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Breast and bottle - can it be done? |
By Heather Welford
* You might give formula...
* Myths And Misleadings
Breastfeeding your baby and giving bottles of formula is called 'combination
feeding' or sometimes 'mixed feeding'. Many mothers try this with their babies,
either as a response to a problem, or because of convenience.
Firstly, though, the health facts:
Exclusive breastfeeding - with no water, no solids and no formula, just breast -
is still the healthiest start for your baby. It's what the World Health
Organisation say health professionals should be helping mothers to do, in all
parts of the world, because breastmilk alone is fine for the first six months of
a baby's life. As well as the excellent nutritional start, many studies indicate
that exclusive breastfeeding gives the best protection against the risk of
allergy.
Exclusive breastfeeding is the best way to maintain your milk supply, too.
Giving anything else can reduce your milk, because the more often your baby
breastfeeds, the more milk you make...as long as he is breastfeeding
effectively. Formula milk may take longer to digest than breastmilk, and this
means a longer gap between feeds. That can have an impact on your supply.
Breastmilk remaining in your breasts sends a hormonal message to your milk
production system, saying 'stop making milk'. So, if you introduce formula to a
breastfed baby, you will, inevitably, reduce your milk production. Your own milk
will dwindle, and in time, cease, so you are unable to give your baby a
satisfying breastfeed when he does come to the breast. This is especially likely
to happen if you introduce formula in the first weeks, when it is important to
establish breastfeeding. Some women can continue making some milk for a long
time, but this does vary.
Basically, the sooner you introduce formula, the quicker your own milk
production will reduce, and then disappear. If it's important for you to
breastfeed, remember that fully breastfeeding without formula gives your body
the chance to build up and maintain the right amount of breastmilk for your
baby.
Feeding is always much more than getting milk into your baby. It involves your
feelings, as well, and your life, as well as health considerations. There may be
situations where you need to think about giving formula as well - what might you
want to think about before you do so? And what are your options?
You might give formula...
• Because you are going back to work, and you want to make sure he will take
formula before you start back
Don't worry too far in advance! There's no evidence that babies have to get used
to a bottle at any specific age. If your baby does seem to reject the formula,
try with expressed breastmilk, and have someone else give the bottle instead of
you, when your baby is happy and alert; don't try to 'starve' him into
submission. Feeding from a bottle is a new skill, and your baby is likely to
learn it better when he is relaxed and not hungry.
Older babies can learn to take formula (or EBM) from a cup - try an eggcup if
you think an ordinary cup is too big, or if your baby doesn't manage to suck
from a spouted cup.
• Because you are now back at work, and your working hours don't allow you to
fully breastfeed.
Can you express at work, for your baby to have later? Older babies may not
actually need milk in the hours you are away, as long as they can breastfeed
when you are at home, morning, evening, night and at the weekend. Talk this over
with your health visitor or a breastfeeding counsellor.
• Because you want a break and to have someone else care for the baby when you
are not there.
Think about expressed breastmilk as an alternative, or solids if your baby is
old enough for them.
• To allow your partner to share the feeding.
- Fathers don't need to feel left out when you're breastfeeding. Dads can show
the baby love and comfort, and get involved in all the other tasks like bathing,
dressing, washing, nappy changing.
• Because you worry you don't have enough milk for your baby to keep him
well-nourished or happy.
If you are concerned about your milk supply, then more frequent feeding will
help ensure a better supply, as long as your baby is feeding effectively,
well-positioned and attached to remove the milk.
• To allow sore or cracked nipples to heal.
- Expressing can rest the nipples (in fact, you must express to make sure your
supply is kept up), and you need to amend positioning and attachment so your
baby's suck doesn't damage your nipples again. Ask your midwife or health
visitor about moist wound healing, to speed up repair, too.
• To feed the baby at night to help him sleep.
Think about co-sleeping with your baby to make breastfeeds at night easier (it's
safe as long as your baby doesn't get hot, neither you or your partner is a
smoker, or unable to care for your baby because of drink or drugs).
Very occasionally, there's really no alternative to formula. If breastfeeding -
for whatever reason - isn't working, then your baby needs to be fed somehow. If
you want to, you can revert to full breastfeeding once the crisis is over.
Sometimes, mothers feel that giving formula is a way of helping to keep
breastfeeding going - they need the break from the baby, or the feeding. They
may feel they need to sleep when the baby sleeps, and a bottle of formula may
increase the chances of this happening.
For some mothers, the responsibility of being the sole food provider is intense,
and worrying. They feel they want a reliable alternative from time to time.
So, if it's your choice to combine breast and formula, here's how to do it so
you can maintain your breastfeeding as well:
• Remember a bottle-feed will have an effect. In the short term, your breasts
may overfill and be uncomfortable; in the longer term, breasts whose milk is not
removed start to reduce their production. You can express while your baby is
having the bottle feed if this becomes an issue. Once breastfeeding is well
established, however, the occasional bottle is less likely to have a negative
effect - and when breastfeeding has been going for several months, your supply
is likely to withstand regular bottles without dwindling.
• Make top-ups (formula given after a breastfeed, usually to help a baby who
seems constantly unsatisfied on the breast) very small, and try not to give them
too often. The risk with top-ups is that they end up being given routinely, or
in response to any unsettled behaviour from the baby...and they then start
taking the place of breastmilk, as the supply winds down in response.
• Don't introduce a teat unless you are also working on ensuring the baby is
learning how to suck at the breast. 'Nipple-teat confusion' is more likely to
happen when breastfeeding isn't going well - the baby gets a productive bottle
and rejects the less rewarding breast. He's not so much confused as stating a
preference!
You can either give a bottle instead of a breastfeed, or in addition to a
breastfeed (this is called a 'top up').
If you are giving a bottle instead of a breastfeed, then your baby will need the
amount of formula appropriate to his age and size - check the packet for
guidance, though remember some babies need more, or less, than this.
If you are topping up, then check the amounts with your midwife or health
visitor. Remember, the more you give, the greater the impact on your breastmilk
supply.
Myths And Misleadings:
• "A baby who wolfs down a bottle is obviously 'starving'. "
Not necessarily! Some babies love to suck, and with a teat in their mouths, they
more or less have to suck or gag...they don't have the control they have at the
breast.
• "You ruin all the benefits of breastfeeding if you give any formula."
Nonsense. The more breastmilk the better, it's true, but the immune-boosting
antibodies of breastmilk, and the nourishment, are always there.
• "Your baby's digestive system will be affected by having two sorts of milk in
it."
No - not true. Most babies cope fine with breast and formula, though a few
really don't settle with formula, and may throw it back up. |
Source:
http://www.ukparents.co.uk/archives/breastbottle%20welford.shtml#Further%20Information
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