Mixed feeding: Breast and bottle feeding

Also known as partial or combination feeding, mixed feeding is when a bottle of formula or expressed breast milk is used to feed a baby alongside breastfeeding.

If you're looking to learn more about mixed feeding, we're here to help. This guide covers everything you need to know before getting started.

What is mixed feeding?

Mixed feeding is when parents both bottle-feed and directly breastfeed their baby. With bottle feeding as part of your mixed feeding journey, you can use either expressed breast milk or formula. Some parents choose to mix feed their little one because they're experiencing issues with breastfeeding or have a low breast milk supply.

Remember that every parent and baby are different, and so is every baby's feeding journey. So, you should always choose what works best for you and your baby.

There are many different approaches to mixed feeding, including:

• Breastfeeding and bottle feeding with expressed milk
• Breastfeeding and bottle feeding with formula
• Breastfeeding and giving both expressed breastmilk and formula in a bottle.

Combination feeding offers lots of parents flexibility and gives other people besides mum the chance to feed the baby using a bottle.

Some of the benefits of combination feeding include:

• Family and friends can be involved in feeding the baby
• Mum can get a break and have some freedom away from breastfeeding if she wants
• It can be handy if you're going back to work and plan on expressing breast milk to be given to your baby in a bottle
• If you're going away and need to leave your baby, they can still be given breast milk in a bottle
• You can monitor how much milk your baby is getting when you use a bottle
• Feeding using both breast and bottle means that you can still maintain your breast milk supply if you continue to pump and directly breastfeed.

The potential challenges of mixed feeding a baby

Before you begin combination feeding, consider the fact that bringing a bottle into the mix can sometimes affect the amount of breast milk you produce. Also, some babies might struggle to latch on or breastfeed because they need to use a different sucking action when feeding from a bottle.

Reducing breastfeeds can also increase the risk of getting sore nipples, blocked milk ducts, or mastitis.

Don't worry too much though. If you start bottle feeding your baby when they're a little older, you're both comfortable with breastfeeding and continue to breastfeed and express using a pump frequently, your breast milk supply shouldn't be impacted.

If you're concerned that you have a low breast milk supply, it may help to seek help from a lactation expert before you start mixed feeding.

When can you start mixed-feeding babies?

The WHO and UNICEF recommend exclusive breastfeeding for the first six months of life, and you should you should speak to your health visitor before you begin combi feeding.

It's recommended that parents wait until their baby is comfortable with breastfeeding before bringing a bottle of expressed breast milk or formula into the mix.

It can help for babies to be exclusively breastfed for the first six to eight weeks to help establish a good latch and a great routine. After this time, you can think about introducing a bottle if you want.

When you first introduce a bottle:

• Make sure that your baby is happy, relaxed, and not too hungry
• Ask someone else to give them the bottle - your baby might not feed from a bottle at first if they can sense that your breasts (and breast milk) are close by
• Try different feeding positions
• Use a bottle with a breast-like teat
• Stay patient and calm - it's normal for a baby to not accept a bottle right away.

How to combination feed

Mixed feeding may come easy to some but may be a bit more of a challenge for others. Let's run through how to mix feed with either expressed breast milk or formula.

How to mix feed with expressed breast milk

If you'd like to combine breastfeeding with expressed milk feeds, you'll need a breast pump to collect your breast milk to give to your baby in a bottle.

Parents often find that when they express breast milk in the morning, they're able to collect more in a shorter amount of time. But it's also worth noting that expressing at night helps to maintain your long-term milk supply, so try to do both if you can.

It's also important that you carry on breastfeeding or expressing regularly from each boob. If you don't, there's a chance that your boobs can become painful and engorged.

How to mix feed with formula

Before introducing formula feeds into your baby's routine, you should speak to your health visitor.

If you'd like to combine breastfeeding and formula feeding, it's recommended that you introduce your little one to formula gradually. Not only does this give time for your body to reduce the volume of breast milk it produces, but it also allows your little one's digestive system plenty of time to adjust.

If you're introducing formula feeds because you're going back to work, it can help to start combination feeding a few weeks in advance. Establishing a good combination feeding schedule can help you get into the swing of your new routine.

Breastfeeding works on a supply and demand process, so it's important to remember that the more formula you feed a baby, the less breast milk your body will create. Combination feeding using formula can reduce the quantity of breast milk you make, so you should carry on breastfeeding your little one and expressing using a pump regularly if you want to keep your supply going.

What you'll need to mix feed

Before you get started, you should make sure you have all the feeding equipment you'll need, including:

• baby formula
• a breast pump
• breast milk storage pouches, 
• bottles
• extra teats in a range of flow rates
• sterilisers
• bibs

Sources

• Mixed feeding: supplementing with formula | Raising Children Network
• Mixed feeding | Australian Breastfeeding Association
• Mixed feeding | Pregnancy Birth and Baby (pregnancybirthbaby.org.au)