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Combining Breast and Bottle Feeding

It was an easy two-hour drive to Scranton, PA, with her 10-week-old son, Connor, snoozing in his car seat, and the actress and writer Amy Wilson was ready for her performance in The Vagina Monologues, the hilarious play about--well, you know what it's about. It would be her first time working since before Connor's arrival, but her parents lived in the area, so her mom was on call for babysitting.

Despite some reflux, Connor had been a champion nurser. Wilson had yet to get him to drink any breast milk out of a bottle, however. "I was sure that once he was hungry enough, he'd eat. Of course he would," says Wilson.

He didn't. Eight hours later, Wilson returned to find her mother holding a wide-eyed Connor, who had refused to drink even an ounce of milk from the bottle--he'd gone purple with anger at the sight of it. "I had listened to all the experts the first time around who warned of 'nipple confusion' if even one bottle was introduced too early," recalls Wilson. "But I'd waited too long, and he never wanted any part of it. If I had to leave him for a funeral or a meeting or a haircut, he'd simply not eat until the moment I returned."

By now, you've surely heard that "breast is best." Breastfeeding is the ideal way to feed your child for the first year of life: It provides optimal nutrition and is a fantastic way to bond. It may reduce rates of childhood obesity, diabetes, and ear infections, among other health benefits.

The only downside to nursing is that it may be hard: It can be physically exhausting and challenging to learn how to do it. "The fact is, breastfeeding is easier for some women," says Marianne Neifert, M.D., author of Great Expectations: The Essential Guide to Breastfeeding. "Some women put in a lot of effort and they might not produce as much milk as someone who puts in less effort." Add to this the fact that new moms don't get a ton of breastfeeding instruction during their short stay at the hospital, employers aren't always supportive of pumping, and much of America gets icked-out when a mom nurses at the mall. But before you throw in the towel, realize there's no one right way to feed a baby. You don't have to breastfeed exclusively--you can combine it with bottle-feeding in a routine that works for both of you.

If doing a combo of the two means that you're happier and saner, then you should do it--without worrying about what anyone else thinks. "Maybe more women would make it to a year of breastfeeding if they could go see a movie every once in a while," says Wilson, who recently wrote When Did I Get Like This? The Screamer, The Worrier, The Dinosaur-Chicken-Nugget Buyer and Other Mothers I Swore I'd Never Be. Here's how to make the most of both feeding methods so you can get some rest, go to work, and maybe even get out to see that movie.

Gear Up

Your little sucker might have a preference when it comes to bottles, so you may need to try a few different types before you hit on the ones he likes best. Just be sure the ones you try are free of BPA, a potential toxin.

If you're hoping to pump breast milk on a regular basis (you're going back to work, for example), you'll want a double electric breast pump. While they can be pricey (they average about $300), you'll soon save that much in formula expenses. If you're going to supplement with formula and won't be expressing much, a less-expensive manual pump will do the job.

Not sure how you'll feel about pumping? Try it out by renting a hospital-grade electric pump for about $75 a month. Ask at your hospital or find locations near you at Medelabreastfeedingus.com. Another great tool to have is a super-convenient hands-free bra/bustier, which means that you can e-mail, eat lunch, or entertain your toddler--all while pumping! (Sounds strange, but trust us--it makes a huge quality-of-life difference.) Or you can get the same effect by cutting two vertical openings in a sports bra to hold your pumping cups in place.

Get Ready

The idea of "nipple confusion" (the notion that once a baby is fed from a bottle, he'll never accept the breast again) has been largely debunked. The general guideline is that you want to wait until your milk supply is established, usually around two to three weeks after birth, and your baby is feeding well before introducing a bottle. But there aren't any hard-and-fast rules. Some moms successfully introduce a bottle almost as soon as they come home from the hospital.

However, it's also possible to wait too long, says Susan Burger, a lactation consultant in New York City. Since babies start to get more socially aware around 6 weeks and become more specific about their preferences, some will balk at or even refuse the bottle if it's introduced much after this age.

A good time to introduce those first few bottles is during the second feeding of the day, when your baby is hungry but not starving, and likely to be in a good mood. It can also help to have your partner or Grandma feed your baby the first bottle, so that your boobs aren't there to tempt him.

Pump Like a Pro:

To maintain your milk supply at your current level, just turn to your pump whenever you would normally nurse your baby. If you want to stock up on extra milk, add in a pumping session. In fact, you may want to start doing this a few weeks before you return to work, so you have a nice starting supply. You'll have the most milk in the morning, so if you pump right after your morning feeding session, you can save that milk for later.

Supplementing Secrets:

If it's not realistic to pump at work or you can't do it as often as you need to, supplement with formula. Most babies will do fine on a regular cow's-milk formula, but ask your pediatrician what she recommends for your baby. Start by replacing just one feeding session with formula, and drop that nursing session. If you feel like your breasts are going to explode, you can pump a little bit to relieve the pressure and make it to your next feeding. (If you completely empty your breasts, that will just send a message to your boobs to produce more milk.) The ideal is to drop one nursing session a week; otherwise, you'll be at increased risk for clogged milk ducts and mastitis. Some women, however, find that they can get away with dropping a feeding every four or five days (you may want to write it all down to keep track, especially if you're still sleep-deprived!).

When her second son, Seamus, was born 18 months after Connor, Wilson introduced the bottle early and often, and he switched easily between the two. "So many women give up on breastfeeding after just a couple of weeks because it's hard and because it seems like it's all or nothing. No one tells you that it gets easier, that your partner can be on duty without your baby being warped, and that you just may come to love nursing," says Wilson. "I think if there were less judgment, more support, and more open conversation about 'doing the combo' of nursing and bottle-feeding, many women would breastfeed longer. And that's a win-win for everyone."

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