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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.

Combination Feeding: Bottle and Breast Feeding

Also known as mixed or partial feeding, combination or combo feeding means breastfeeding and bottle feeding at the same time and describes 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 combination feeding, we’re here to help. This guide covers everything you need to know before getting started with combination feeding.

What is combination feeding?

Put simply, combination feeding is when parents both bottle-feed and directly breastfeed their baby.

When bottle feeding as part of your combination feeding journey, you can use either expressed breast milk or formula, but remember that every parent and baby are different, and so is every infant’s feeding journey. So, you should always choose what works best for you and your baby.

What are the benefits of combination feeding?

Combination feeding offers lots of parents flexibility and gives other people besides mom 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.
  • Mom 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 direct breastfeed.

Before you begin combination feeding, you should be aware that bringing a bottle into the mix can sometimes affect the amount of breast milk you produce. Also, some babies might not breastfeed as well because they need to use a different sucking action when feeding from a bottle.

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.

When should I start combination feeding?

It's recommended that parents wait until their baby is comfortable with breastfeeding before bringing a bottle of breast milk or formula into the mix. You should speak to your health visitor before starting combination feeding.

Guidelines suggest that babies should be exclusively breastfed for the first six to eight weeks to help you 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 the baby their 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 nipple.
  • Stay patient and calm. It's normal for a baby to not accept a bottle right away.

You can find more bottle feeding tips here.

How to combination feed with a bottle and 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 combination feed with a bottle and formula

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

If you'd like to give your baby infant formula in a bottle alongside breastfeeding, it’s recommended that you introduce them to formula gradually. Not only does this give your body time to reduce the amount of milk it makes, 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.

Combination feeding using formula can reduce the quantity of breast milk you make, so you must carry on breastfeeding your little one and expressing using a pump regularly to keep your supply going.

  • 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 and never be tempted to use your breast milk as a substitute for water when mixing powdered or concentrated formula.

    • Before preparing a mixed bottle, you should wash your hands, clean your kitchen countertop, and make sure all your feeding equipment is sterilized.
    • 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 breast milk you’ve expressed. 
    • If you want to mix ready-to-feed formula with breast milk, you can pour it into the same bottle as your expressed breast milk right away, because ready-to-serve formula is already prepared.
  • Can I stop combination feeding and go back to breastfeeding?

    Yes, if you still have a good supply of breast milk, it’s possible to go back to exclusively breastfeeding if you want to. If this move is right for you, you should try to make the change gradually by offering your breast first and reducing the amount of formula you give your baby little by little.

    If you're struggling, don’t be afraid to ask your midwife, health visitor or a local breastfeeding support group or lactation consultant for help and advice. Remember, the more you express, the more you'll make, so continuing to pump and having lots of skin-to-skin time with your baby will help to boost your milk supply and encourage your baby to go back to only breastfeeding.  

  • What should I do if my baby won’t latch for breastfeeding after combination feeding?

    If you notice that your baby is struggling to latch during breastfeeds since you started combination feeding, you may find it helpful to ask your midwife or health visitor about the best bottle feeding positions and breastfeeding attachment methods.

    These can help avoid any confusion your baby may have between your nipple and the bottle's teat.

  • What should I do if my baby refuses their bottle after combination feeding?

    If your little one seems to be refusing to feed from their bottle, they've likely become used to feeding directly from your breast.

    To help encourage them, you could ask your partner or a friend or family member to give your baby the bottle instead – they'll be less likely to turn away from their bottle if they know your breasts are off-limit.