Ah, combo feeding. Some feel it’s the best of both worlds; others feel its the worst of both worlds. In my opinion, combo feeders are left out of the conversation more than anyone else in the infant feeding debate. This is unfortunate for obvious reasons, but it’s also just plain stupid – because who better to help heal the us vs them nature of this discussion? They understand how it feels to nurse in public, and to love the act of breastfeeding so much that you can’t understand why anyone wouldn’t want to. They understand how using formula has nothing to do with how good a parent you are, how it can mean a full baby and a calm family, and how public health messaging can make you feel like unless you’re exclusively breastfeeding, you may as well not even try.
They understand all of this. So maybe it’s time that everyone tries to understand them. Reading Anna’s story is a good place to start.
Happy Friday, fearless ones,
A year or so before I got pregnant with my first child, my sister-in-law, a nurse in training, took a class about infant care and came over, bursting with information about breastfeeding. By the end of that conversation I felt guilty about not breastfeeding my non-existent child. I was on anti-depressants at the time, and knew that if I had a baby, my chance of developing post-partum depression was automatically higher, and that many anti-depressants were not compatible with breastfeeding. The ones I was taking, that worked for me, were not.
Then I got pregnant and got off of my meds around the same time. I started reading up on breastfeeding. I was asked at my first pre-natal appointment if I planned to breastfeed. At that point, I was willing to give it a go and hoped that it would work. I ran across Bottled Up, and read it avidly. It helped me come to terms with the possibility of formula-feeding, but I still wanted to make breastfeeding work if I could.
When I gave birth, after nine months of morning sickness and several months of gestational diabetes (which forced me to be very careful about what I ate), I had a tiny child who took a day or so to realize that the breast was where the food came from. Then she got pretty excited about it and wanted to eat constantly. At one point, in the middle of the night, she wanted to eat again right after a feeding. I’d been going to get some rest while my husband looked after her. I was exhausted, still sore from giving birth, and my nipples hurt. I punched the wall. Then I got myself settled and fed my daughter again.
We got into a routine: she’d eat every two hours or so at night, and during the day, she’d eat a little more frequently. It felt like all I did was breastfeed. My nipples were still sore, and getting worse, and it turned out I had thrush. A trip to the doctor got me a prescription for drops for her mouth and cream for my nipples, and a suggestion that we go to the public health unit to weigh her before and after a feeding to see how much she was getting, since she was barely back to her birth weight at a month old. The doctor was careful to reassure me that everything else was fine with her, and that I was doing everything right.
The nurse was the same, but after a feeding where she was so fussy we spent most of the time wrestling with her and trying to get her to calm down enough to eat, my daughter had gotten a grand total of 5 grams of milk. I’d already upped my fluid intake and started doing breast compressions while feeding her, and the nurse suggested a few more things to do to up my supply. I also went back to the doctor for a prescription for Domperidone. He told me that we might just need to supplement, and gave us some of the sample cans of formula he had lying around the office. My husband and I talked things over and decided to give the medication a few days to kick in and then we’d check her weight again.
After three days on the medication, which didn’t seem to be making much of a difference, I walked her over to the public health unit, plopped her on the scale and stared at the numbers. I had last weighed her on Monday. This was Friday. In those five days, she had gained one ounce. One! At a time when she was supposed to be gaining somewhere between 5-8 ounces a week (at least, that’s what I gathered from WHO and a couple other sources) and had spent hours of each day on the breast!
My body seemed to be capable of making enough milk to keep her going and to get her gaining a little bit of weight, but it just wasn’t enough. I was almost relieved when I stared at that scale and knew for sure that we needed to supplement. We weren’t going to give up the breastfeeding, but knowing that someone else could give her a meal too took a lot of pressure off of me. It was frustrating knowing that my body wasn’t quite up to the task, but given that my body’s response to pregnancy was copious amounts of vomiting, followed by diabetes, I wasn’t entirely surprised that my body wasn’t entirely cooperating with breastfeeding.
When my husband got home from work that night, I mixed up a bottle, handed it to him, and he fed our daughter. She looked a little confused by the whole thing, but she happily downed a few ounces of formula and then dozed off for the first time in hours.
Has it made a difference?
She’s sleeping better. She’s happier when she’s not eating because she’s not constantly hungry, which means I can set her down for a few minutes without her crying about it. She’s going through even more diapers than before and is back to pooping daily, rather than every couple of days. The poop smells weirder with formula, but I’ll happily take a smellier child over an underweight one.
The Monday after we started supplementing, I headed back to the public health unit to use their baby scale. I’d had to give her a bottle earlier because she’d emptied out my breasts and was hungry and my body wasn’t replenishing the milk quickly enough. She’d dozed off right after that. I was actually able to put her in the stroller and be the mother with the sleeping baby, rather than the screaming one. When she woke up while I was taking her clothes off before plopping her on the scale, she was happy and for once, didn’t cry about it. I was hoping desperately for a weight gain of at least 3 ounces, something to get us almost to six pounds. I set her down and then I stared at the scale. Then I blinked and looked again.
Six pounds, four-point-seven ounces.
Over the weekend, she had gained almost half a pound. This was the difference that the addition of 6-8 ounces of formula per day made. I almost burst into tears of relief right there.
So now we are combo-feeding, or mixed feeding, or whatever else it’s called. I’m going to breastfeed as long as we can (or until we hit a year, because I doubt we’ll want to do it longer than that), and as much as I can, but she’s probably still going to get a bottle or two per day unless my milk supply suddenly and drastically increases. She’s content with different kinds of bottles and different kinds of nipples, the basic infant formula appears to be fine with her, and she doesn’t have a problem switching back and forth from breast to bottle. As I write this, she’s attached to my breast, but she’s getting a bottle at her next feed when my husband gets home from work.
I’ve definitely had moments of angst and frustration that my body’s not enough, but it’s been mingled with relief that she’s no longer hungry all the time and that she’s finally gaining weight. My tiny child now has ribs that don’t stick out, and legs that don’t look like sticks. She’s going to be okay, so we’re all happy.
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