Breast, Bottle or Both?

Ellie Jameson - 6 Aug 17

I’m here to talk about combi-feeding.  Not to tell you that it’s good, or bad, but simply that it’s out there, it exists and it can work.

My personal story starts like this.  I always thought (rather arrogantly in retrospect) that I would exclusively breastfeed my baby.  I’d done the research, been to the classes and even bought the expensive purple nipple cream, in anticipation of cracked nipples.  When my first daughter was born, despite her arrival being the opposite of the zen home-birth I had planned, she latched on right away, and everything was perfect. I checked out of the hospital shortly after she was born, and home we went, to start our new life as a family.

And then came the weigh-ins. After 5 days she hadn’t lost too much weight, so home we went. I continued feeding. In all honestly I was finding it quite easy. I didn’t even need the purple nipple cream! At the 10 day check, however, she had lost more weight. Not a lot. Maybe 2oz, but enough for my Midwife to express concern, put me on Domperidone (a prescription drug for digestive issues I think, that had the side effect of apparently making you produce more milk), tell me to express after every feed and rather forcefully suggest I attend her breastfeeding clinic.

We struggled on for a few more days. I tried expressing but the baby wanted to feed most of the time, and when she wasn’t feeding she was asleep on me. I only ever got an ounce out of the pump. It was sole destroying. I tried other pumps, but they made no difference. I attended the breastfeeding clinic every few days, but I didn’t find it supportive. I was told that the baby’s latch, or my positioning, were wrong, only for them to be checked and confirmed to be correct. The baby’s weight plateaued. My mood took a nose dive.  The group leaders (including my community midwife, the local breastfeeding guru) were frustrated that they couldn’t sort it out, and I took this very personally. I felt like they hated me and the baby, because we didn’t follow the rules.

It all came to a head a week or so later, when I was at the breastfeeding clinic for a weigh-in and she’d lost weight again. The look on the midwife’s face.  It made me feel like the worst mother ever. She referred me to a pediatrician (it was a Friday so we couldn’t go until the Monday morning) and then suggested, like it was the most disappointing and hideous thing ever, that I could try the baby on some formula.  She looked both disgusted and heartbroken at the thought.

I went to Asda to buy the formula, and then I went home and cried. The baby wouldn’t take it. I cried some more. I rang my husband in despair. And then I rang a friend who cheered me up, by taking me shopping for comedy baby clothes in TKMaxx, and I realised that, in the grander scheme of things, this wasn’t really the end of the world.

Over the weekend I persevered with the formula. The baby did start taking it, but she puked all over herself if I gave her more than 2oz at a time.  We worked out our own pattern, where she had a few top ups in the day, but in the evening and at night I would just breastfeed her, as she wanted the closeness.

I went to the paediatrician’s appointment with my mum, both of us ready to fight if we needed to. But after seeing a nurse, who weighed the baby and said she’d put on 8oz over the weekend, and a registrar, who was lovely, the first person to actually listen to me and reassure me that I was doing OK, it transpired that the paediatric consultant had bigger fish to fry and just wanted to discharge me, so he could carry on being very busy and important.  I went home, studiously avoided weighing the baby in public, and me, my baby, my boobs and the formula, lived happily ever after.

So why am I writing this?

Firstly, and most importantly, because nobody talks about combi-feeding.  There is no information on it anywhere. Every piece of information you are given states you WILL have enough milk.  Everything you read tells you that if you offer your baby a bottle, when you are breastfeeding, the baby will never breastfeed again.  Everything suggests that even a small formula feed will cause your milk to dry up.  The reason I cried, when I was told to introduce formula, was because I felt it meant I had to stop breastfeeding.  That was the impression I had been given.

But it couldn’t have been further from the truth.  My daughter continued to breastfeed until she was 15 months old. We gradually phased out the formula as she began to eat more solid food. But without the formula, where would we have been? In hospital with her failing to thrive?  Me looking online for milk donors?  That would have been a horrible start for us both.  Call me selfish, but I wanted to enjoy my new baby, and sometimes you have to think about what is best for everyone.

I’m also writing this because combi-feeding has given me a lovely perspective on being a mum. I have had the disapproving glances and comments, as I have breastfed my baby in a public place.  I have also had the random strangers saying how nice it is to see it, and the bonding with other mums over finding breastfeeding friendly dresses (and how much it hurts when the baby practices the pincer grip on your other nipple!).  I have had the uncomfortable feeling of taking a bottle out in a room full of breastfeeding mums, and I’ve had the cold stares as I have bought formula in the supermarket, but I’ve also had many a lovely conversation with mums who couldn’t or chose not to breastfeed, about how they’ve coped with it all.

So in many ways I am lucky. I am lucky that I have seen both sides of this story and know the highs and lows of both too.  I am lucky that my baby grew, without incident, into a healthy, strapping 5 year old, who sometimes speaks to me like I am her child.  I’m lucky that, when I had my two subsequent children, and the exact same thing happened with both, I had the confidence to say, ‘leave it to me. I’ve got this,’ and return to the weigh-in clinic a few days later with the evidence of a baby that was steadily gaining weight.

The other reason I am writing this, is that I believe, for many of us, the current guidance isn’t working.  It can feel threatening and terrifying when you are told that your baby will be physically, developmentally and accademically held back if you don’t succeed at breastfeeding. I was told, as a new mum, that breastfeeding was easy, and that anyone who stopped was just giving up, or not trying hard enough.  I was told that supply and demand would ensure your baby was getting enough milk, so long as you let them feed whenever they wanted.  But I was feeding my daughter ALL the time, and co-sleeping (whilst my nipple was in her mouth) through the night, and she was slowly starving.  I felt like a freak.  I’d been led to believe this never happened, but the more I spoke to people about my situation, the more common it seemed to be.

My mum gave my brother an occasional bottle, when he hadn’t regained his birthweight at 6 weeks. She was so embarrassed and worried by how thin he was, she refused to go to his 6 week check, sending my dad in her place. My aunt gave my cousin one bottle of formula a day when they began to struggle with weight-gain.  Both my grandmas gave one of their children porridge at 10 days old when they couldn’t be satisfied with breastmilk alone (don’t try this one at home though!).  I found friends whose children had slipped steadily down the centile charts… colleagues who had been frightened to attend the weigh-in clinics.  Yet all these women still continued to breastfeed.  They just were’t doing it exclusively.

And what about the women struggling with cluster feeding in the evening, or those who have to go back to work early, or those whose nipples are in agony, or those who simply really need to sleep? If, psychologically, you are really struggling with breastfeeding, one formula feed a day might be enough to give you the mental energy to keep going.

I’m not here to persuade anyone who is exclusively breastfeeding to stop, or anyone who is formula feeding that they need to give breastfeeding another go.  All I’m saying is that if you’re struggling (whether that’s struggling with a ravenous and increasingly skinny baby, struggling to sleep, struggling with your sanity, struggling to feed in public or struggling with a nipple that’s falling off) there may be a middle way, and that middle way might just keep you breastfeeding longer…

Ellie Jameson

Hi, I'm Ellie, Wife, Mum to three little girls, part-time teacher, part-time illustrator and part-time stay at home mum (if such a thing exists!). Life is busy but good. I'm based in Cornwall, UK, which is beautiful, especially when the sun is out. We love escaping from work and having adventures in the great outdoors.

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