Combo feeding, las dos.
January 6, 2016 7:53 AM   Subscribe

Expecting baby no. 2 any day now and this time we'd like to split the workload of feeding the baby. What do we need to know to make this work? What worked for you?

Some more info: I want to do breastfeeding as well. Have a pump. Might introduce a pacifier later, so between breast, bottle, and that there may be nipple confusion concerns coming up. Will both be on parental leave, first I (mom) go for about 9 months, then dad for about 9 months, then daycare. We're fine with the bottle feeding being either pumped breast milk or formula. Concerned about balancing supply upkeep with actual effort reduction, for example getting up at night to pump doesn't seem less work for me than nursing in bed and adds work for the dad with bottle feeding.
posted by meijusa to Grab Bag (6 answers total) 2 users marked this as a favorite
 
With our second, I breast fed for a long time, but we also used bottles. Right from the start due to various issues. I breast fed mostly while on maternity leave, and used the occasional pumped bottle or formula. At night, the baby slept in a cosleeper and after she was big enough she basically breast fed through the night while I kept sleeping. When I went back to work, I pumped every three hours to maintain supply until she was one. Then I just sort of stop and my supply evened out to being available when she breast fed in the mornings, after work sometimes, and at bedtime. I think the best thing you can do is just be in tune to your baby, ask for help when you need it, and don't be afraid to try a bottle - or even formula - if you need a break/have to go somewhere/want dad to bond or whatever.
posted by dpx.mfx at 8:50 AM on January 6, 2016


Nipple preference is uncommon, but it does happen. The biggest way to prevent it from happening is to use paced bottle feeding. Here's a video. Best practice for this is to also wait to introduce artificial nipples until supply is well established, between 3-6 weeks. Your maximum milk supply is set around six weeks (though having breastfed another, your body is already primed to make milk and you're unlikely to encounter supply problems unless the baby has a functional problem getting milk, like lip or tongue tie) so that might be something to keep in mind. You want your baby to have lots of colostrum, which continues to be present in the milk in some quantity through 4-6 weeks, and you want to let your baby feed pretty much on demand during this time, as all that trying clusterfeeding exists to up your milk supply for future growth. Which isn't to say that one bottle here or there will create any huge problems, but I'd just treat it as an occasional treat during this time when you really need to take a break.

Hand expression in the very early days, especially when colostrum is present, is a predictor of successful milk supply, more than pumping. Most women respond better to hand expression than pumping and will remove more milk this way--in places where women are taught hand expression, they're more likely to end up with oversupplies than low supplies. It takes practice to get hand expression to work and can be a little messier. A wide mouthed jar or bottle is useful. I'd give hand expression a try in the first few weeks, especially if you get painfully engorged. Bottle or jar this milk and keep it around for bottle feeding. Remember that you don't need a lot to bottle feed a newborn. Here's a chart of newborn stomach capacity.

After six weeks or so, I'd pick one time a day to pump or express. Milk output is biggest first thing in the morning, so that's a good time to add a session. Pump the other breast while your baby is feeding, or pump right after they feed. Get what you can in a session, and top off with formula what you can't.

As for when to have dad take over bottle feedings, if you want to do a regular daily session, I'd pick a block of time, like from 10 pm - 2 am. There are physiological reasons why breastfeeding or pumping from 2 am - 6 am is a good idea--estrogen surges from this time unless it's being suppressed by prolactin, which is released when you have a letdown. Breastfeeding in the early morning hours signals to your body to make more milk throughout the day.

Generally, though, I just wouldn't worry about your milk supply unless there's a problem (most moms who have successfully breastfed one end up with too much milk with the second!), express what you can but don't worry too much about the amount you get, add formula here and there if you need it. Mostly breastfeed, and your supply should be fine.

Good luck! And if you need more guidance either before or when the baby is here, consider checking out reddit.com/r/breastfeeding. It is an incredibly supportive breastfeeding forum (and they're okay with combo feeding) with several lactation consultants as moderators.
posted by PhoBWanKenobi at 8:54 AM on January 6, 2016 [1 favorite]


Every baby is different, but we introduced ours to the bottle at age 3 days and she never had any issues with nipple confusion. Just that one bottle feeding a day helped me get started on pumping. I never woke up just to pump (I know other mothers who do this) but there were nights when I stayed up pretty late to pump after my husband went to bed. Also, I am SO GLAD my husband was able to help with feedings during those early days.

For the first three months, I always had a pretty hefty supply of breast milk in the fridge for others to feed her, and I couldn't go more than a few hours without needing to feed or pump while I was awake, so that kept up pretty well. Then when she was four months I had to go away for a few days and she's been a big bottle fan ever since. She'll still breastfeed, though, if that's what's offered. But it's kind of a struggle at times. Currently, the pediatrician has told me to breastfeed her first when she's hungry and fill in the gaps with formula. But I don't pump anymore. Maybe if I really, really can't get her to breastfeed for awhile, but that's not very often.

Sound confusing? It kind of has been for me at times, but my baby's health is right on track and that's what's important to me.
posted by Pearl928 at 8:58 AM on January 6, 2016


I fed my daughter exclusively with bottles of pumped milk, then added in a bit of formula several months down the road. I started doing that because we had some jaundice issues in the beginning, so it was really helpful to know exactly how much she was eating. Breastfeeding wasn't a huge problem, but we got into the swing of things so much that we just stuck with what we had.

I will say that at one point I did pull out my boob just to see how she would do; even though it had been a good four months, she latched on better than I thought she ever had. So I wouldn't worry too much about the nipple confusion issue, once you've figured out what nipple works for her. (We used the Medela two-ounce cylinders for a couple months, then the six-ounce bottles until she stopped bottles entirely at 15 months. We bought a couple 10-ounce bottles, but she never needed anything so huge, even when she was on whole milk after 12 months.)

It made a HUGE difference in how my husband and I were able to share duties. I knew ahead of time that I was looking at gallbladder surgery when she was a month old, potentially needing to feed with bottles AND formula (because of pain meds, which I didn't end up needing). I didn't end up needing formula, but it was a relief to know that when my tiny little person was overnight with her grandparents, she was still getting the food she was used to.

Re: supply issues, I feel like I had a ton of stuff and it only reduced when I reduced the time between pumping. I ended up pumping once a day at the office, and then not at all, but that was mainly because it was pretty inconvenient and I felt like the supply we had was sufficient. My daughter kept growing and developing happily, so I tapered off a little more.

We ended up adding formula in gradually. I've heard that babies who are formula fed sleep more deeply; I also thought that whatever nutritional benefit she gets from breast milk over formula would probably be most worthwhile when she's active during the day. So she had formula at night and pumped milk during the day, whether at daycare or at home.

The best thing was having those Enfamil packets you can just mix into a [baby] bottle of water. We did a big trip when she was seven months old that involved me being away from her all day for several days in a row, and we couldn't have done that as easily. Plus if you run out, you can just pick some up at Target or the drug store.

Let me repeat again and again and again: YOU DO WHAT IS RIGHT FOR YOU. Needing sleep is NOT TRIVIAL, NOT IN ANY WAY, so if pumping or feeding in the middle of the night is getting in the way of being a well-rested parent, keep that in mind and don't feel guilty about it. (We tended to trade off nights or instances based on how many times she woke up; usually it wasn't too bad since we went to bed late anyway and my husband can fall asleep more quickly than I can.)

Good luck! You'll do great! Congrats!
posted by St. Hubbins at 9:33 AM on January 6, 2016


I (dad) fed both of our kids for the one middle of the night feeding. Mom didn't wake up to pump - just pumped first thing in the morning. We did this starting very soon. I would guess that started at week 2 or 3 for baby 1 and day 5 or so for baby 2. It is easily the most wonderful thing I've done as a dad - Mom got a bit more sleep (even more necessary with the second) and they both bonded with me really strongly from the snuggle/bottle experience. Our second was down to only one feeding (mine) in the middle of the night by month 3 or so, and he was often as (if not more) soothed by me than his mom.

Daytime feedings it didn't make that much sense for her to pump and then give the milk to me to feed - but we did supplement some with formula eventually and I did all of those feedings (and any feeding while she was out of the house).
posted by lab.beetle at 7:34 PM on January 6, 2016 [1 favorite]


Just start pumping! My baby doc recommended that I start within the first month if i wanted my baby (now 6 months) to take a bottle. I'm so glad she suggested this, because I probably would have waited longer. It was so nice that my husband could do a feeding at night or just so I could take a break, and he liked to be able to do it, too. Gave him a chance to bond with just her while I slipped out for a nap or a movie. I think I went out for a movie when she was less than a month, because she already was comfortable with dad and dad feeding her. I'm still pumping a lot which does get old, but it's been worth it overall.
posted by Rocket26 at 6:20 AM on January 8, 2016


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