Cate, it sounds as though you have been down all the right roads to keep on breastfeeding your DS, that's fantastic! It is quite difficult when you realise that you won't be able to breastfeed exclusively, and that some top ups will be needed. And TBH, I found it even more difficult working out just WHEN my DS needed those top ups!!! But it does get easier over time, and although we never really cut out the comp feeds in the first 12 months, we did manage to breastfeed for over 2 years! So it can be done .

I would suggest getting in touch with one of your LCs again, and having a session with them where they can go through with you how to read Zac's signs, and how to know when it's appropriate to 'top up'. I think that will be the most helpful thing for you by far. You WILL work it out, but it will take a little information, and practice. I know I certainly found it quite hard, it was probably the most challenging thing I encountered in my first year of parenting.

As for HOW - I would definitely recommend feeding on demand, and topping up according to need. The more breastfeeds you offer, the better, for all sorts of reasons. Nipple confusion is a real possiblity, it sounds as though you may be experiencing some of this already. Try to make sure that the teats you use are as slow as you can find, and pace the bottle feeds out to mimic a breastfeed as much as possible. Also, have a chat to your LC about other methods of comp feeding that might be suitable in your situation. Try to BF before he gets really hungry, certainly before he's crying, and even while he's still waking up. If you haven't already, chat to your LC about taking some motilium to help your supply along while you're bfing. Given your history, it might be something that can keep things going well for you. And lastly, check out this website BFAR - Breastfeeding After Breast and Nipple Surgeries and see if there's anything helpful for you there, and check out the links to their sister site lowmilksupply.

I hope some of that helps you. Good luck on your journey, and remember that we're all here to support you