If you're looking to learn more about combination feeding, we’re here to help. Our handy guide will cover everything you need to know before getting started with combination feeding.
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.
The benefits of breast and formula combination feeding
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 abottle 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,
- extra teats in a range of flow rates
Top tips for successful combination feeding
To wrap up, let's cover some general tips and advice for mixed feeding a baby.
- Keep an eye out for your baby's early feeding cues to make sure they get a good breastfeeding latch.
- Don’t rush your baby during feeds.
- Continuing to pump and hand express to manage your breast milk supply.
- Monitor your baby’s poos to ensure they’re getting enough milk and are well hydrated.
- Speak to a lactation consultant if help is needed.
When reflecting on her feeding journey Danielle says, "[her] son did a little bit of bottle feeding and breastfeeding, but [her] daughter has not been interested in a bottle at all". She believes that "if breastfeeding doesn’t work out for whatever reason, it's ok. If your baby accepts a bottle, go with it. As long as they're getting their milk from somewhere, that’s what really matters".
Jessa and Jaryd told us that "as [they] were preparing for [their] infant feeding journey, [they] had been influenced by societal stigmas surrounding different feeding options. [They] decided that [they] wanted to learn about it more as part of our [their] journey". For them, it was a mixed journey and they implemented both bottle and breast.
Molly said that she "left the hospital in a routine of combine feeding, breastfeeding and formula feeding, and it worked for me and my baby. I was and am still confident that my choice was the best one for the both of us."
And Gianni believes that "regardless of if you nurse directly, pump and feed using a bottle, or formula feed, it is ok. If your baby is healthy, growing and thriving, it is ok".
Mixed feeding FAQs
Can you start mixed feeding from birth?
Health experts recommend feeding babies exclusively with breast milk for around six months. However, any amount of breast milk is beneficial and it’s ok to supplement it with formula if that’s what works best for you and your little one.
Can you mix breast milk with formula in the same bottle?
Yes, if you follow safe preparation guidelines, you can give your baby a mix of breast milk and formula in the same bottle.
If you decide to do so, you should follow the manufacturer's instructions exactly when preparing the formula, before adding your expressed breast milk. When mixing formula, never substitute water for your breast milk.
- Before preparing a mixed bottle, you should wash your hands and make sure all your feeding equipment is sterilised.
- If you’re combining concentrated liquid or powdered formula with expressed breast milk, you should read the manufacturer’s directions carefully and prepare the formula according. Then once the bottle is ready, you can pour in any of your expressed breast milk.
- If you want to mix your breast milk with ready-to-feed formula, you can pour it into the same bottle as your expressed breast milk right away, because ready-to-serve formula is already prepared.
What should I do if my baby won’t latch for breastfeeding after mixed feeding
If you're struggling to begin combination feeding, it can help to ask your midwife or health visitor about the best bottle position and breastfeeding attachment methods. These can help ensure your baby doesn’t get confused between your nipple and the bottle's teat.
Can I stop combination feeding and go back to breastfeeding?
Yes, if you still have a good breast milk supply, it’s often possible to go back to exclusive breastfeeding. If you decide to do this, try to make the change gradually by offering your breast first and reducing the formula you give your baby.
The more you express, the more you'll make. So, continuing to pump and having plenty of skin-to-skin contact with your little one will help to boost your milk supply and encourage them to go back to only breastfeeding.
If you're struggling, don’t be afraid to reach out. You can ask your midwife, health visitor or a local breastfeeding support group or lactation consultant for help and advice.