Key Principles of comi-feeding

Adding a supplemental feed will have an effect on your own breast milk supply. Therefore, all things being normal, most health care professionals suggest that you don’t start to supplement until breastfeeding is established at two weeks of age. However, for some introducing a supplemental feed might be what is needed to maintain your breastfeeding. Every mum and baby is different, and there is not a one size fits all, so we shouldn’t take this approach with blanket rules on supplementing. Instead you should be aware of the principles and how and when to get help if you need it.

The theory in general is this: If you offer a bottle of formula instead of a breastfeed, then your baby will have a longer spell between breastfeeds. We know, as mentioned in physiology of breast feeding, that suckling and removal of milk from the breast stimulates milk production. Indeed, a breast full of milk will switch off the stimulation signal to make more milk, and milk is not produced. So if you introduce a bottle, and don’t remove milk from the breast, then your full breast will switch off the milk making button. So in theory, if you wish to permanently introduce a supplemental feed, then there is no need to try and stimulate milk production, your body will adapt to the dropped breast milk feed.

If however you are struggling with your milk supply, and you have introduced a supplemental feed as a top up, you need to ensure that you are still stimulating and removing milk from your breast in order to continually stimulate milk production. This is a tricky balance because ideally you would feed your baby first, then offer a top up, if they were still hungry, after your breastfeed. However, your baby is then likely to last longer until the next feed. So you may wish to express in between feeds, to stimulate supply, this however can lead to a less full breast, when the baby wants to feed again, and thus requiring an additional top up. Some mums supply is tight, with little leeway. These mums may wish to get additional help early on in order to maintain their supply.

Realistically, these mums will find themselves expressing and feeding around the clock, which is exhausting, and gives little time for anything else. Don’t underestimate the toll this can have on a mums mental health, so the earlier the help the better.