Starting mixed feeding- what do I need to know?

I would get in touch with a lactation specialist or someone who is trained in breastfeeding support. It could be an improper latch so baby is getting tired at the breast because he’s having to work extra hard to get anything out x

I would definitly get more support. 90mls is ALOT to top up. That’s a full feed for my boys at 11 weeks because they feed more frequently

@Rosie it’s all been checked multiple times by lactation specialists- I’ve been attending breastfeeding groups that are specialist run 💚 but he does get very tired, which might mean I’m not producing enough? X

@Ceri-Ann that’s good to know- I did think that was a lot!

@Ceri-Ann yes it’s an extra full feed but they want him to put on weight so the additional amount will help him get there surely? He’ll only drink as much as he wants to🥰

@Becky are you pumping aswell?x

I started combi feeding after troublesome breastfeeding when our son was born and he's been putting on weight perfectly since. I breast feed on both breasts, then top up each feed with Kendamil (90ml top up during the day and 120ml top up at night). I'm actively trying to up my supply so he doesn't always finish the formula bottles but that's ok. I do still pump too and save it up to get one full feed every other day. If you would like a sound board, please feel free to message me x

@Rosie up until now, some, but with how often he’s been on the breast, there isn’t physically enough time before the next feed after he’s been winded, nappy changed etc 😅 but if the formula can extend the time between feeds, then I can and will express and bottle feed more x

@Becky oh girl bless you! Hope everything works out and you get little one to the weight he needs to be x

@Rosie but this is not the appropriate course of action for a breast fed baby. Further support should be offered to assess if there is an issue that can ensure better milk transfer for baby and increasing milk supply not decreasing by giving far too much formula! Babies that are not used to the bottle will actually take far more than they need and get used to the easier flow of a bottle vs breast and often significantly reduce breast feeding - this does not mean they’re hungry! Given the amount baby feeds it’s likely there may be a latch issue such as missed tongue tie that could be rectified to increase weight and still continue exclusive breast feeding

@Ceri-Ann but it is tho? Otherwise a health care professional wouldn’t advise to do so. As she stated she’s had her latch checked and it’s fine I personally would rather give my baby extra formula feeds to bring his weight up than have it drop to a point he is hospitalised but that’s just me

@Rosie some healthcare professionals are lazy and will do whatever to make their life as easy as possible and the least amount of paperwork. I say that having gone out to many postnatal women in floods of tears having been told to give formula or that breastfeeding isn’t possible because of a fixable reason!! Some also have very poor training in assessing for latch as well as tongue and lip ties hense why so many get missed. If mum really wants to continue with exclusive breast feeding the course of action should be to try to get milk supply up and refer on for specialist support and reassess in 2-4 weeks not offer huge amounts of formula Many babies also lose a lot of water weight in the first few weeks, particularly if mum had fluids in labour so the birthweight is not always a true reading of what they would be without that excess fluid

@Ceri-Ann that is true tongue ties can get missed but in the mean time surely it’s better to get him to a safe weight? No?

@Rosie baby has not not lost weight since a few days old, a drop of 2 centile, as long as appropriate continued monitoring is in place, is not actually a danger to baby. The centile health visitors use are also different to those used by maternity services so need to be observed for a few measurements to see the trend

Have you been assessed by an IBCLC and tongue tie specialist? Am aware the “specialists” that run our breastfeeding groups etc were far from helpful and missed my little ones tongue tie. It’s worth just double checking if you haven’t seen someone qualified in tongue ties because it can make a big difference to feeding.

@Ceri-Ann that’s interesting. Learn something new everyday! OP - I combi fed mine for a little while and he was fine, do whatever you feel is best for YOUR baby but defo get reassessed for what’s been mentioned about tongue ties etc x

Really interesting debates! He has been checked by a tongue tie specialist before we left the hospital because of the initial problems establishing breastfeeding- he is a C-section baby and the initial difficulty ended up being down to mucus (c section babies have a lot) and a lack of energy/stamina. He’s still slow on the breast so my guess is that he’s getting tired before he gets full- he’s just had, what I would have considered, a full breastfeed for him (25 mins), but after a 15 min snooze, he’s guzzled 70ml of formula, so unfortunately I do think the health visitor was right. My hope is that by giving formula in the short term, I can win some time to express breast milk and start top up feeding primarily with that 💚

And thank you all! This has been fascinating x

@Becky just make sure when you give baby formula you express and keep expressing to the feeding pattern baby has been feeding. If you don’t your body will see it as a sign that baby has reduced their feeding and in turn reduce its production. Breast milk is all about supply in demand. If you reduce the demand you reduce the supply! Something else that may be worth looking into is cranio oeseopathy. This can also help with feeding struggles . We were recommended this by the IBCLC that we saw for our twins tongue ties. She didn’t feel twin 1 (who had over 12% weight loss by day 7 while bottle feeding) would benefit from the tongue ties snipping but the osteopathy may help as he had a high palate - I didn’t even know this was a thing and have been a midwife for almost 10 years! (he had jaundice and when that resolved his weight shot back up and is a chunk now!)

Also make sure you’re looking after yourself! We see so many mums who don’t eat enough or drink enough and breast milk suffers when this is the case, particularly when babies are feeding as often as you’ve said yours is

Came here to say everything Ceri-Ann did! Breast compressions whilst feeding bub might also help get more volume into him. Also important to note the centile charts used are for formula fed babies. Although weigh gain has been slow, plenty of wet and dirty nappies does indicate baby is getting enough. I would definitely recommend investing in an ibclc if you have the means to do so for a full feeding assessment!

My son dropped percentiles (from 14th down to 5th) over ages 3-4 months, EBF with dairy and soy sensitivities. Sometimes our milk is just not fatty enough to get the weight gain. We fortified breast milk with formula to bump up the calories and he started putting on weight, went back up to 9th percentile and we continue to monitor.

@Becky I just wanted to say please don’t feel guilty - the exact same thing happened to us too. My little girl at day 5 was weighed and lost 12.9% of her birth weight - I felt devastated too that I didn’t notice my baby was so hungry 😭. I beat myself up about it too but slowly realised not to be so tough on myself as I am getting to know my baby. We were recommended formula top ups during a hospital stay (she was jaundice too) and it’s looking likely she will be combi fed now long term. I am a bit gutted as wanted just breastfed only but like people have said it doesn’t matter as long as she’s fed! I literally don’t feel like I know much about mixed/combi feeding so thanks for your post xx

@Ceri-Ann I have personally have actually had a very positive with the support I have been given from healthcare professionals so hope this isn’t the case for majority It’s more awareness of knowing what’s available in your area. An audit picked me up an appointment with infant feeding team, midwife and health visitor supportive. Aware of breastfeeding support groups which I am planning to attend this week. X

@Shannen/Tahira unfortunately in some areas, there are groups of older professionals who do not like the changes that have been made to support processes and very much put up a resistance against them meaning many families don’t get the support, and are not made aware of how to access the support. It’s not a majority but sadly it’s a fair few. Sadly not all areas have breast feeding support groups - the nearest one to me is 15 miles away which to many in our area who don’t have their own transport and are on maternity pay so don’t have funds for public transport, just isn’t practical so those professionals are the only support available to some groups of people

@Ceri-Ann that’s devastating that breastfeeding group is 15 miles away I’m very lucky to drive and have quite a few nearby. X

@Shannen/Tahira it’s not uncommon, my nearest is 12 miles away. At the children’s centre in middle of town and have to pay for parking. They aren’t always very accessible and here public transport may as well not exist. We have a bus twice a day!

@Shannen/Tahira yeah the government stripped most funding from sure start centres a few years ago. With that funding went all of the support they offered. It all fall back to midwives and health visitors who we all know are severely understaffed and overworked!