Another solution to the One Bottle of Formula Just at Night question 
might be to suggest that the mom express the leftover milk in the 
breasts after breastfeeding throughout the day, store it up in the 
fridge, and then supplement with her _own_ milk at night.  I used to 
have quite a lot of clients who liked to do this so as to either give 
themselves a break during the night, or to use their own milk as a 
top-up during that marathon nursing session which seems to occur in 
the early evenings (often known as "colic", when the baby becomes 
frantic and hysterical when not at the breast, but if accommodated 
then eventually passes out and sleeps for 5 hours at a stretch).   I 
would warn mothers though not to go too long without draining the 
breasts, ie to wake the baby up to breastfeed after 4-5 hours or any 
time the breasts were becoming too full.  This used to work very well 
for mothers in the first couple of months who were convinced that 
they were not getting enough sleep.  The easiest time to express the 
extra milk is in the mornings, because the breasts seemed fuller then 
(after sleep ...) and the least easy time to express is in the 
evenings.  But expressing a little bit here and there will easily add 
up to whatever the baby takes at a "feed" (whatever that is 
...).  Most mothers can manage to express at least 100 ml extra a day 
like this.  It's certainly preferable to altering the baby's pristine 
gut and spoiling the mother's exclusive breastfeeding record 
(something she needs to be cheered on about!)  by introducing formula.

Pamela Morrison IBCLC
Rustington, England

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