Combined feeding. When breastfeeding fails

Kombinované krmení. Když se kojení nedaří

The transition to parenthood requires many decisions. One of the most important is the choice of feeding method. The World Health Organization (WHO) recommends exclusive breastfeeding for children up to 6 months of age and even longer with the introduction of complementary foods. Statistics published by the Lactation League show that 16.3% of Czech mothers adhere to this recommendation. Most of them (63%) are forced to switch to combined feeding - a combination of breastfeeding and formula - for health or personal reasons.

Breastfeeding brings benefits to both baby and mother

Pediatricians and nutritionists consider breast milk for the healthiest feeding option (it is important that the diet of a breastfeeding woman is varied and balanced), which brings a lot of benefits for mother and child :

  • Breast milk is a natural source of all the nutrients a baby needs for growth and development.
  • Breast milk is easily digestible. Its sweet taste and creamy consistency are appealing to babies.
  • Breast milk is rich in antibodies that strengthen the baby's immunity.
  • Breastfed babies have a lower incidence of allergies, eczema, ear infections, and stomach problems.
  • Breastfed babies are less likely to be hospitalized with respiratory infections.
  • Breastfed babies are less prone to obesity or diabetes.
  • Breastfeeding helps prevent sudden infant death syndrome.
  • Women who breastfeed get back into shape faster after pregnancy.
  • Breastfeeding helps reduce the risk of breast and ovarian cancer, diabetes, and other diseases.
  • Women who breastfeed are in better psychological well-being.
  • Breast milk is always fresh and available at any time.

Although breastfeeding has many benefits, not every mother is able to do it. Recent research from the American Academy of Pediatrics found that 59% of mothers are not adequately prepared to breastfeed. 1 Insufficient milk supply, painful breastfeeding, breastfeeding twins or triplets, women returning to the workforce, medication use, stress, exhaustion, problems breastfeeding on the go or in public, hunger, restlessness, slow weight gain or weight loss in the baby, and other health and personal reasons lead parents to feel pressured to breastfeed. Supplement the child's natural nutrition with infant milk .

You know that... In a recent survey, 8 out of 10 new mothers who were unable to breastfeed their baby said that combined feeding allowed them to extend the duration of breastfeeding 2 .

How to switch to combined feeding

Breastfeeding regularly, at least eight to twelve times a day, helps you maintain a healthy milk supply, especially in the early weeks.

If you have decided to supplement your baby with formula, you should be aware of all the aspects associated with your decision. Be aware that formula does not adapt to the changing needs of the baby, its preparation requires more time and financial costs. In addition, early feeding with infant formula is associated with the risk of reduced breast milk production 3 .

Don't rush the introduction of breast milk. Gradually reduce the number of feedings to minimize the risk of breast engorgement and inflammation of the mammary glands. You can start by skipping one feeding and offering your baby a bottle of expressed or pumped breast milk.

You know that... Breast milk contains more than 1,000 proteins that help your baby grow and develop, activate their immune system, and develop and protect neurons in the brain 4 .

From the recommendations of experts:

  • Offer your baby a bottle of milk when he is relaxed, not tired, or too hungry.
  • Use a slow-flow nipple that mimics breastfeeding.
  • Express milk regularly between bottle feedings to maintain your milk supply.
  • Focus on your baby throughout the feeding. Remember that this ritual strengthens the bond between you.
  • Be patient. Some babies need more time to adjust to the transition from breast to bottle. Your baby will take a bottle when he is hungry, so don't worry about not getting fed if you can't breastfeed him.
  • Separate breastfeeding times from feeding times. Remember that babies don't like change. That's why it's important to teach them a daily routine.
  • Make a support plan. Being a new parent is exhausting. Especially if you are working or need a well-deserved break. You can ask a family member or close friend to help you with babysitting and feeding your baby.
  • Choose a quality formula that suits your baby's age and needs. A pediatrician or nutritionist can help with recommendations.

Proteins, carbohydrates and fats make up 98% of quality dairy nutrition. Prebiotics, probiotic bacteria and HMOs (breast milk oligosaccharides) have a great influence on your baby's comfortable digestion . Although most infant formulas are modeled after breast milk, not all are the same 5 :

  • Dairy nutrition based on cow's milk. It is the most preferred milk option. According to Healthy Children, it represents 80% of the infant formula market. It is based on cow's milk with milk sugar (lactose). It is modified to be easily digestible and meet the nutritional needs of the baby. Some formulas are enriched with other beneficial substances, such as prebiotics, probiotics and nucleotides. Infant formula containing probiotics and lactic acid bacteria supports the growth of good intestinal bacteria, strengthens immunity and stimulates bowel movements.
  • Dairy nutrition based on goat's milk. Goat milk formula is suitable for infants who are intolerant to cow's milk.
  • Hydrolyzed milk nutrition. It is intended for children with special nutritional needs, its selection should be consulted with a pediatrician. It contains more digestible – partially or extensively digested (predigested or hydrolyzed) milk protein. Milk with partially digested protein is suitable for diarrhea, tummy aches, problems with blinking, constipation or colic. Milk with extensively digested protein is intended for babies with an allergy to cow's or goat's milk proteins.
  • Organic dairy nutrition. It is based on standard infant formula, but the base is organic milk.
  • Soy-based milk nutrition. This type of milk is sometimes recommended for children who are unable to digest lactose or is chosen by vegetarian/vegan parents.
  • Special milk nutrition. It is intended for infants with specific disorders or diseases, including premature babies. It is given on the recommendation of a pediatrician.

When choosing milk, focus on the composition

The best infant formula is the one that suits your baby . It should be adapted to your baby's age and individual needs, especially dietary or allergy restrictions. Consult your pediatrician about the choice of formula.

Your baby will tell you when it's time for a change.

You can tell if your baby is not getting the right amount of breast milk by looking at these 8 signs:

  • excessive blinking
  • very slow weight gain
  • nervousness after feeding and during the day
  • loose stools, blood in the stool
  • constipation
  • allergy symptoms (eczema, swelling, skin rashes, hives, wheezing, etc.)
  • poor sleep pattern
  • bottle refusal

Resources:

1. https://www.babycenter.com/baby/breastfeeding/can-i-mix-breast-milk-and-formula_8883

2. https://www.sharp.com/health-news/when-breastfeeding-doesnt-go-as-planned

3. https://pubmed.ncbi.nlm.nih.gov/16140702

4. https://www.medela.com/breastfeeding/mums-journey/breast-milk-vs-formula

5. All milk on the market must comply with mandatory legislation, or their composition must meet the legislative minimum.