Season 1 / Episode 10 / Feeding

Feeding: Combination

This is the story of how we found a balance between breast and formula feeding that came with its advantages for mommy.

Two parts, one conversation

Part 1 The Moms

Feeding: Combination, with the moms

paula’s story

Every mom’s feeding journey starts and ends differently. It is unique as we are all unique; our needs, our wants and our priorities all vary from mother to mother and from child to child. I love that we live in a world of possibilities with choices to do what works best for us and our children. Options, having options, I think, help us balance those needs and meet those wants; it's just about finding the right formula that works best for us, no pun intended.

I never gave my children formula, but I tried to give them breastmilk in a bottle. Maya wasn’t interested, but Maddie was successful a couple of times when she was being babysat. Thankfully, my girls had no weight or drinking issues, so my breast was pretty much all they knew, which also had its confinements.

melissa’s story

Melissa’s feeding journey was quite a mixed bag. She has four children, accompanied by three feeding journeys, as a set of twins joined the party at the end. With every intention to breastfeed, Melissa gave birth to her firstborn, Ben, at 35 weeks, almost one month premature. Ben was born with a very high palette, which made it impossible for her to feed him at the breast. Although she intended to give him breastmilk, her only option was to pump, which she did exclusively for seven months. As soon as she started giving him solid foods, her supply started to dwindle, and she switched to formula to provide him with the calories he needed in addition to his food. With her second, Callie, she exclusively breastfed, and in addition to breastfeeding her, she would give a bottle of breastmilk every night before bed to get her accustomed to the bottle. Why? The freedom.

“mike and i are the type of parents WHO like to go out at night…”

Again, like clockwork, at the 7-month mark, her supply decreased, and Callie was switched to formula.

Next up, the twins. Melissa had just started her business, Melii, and was working full-time, which made it unsustainable for her to breastfeed two babies with the demands of her work, so she exclusively pumped both of them. And then…guess what, you got it! At seven months, her body said no more, and they were also switched to formula.

Don’t be fooled! Melissa shares that before becoming a mom and actually living her feeding journeys, she was completely convinced that breast is best and formula was a last resort. Until, of course, she had her own experiences.

“nobody tells you that the hardest part is feeding your child…”

Melissa says she realized only after she lived her experiences that no matter how her kids got their nutrients, as long as they were gaining weight, not crying and happy, that was good enough for her.

Francesca’s story

Francesca starts her story by telling us that her daughter Tessa was born at the start of the pandemic, which made for a pretty unique experience. She says that she definitely felt the pressure to breastfeed in the pre-birth classes, and being at the hospital alone, the nursing staff that would probably otherwise support her were occupied doing other things. In Quebec, a CLSC nurse comes to our house to check in right after the baby is born. In Francesca’s case, the nurse came to check Tessa’s weight gain and advised Francesca to supplement with formula as she thought her milk hadn’t fully come in yet. Francesca also tells us that Tessa was very slow at the breast and would fall asleep quickly, maybe not taking in as much nutrients as she would have liked. Being a first-time mom, Francesca was adamant about breastfeeding, but things didn’t go as she thought. Nights were particularly gruelling; she would be in pain and feed Tessa for an hour and a half to have her wake up hungry again thirty minutes later.

“i was breastfeeding her at one thirty in the morning, and i was just there crying…”

In despair, Francesca knew this was not sustainable for her or Tessa, so she started pumping. She admits that it was a game-changer; Tessa was able to feed faster, and her husband was able to help. What a relief! However, she noticed that Tessa was still asking for more than what Francesca could produce, and that’s when they decided to start introducing formula to supplement the bottled breast milk. They began with the nighttime feed and gave her a bottle with formula to top her up for the night. As you may know, breastfeeding being a supply-and-demand thing, her supply started to dwindle, and the pumping in the middle of the night was no longer a sacrifice that Francesca was willing to make. She needed to take care of herself to have the energy to feed Tessa and meet her needs, so she decided to feed Tessa formula exclusively at five or six months.

When Francesca’s son Brayden was born, she explained that once again, she was keen on breastfeeding, but having a bit of experience under her belt, she was not willing to sacrifice her mental health again in the name of breastfeeding.

“if this goes awry, i am going straight to the pump…”

Soon enough, breastfeeding was not going as planned, and Francesca embarked on her pumping journey once again. She was told that her supply would be the strongest at three in the morning, and that’s when pumping would be the most effective. She said to herself that she would tough it out for six months, and then when she would start introducing solids to Brayden, she would do the same thing as with Tessa and supplement with formula. After three months of pumping at prime time, she realized that she had a stockpile in her fridge, more milk than she needed on a daily basis.

“We have to start freezing this; IT’S way too much…”

Consequently, Francesca started to pump less and less as Brayden went through the stockpile they had in the freezer. Her supply started diminishing, and Brayden switched to formula when he started solid foods.

Although we hear about all the stigmas about formula around us, Francesca didn’t have a strong opinion on one way or the other before she became a mom. In her mind, as long as her babies are fed and the family's mental health is intact, they are golden.

moral of the story: every family has their own formula.

Up next in this episode Part 2: Naomi Berkowicz responds ↓

Part 2 The Specialist Responds

Feeding: Combination, with Naomi Berkowicz

Naomi Berkowicz, RD, IBCLC

Registered Dietitian, International Board Certified Lactation Consultant

Registered Dietitian, International Board Certified Lactation Consultant

This podcast delves into the shared experiences of combination feeding with lactation consultant Naomi Berkowitz, drawing on the journeys of Francesca and Melissa. It explores the introduction of solid foods at seven months and how it impacted their milk supply, as well as potential reasons for the milk supply dwindling, such as the return of the menstrual cycle and sensitivity to changes in breastfeeding or pumping stimulation.

navigating breastfeeding

Breastfeeding can decrease over time due to children eating food, which might make a mother feel there isn't enough milk. If you are concerned about your milk supply, consult healthcare professionals and monitor your baby's weight gain and elimination. Some mothers experience pressure from healthcare professionals to breastfeed, but others may receive support in using formula. At the end of the day, it’s what works for you and your baby. Naomi considers the factors that should be considered when deciding whether to continue breastfeeding or supplement with other methods such as formula or donor milk. Factors include the baby's overall health, weight gain, and the parent's ability to produce enough milk. The most important thing is that the baby is properly fed, and the method used is not as important as long as it is a safe food source.

supporting all feeding choices

Naomi underscores the significance of convenience and personal choice in breastfeeding and feeding methods for parents. She stresses the need for support and guidance in achieving individual feeding goals, whether it's breastfeeding, combo feeding, or using a pump. She also reiterates that there should be no judgment in personal decisions regarding family feeding, as it ultimately impacts the well-being of the child and the parent.

Naomi goes on to state that parents should make informed choices in breastfeeding versus formula feeding, acknowledging that both options have their own benefits and challenges. She emphasizes the need for clear information and decision-making free from external pressure or fear. Combination feeding shouldn’t be viewed as a “plan b”; rather, it should be a different path that could be explored to do what feels right for both the parents and their baby.

In the conversation, the question arises of whether breast milk and formula can be mixed. The answer depends on the goals and needs of the parents and baby, as mixing can impact the effectiveness of increasing supply or evaluating whether breast milk alone is sufficient. The topic of topping up before bedtime for better sleep is also discussed, with a more nuanced answer acknowledging that fuller babies may sleep better and recognizing that bottle-fed babies tend to drink more than breastfed babies due to the convenience of the bottle.

Relationship Between Feeding and Infant Sleep

Naomi explains that bottle-fed babies may consume more breast milk or formula and potentially sleep longer, but this is not guaranteed. Babies’ temperament, capacity to take milk, and digestion speed affect their sleep patterns. Formula and breast milk have the same amount of calories at the base, but breast milk can increase in calories based on the timing of the feed. There is a misconception that a mother's milk is not high in calories enough, leading to the need for formula. It is clarified that it is actually a quantity issue, not a calorie issue. The conversation also touches on pumping, its challenges, and the evolution of pumps over time.

As Naomi mentions throughout the podcast, there are various options for baby feeding, and she emphasizes the importance of safety and security. When people say, “Fed is best,” Naomi says, “Fed is required” by any means, route, or option, as long as it’s safe and works for you and your baby.