Combination Feeding: What It Is & How To Do It

Most parents make the choice between breastmilk or formula when they have a baby, but for some people, it might not be as straightforward a decision.

There are many reasons that parents might choose to try mixed feeding for their baby, and we'll try to outline a few of them for you so that you are best-equipped to decide what is best for you. There are definitely pros and cons to full-time breastfeeding or to changing up your baby's feeding routine.

It's important to make the decision to start mixed feeding from a positive place as this can be a great thing for you and your baby. Choosing to start mixed feeding because you're too busy when you still want to breastfeed your infant can cause stress and strain, and be hard for both mother and baby. Working out a routine for both of you that works every day will be key to making the most of combination feeding.

While you're here, why not check out our article about why baby ear protection is so important or if you can put cereal in a baby's bottle?

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The term combination feeding refers to when parents choose to combine breastfeeding with bottle feeding, instead of choosing exclusively one or the other. It might be something you want to consider if you are breastfeeding and want to have some flexibility with a partner.

If you are feeding your baby formula, but wanting to transition to breastfeeding, it could be a good choice to transition gradually. When you need to leave your baby for long periods of time, it might also be easier to do combination feeding than solely breastfeeding.

It's important to know that if you start to introduce formula feeding to your baby, you might find your own breast milk supply becoming less over time. However, if you start bottle feeding your baby after they are a few months old, your breastmilk supply probably won't be affected.

There have also been studies to show that babies might not be able to breastfeed as easily if you alternate breastfeeding and bottle feeding because they will learn a slightly different sucking action when they are using a bottle compared to a nipple. This is why it can be slightly more complicated to alternate formula feeding with breastfeeding while your baby is very young.

You might choose to begin combination feeding breastmilk and formula to your infant as it allows you to let your partner or a nanny feed your baby some expressed breast milk from bottles, or formula, for a bit more flexibility and less reliance on you. It will also allow you to have a stored breast milk supply for your baby in case you can't feed them from the breast for any reason.

If you would like to feed your baby both breast milk and formula, or breast milk from the bottle and nipple, then there are ways that you can do this.

It's recommended to stick to exclusively breastfeeding your baby for the first few weeks (rather than start with mixed feeding) to make sure you and your baby are both completely comfortable and happy before you start introducing a different type of feeding.

Mixed feeding can be completely safe and healthy for your baby, but it could cause issues for your health. When you alternate between breastfeeding and bottle feeding, then you might be more at risk of health problems like engorgement, mastitis, and blocked ducts, which can be very painful and can cause you problems when it comes to breastfeeding your baby later down the line.

If you've decided to combine breastfeeding and bottle, you might be thinking that it's going to make your life easier, but in reality, it can actually end up being a lot more work for parents. Mothers who are breastfeeding will still need to pump to make sure they are regularly removing milk from their breasts. Also, buying formula milk, sterilizing bottles, and making up bottle milk can be very time-consuming when you are trying to juggle both types of feeding.

If your breastfed baby is also drinking formula milk, then your breasts will make less milk to adjust to that. This can affect your milk supply in the long run, so you may need to express breastmilk each time that your baby has formula to reduce the impact that formula feeding has on your milk supply.

There is also the risk that if you choose combined nursing, your baby might choose the formula bottle over breastfeeding, and it could end up that they completely refuse to breastfeed. It might make it difficult for them to latch on and accept your breast when you want them to.

For these reasons, it's usually recommended for new mothers to try breastfeeding for the first few weeks to get their baby comfortable before attempting mixed feeding with formula.

If you have been breastfeeding your baby exclusively for a few months, then you might be tempted to move to combination feeding. It can be a lot easier to manage and can take some pressure off of mom to always be providing every meal. Combining breastfeeding with formula will allow your baby still to get the benefits from breastmilk with a little bit less pressure on mom. Here are some of our top tips to support parents making the move to combination feeding.

To start introducing your baby to formula milk from a bottle, it's a good idea to do this gradually over time. This will hopefully prevent you from having painful breasts that are swollen, or suffering from a condition like mastitis.

If you've made the choice to start combination feeding so that you can go back to work or leave your child for longer hours at a time, then we recommend starting a few weeks before you change up the routine, so that your infant is able to get used to the change. If you know your baby might need to be fed milk from a bottle later on, then it's a good idea to introduce a bottle on one or two feeds when they are between four and six weeks old, so they will be more adaptable to different kinds of feeding.

Babies that are older than six months old might be able to drink milk from a cup. If this is the case, you might be able to skip the bottle stage altogether and go straight to the cup.

Parents will often have a few issues with their little one getting the hang of bottle feeding if it is introduced after they're a few months old. This is because the bottle is a slightly different shape from the nipple, and it requires a bit of a different sucking action in order for them to get the milk that they need. This is known as 'nipple confusion' and can be a real issue for parents when combining nursing their infant with formula feeding. You might find it easier to give your baby a bottle when they are relaxed instead of the time that they're usually hungry so that they are less likely to get frustrated if they can't get their usual milk supply.

If you are still struggling to get your baby to bottle feed when they usually breastfeed, then it might be a good idea to ask someone else to give your baby their first few bottle feeds so they don't smell your breastmilk. Differentiating bottle and breastfeeding with different positions for each could also help them to adjust.

When you are transitioning to combination breast and formula feeding, make sure you are expressing your breast milk with a pump regularly so that you keep releasing prolactin, which encourages your breast to keep making milk. A good amount to pump is around eight times a day, with one pump during the night too. If you don't want to start using an electric pump, or you find it difficult to pump with, then you might find it easier to pump by hand at the beginning.

Try holding your baby close to your body while you bottle feed, with their skin touching yours. Try to encourage skin-to-skin contact with your baby as much as you can, which will also encourage your body to keep making enough milk supply.

Instead of starting off with the number of bottles you want your baby to have in a day, try to make the change gradually over time.

If you are trying to transition from formula milk to breast milk, then you may want to think about investing in a lactation aid or supplementer, which is a tube that sits alongside your nipple so that your baby can get enough milk when breastfeeding while they're getting used to the new technique.

Sticking to a mixed feeding schedule could make nursing your new baby much easier, so here's an idea of a sample schedule that you could use when you are feeding your baby a combination of breast milk from the breast and bottle and formula from a bottle.

Please note that healthy babies will usually tell us when they're hungry, so it's important to let them take the lead on when they are ready to eat. Feeding should happen roughly every two to three hours, though some babies will require it more often than that. For example, when your baby is a newborn, you will need to pump or feed your baby more often than this, because the milk is still mostly colostrum. This is a sample schedule and must be adapted to the needs of each individual baby.

6:00 a.m.: Mom wakes up and pumps for 20 minutes.

7:30 a.m.: Baby wakes up and gets into bed with mom for a breastfeed.

8.30 a.m.: Baby has a nap.

10 a.m.: Baby wakes up from a nap and breastfeeds again.

11.30 a.m.: Baby has another nap.

1:30 p.m.: Baby will be breastfed again.

5 p.m.: Mom will breastfeed baby again.

7 p.m.: Baby is given 120 ml of formula milk, and mom will pump.

10 p.m.:  Baby will be given 120 ml of formula milk, and mom will pump milk for later in the night.

3:30 a.m.: Baby is fed breast milk from the bottle.

4:00 a.m.: Mom will pump to make sure there is enough milk supply.

If you found this article helpful, then why not take a look at the pick up put down method, or all the sleep regression ages.

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