy

Lindy, it sounds like you are doing extremely well! Good on you for persisting with it! The other thing is I used nipple shields which can help with attachment. My three were never able to latch straight onto the breast because they were so small and my breasts were so big. Anyway, I'm glad to hear that your supply is increasing.

Hi Lindy

I know it's tiring but the more you feed the more your supply will increase, and expressing will help too. It sounds like you are on the right track anyway.

My girls had some formula in hospital while my supply built up, I would just catch up to their quota and the dr would increae it on me!!!! So they would have topups with formula, by the time we left hopsital (4 wks) I had a stockpile of EBM in the freezer so we kept up with an evening bottle, and once that ran out we went to formula. I bf the rest of the time, but they would have that little teatime bottle just to get them through until bedtime, once they started solids the bottle became "dessert" then we dropped it altogether.

If you are going to top up with a bottle offer the breast first then the bottle. Try not to substitute as this may interrupt your supply. Avoid missing feeds too, if you can help it, and if you do miss a feed express instead, this will prevent blocked ducts and also help your supply.Ï

Sharyn
Meg14/4/99
Hannah & Josie 22/3/04 (33 wks)
DH David



...some days are diamonds
.

Hi Lindy...

I also combined breast with bottle... because of suply issues, prem babies and reflux.

I comped my girls so they always fed from the breast first and at every feed (once they were strong enough to do that) and then gave them a bottle of either EBM when I had it for formula when I didn't. The like Nee as soon as possible after a feed I would express with the double pump set.

I also used fungreek and other herbs as well as some other tricks to try and keep my supply up and as long as I kept up with the expressing I could almost keep up with the demand when the girls were feeding well. When they weren't things were a bit harder.

It was time consuming topping up and expressing after each feed but it was well worth it. As my girls got older and we got on top of their reflux they got to be better feeders and we dropped back on the comp feeds until we dropped them completely.

I'd also suggest talking to the ABA or a lactation consultant. I know often people don't think you can combine breast and bottle but I think if you truly have no other choice then there are ways to manage it and the effort is well worth it. I'm sure as your boys get bigger and feed better it will get easier!

hugs

Kate

We are moving house! Yipee!!

Hello Lindy,

We had a our visit to the lactation consultant today and it appears our prob is that bayden is a weak sucker. We will keep comping him after every feed with ebm and the nurse urged Ky to express every 2 hours for the next 24 - 36 hours to build up her supply.
So Ky is bf first then comping. (4 hour feeds) Now she will also express every 2 hours too. (short time only though). Will be interested to see how it works out.

Keep up the good work Lindy.

Regards,
Scott

Thanks everyone

Glad to hear that combining can work, and it is great to hear that some were even able to drop comp feeding after a while. Nee- thanks for the reminder about nipple shields. Haylie had suggested this to me a while ago and I had completely forgotten. Timely as last night Hayden managed to do some nipple damage and I had this painful ache for hours afterwards! Scott- the regular expressing works a treat. I did it 8 times a day for a couple of days and saw a huge difference. It is so satisfying when all of a sudden you start nearly filling up those expressing bottles (only happens for me after a fair few hours of not feeding/expressing). Will be interesting to see if I can maintain it though...Good luck to you and Kylie, you guys are doing so well.

Cheers
Lindy

kate- i was wondering how long you were able to keep up the routine of breast feed/ top up/ expressing at every feed? i was doing this for quite a few weeks, but ended up stopping as the child health nurse said i should try something more realistic and sustainable. i took her advice, but am wondering if i should have just continued on?

scott- how is kylie going? did her supply build up? hope all is going well :-)

thanks guys
lindy

I did the feed then comp then express thing for a little over a year... but not for every feed for that long and as Renee can confrim I am a bit of a stubborn cow!

Initially I expressed full time when the girls were in hospital so I was able to get together a good routine of double pumping hands free while playing on the computer and I followed the same routine when the girls came home. I would twin feed them both, top them up and then whne they slept I double pumped while at the computer. As they slept less or if we had a bad day of sleeping or we went out then I expressed less often and when I didn't have enough EBM they got formula which I personally hated doing so that usually made me make more time to express more!

At times it nearly killed me and I would sit there and think 'there has to be more to life than just making milk!' but I was determined that they'd get as much breastmilk as I could manage so made it a priority when I could and knew that I'd done my best when they had formula.

It gets easier as they get bigger. We had a lot of other feeding issues but as the girls got bigger they got better at feeding so needed less for their top up which meant I could get away with expressing less often. When they started solids I dropped the comps for the feeds when they'd have solids after the feed (I always offered a breastfeed first as I really wanted them to keep feeding and we had a lot of refusal issues). We could have dropped the comps all together a lot earlier than we did but it was the only way I could get them to have their reflux meds and they were very slow weight gainers so they had one bottle of fortified EBM right up until they were one (corrected age). So from around 8ish months onwards I only needed to express once each night to get enough for thier one top up bottle.

I think finding a routine that works for you is the best way to go. So even if that means you only express twice a day (and top up with formula when you run out of EBM) or if that means you express ten times a day if you are happy with that then go for it. Remeber to watch your health and what you are eating as your supply will improve when you are healthy and well rested.

It can be a long road but for me it was well worth the effort... and for the recond my MCHN thought I was nuts as did two LCs I saw!

Please PM me or feel free to email katespaces@yahoo.com.au if you want to chat more. Hope this has helped some!

Kate

We are moving house! Yipee!!

Hi Kate

Great effort- sometimes it really pays to be stubborn ;-) As you said, i think the key is balancing being able to get enough rest with how often you spend feeding/expressing (and doing everything else required when caring for twins!). I was not getting enough sleep (who does?) and was really over-stressed about feeding, so perhaps that is the line the nurse was taking. The other time consuming thing for me is that I have not mastered twin feeding, so doing one at a time takes its toll as well. I'm now expressing whenever I can- after most day feeds, and at night too if I am not too tired. I use formula too as I just don't produce enough milk- even if I express after every feed. Thanks for your reply :-)

Lindy