Friday 13 October 2017

BABY #2: Our Struggle with Combination Feeding and Tips that Helped

Combination feeding (breast and bottle) is something that we choose to do when Isabella was a baby and it worked really well. We had planned to wait until she was six weeks old, but after what felt like hours of constant feeding we ended up giving her a bottle when she was 3 weeks old. We started with the tiny bottles you can buy with ready made Aptamil in that also come with the teats. Isabella happily guzzled away and that was the start of her combination feeding journey. She would happily swap between different bottles, expressed and formula milk and drank it without a problem. Naively that was what I expected this time around. How wrong was I.

When it came to feeding Poppy I was keen to try to breastfeed again, with the aim of starting combination feeding at 6 weeks. I have been really lucky with breastfeeding and started feeding Poppy about five minutes after she was born (you can read my breastfeeding story with Poppy here). I was so determined to make it to 6 weeks this time because I had read that it is the best time to introduce a bottle without causing nipple/teat confusion. There were various times throughout Poppy's first six weeks when I really wanted to introduce the bottle earlier, mainly around the very painful time of having a blocked milk duct. Thanks to the wonders of Lansinoh HPA Lanolin* I cried through the pain and continued breastfeeding. The Lanolin gave me that much needed protective layer, whilst soothing and there was no need to wash it off prior to feeding making life much easier. That paired with the incredibly comfortable Lansinoh Disposable Nursing Pads with Blue Lock™ core*, which helped to keep me dry all day/night as they can hold up to 20x their own weight!
Then the time came for our 6-week check at the doctors, where I discussed my desire to start combination feeding. Having made it to six weeks of exclusively breastfeeding I was very proud of myself; I'd achieved something I didn't manage to do last time. As I hadn't hit a breaking point with breastfeeding this time I wasn't sure when was going to be the right time to introduce a bottle. I only wanted Poppy to have one bottle within 24 hours, so it was never going to be a massive change to exclusively breastfeeding. During our doctors appointment she recommended starting with a bottle sooner rather than later; she had two children and one of them had point blank refused to take a bottle, instead going straight from breastfeeding to drinking from a cup. Using my previous experience of Isabella taking a bottle so easily I hadn't been concerned about this, but took the doctors advice and announced to my husband we were starting combined feeding that night.
Once again we had bought the little ready-made bottles of Aptamil, so we dug them out and I started trying to give Poppy the bottle. Instead of being faced with a baby that guzzled the milk down I was faced with one angry baby. Poppy was not happy with this unfamiliar teat I had placed into her mouth; she refused to suckle and spent most of the time turning her head side to side. We weren't sure what to do, after a while we decided to give in and I breastfed her. Then followed days of trying all the different bottles we had in the house, including MAM, Munchkin and Dr. Brown's, with almost no luck. I expressed (which I lovingly and oh so carefully poured into the Lansinoh Breastmilk Storage Bags* to be kept in the fridge until needed) to see if it was the formula milk she didn't like, but that ended up having to be thrown away (cue stab to the heart...throwing away breastmilk is like throwing away your hard work!). Everyday I tried and everyday I wasn't getting anywhere really.
Poppy eventually started suckling the Lansinoh’s mOmma bottle with NaturalWave™ teat*, progress was slow and the time it took her to drink even the smallest amount was slow too. But I had to try and remember that she was learning a new skill, so it would take time. It was difficult juggling looking after Isabella while spending (quite literally) hours bottle feeding Poppy, as much as Isabella loved to help understandably her attention span wasn't quite hours long. As we had had the most success with the Lansinoh bottle I persisted with that one, combined with formula milk. Eventually she is started to drink from the bottle, without it taking hours and seemed to be mastering the skill of drinking from a bottle.

She is still (over 10 weeks later) pretty fussy when it comes to the bottle she'll drink from. We recently went on holiday and took the MAM bottles with us because they can be sterilised without the use of a steriliser and we were back to the fussing. We also used the ready-made Aptamil milk, so am not sure if it's that or the bottle but either way she wasn't a fan. Very rarely did she finish her bottle, so as soon as we were home she was back using the Lansinoh bottle and was a happy little baby again. Though I'm clearly no expert in the area of introducing a bottle I thought I'd share a few tips that helped us:
  • Keep trying. It might take hours, days, weeks or even months but if you really want or need to introduce a bottle to a baby that isn't so keen it will probably take some dedication and time.
  • Try a range of bottles to begin with. Each baby is different and each brand of bottle is different. Finding the one that suits your baby will hopefully make the transition easier. 
  • Once you've found a bottle that works stick with it. As soon as you've found a bottle that your baby will drink the most from (even if it is still a tiny amount) stick with that bottle for a while. It will allow them to try to learn the skill of drinking from a bottle without the teat changing every feed.
  • Ask others to try giving the bottle. The smell of your milk might cause confusion, so asking a partner/relative/friend to give the bottle to start with might help.
  • Change positions for giving them the bottle. Trying different positions like laying on your raised legs, in your arms, in a still bouncer seat etc. may reveal a position your baby likes to feed in. My husband actually found to begin with the only way Poppy would take a bottle from him was if she was sitting in a breastfeeding pillow. If he held her then she wouldn't drink it, luckily she's ok now but that worked at the beginning.
  • Try expressed and formula milk. This may not always be possible, but if you can express then it might be worth a try. Formula tastes very different to breastmilk, so your baby may need the familiar taste while learning the new skill of drinking from the bottle. You could also try a range different brands of formula milk to see if your baby prefers one over another.
  • Try giving a bottle when you have lots of time and minimal distractions. This is easier said than done, especially if you already have children, but it may take time and needing to rush somewhere will only make it more stressful. I would make sure I set Isabella up with something to play with that she could do by herself (play-doh, duplo, building blocks etc.) and then settle down next to her to start trying to feed Poppy. To begin with I'd spend hours (quite literally as long as the milk was ok out of the fridge), so the afternoon was a good time for us because Isabella wouldn't need a meal making until later and I could focus.
  • Vary the time of day. Trying different times of the day to find what works best for your baby. I read to try when baby isn't too hungry, but obviously they can't be full either. I tried morning, lunch time, afternoon and evening, with evening being the most successful in the end.
I'll never know if it took Poppy longer to get used to a bottle because I exclusively breastfed for 6 weeks or if that was always going to be the way with her. Either way I'm so relieved we've persisted and that she now has one bottle a day. It just gives us a bit more freedom, as my husband can feed Poppy, allowing him to have that bonding time too. Combination feeding works really well for us and our family, but at the end of the day fed is best.

Feel free to leave a comment - I love reading every single one :)

Helen x


  1. This was our story first time around. I dutifully waited until 6 weeks, and then we found that Max just wouldn't have it. We tried so many different brands of bottles, but eventually he took the Tommee Tippee ones, and after that he wasn't at all fussy - he'd drink from anything. I completely agree, keep trying - for us it was just the persistence, rather than the brand of bottle. This time around we combination fed from very early on, although ironically I'm hardly bottle feeding at all now as breastfeeding is just easier most of the time (although I had a blocked duct last week which brought back all the horrors of the early days!)

  2. I think as long as you do what feels right for you that's the best thing. There's so point forcing yourself to do something which is uncomfortable/ painful x

  3. Our second refused every bottle under the sun until she was 9mths. It was a nightmare.

  4. Great tips! Thankfully both of my boys were more than happy to be breastfed or take it from a bottle (I expressed so my husband could also help feed). I didn't realise that it wasn't that easy for everyone. I agree, any amount of time exclusively breastfeeding is a huge accomplishment - just wish I'd had all the things available now, like expressing bags!

  5. We combination feed from 6 weeks too, mainly due to very long cluster feeds in the evenings. I was exhausted and we gave in. It turned out to be the best thing we did. And we continued until I weaned our son at 8 months. But we were lucky that he took to the bottle with no problem

  6. I’m all for feeding a baby how ever they need to get fed. Maybe if i have another I’ll try combo feed

  7. I am also combination feeding with breast milk and formula. My son (6 weeks old) was tongue tied so breatfeeding didnt go to plan and after the first week we reverted to expressing which is something we done for my first son exclusively for 2 months. We finally managed to get an appointment when he was 4 weeks to get the tongue tie sorted but since he was already used to feeding from a bottle it took some getting used to getting back on the breast. Luckily he does okay aslong as he isnt starving then he wants a bottle as he knows the flow is faster but i breastfeed during the day and then we bottle feed during the night so the other half can have that bonding time with feeding and i can have a little time to have a bath and sleep! We have struggled with a few formulas finding the one that settles well with him, we have found the ready made bottles the best but are introducing him to the powders now. Who would have thought feeding a baby can be such a learning process! But a fed baby from anyway is a happy baby which equals happy parents!!

  8. I think this is an informative post and it is very useful and knowledgeable. therefore, I would like to thank you for the efforts you have made in writing this article.
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