Mixed Feeding

Thinking about combination feeding?

When you start thinking about feeding your baby, you may think that it is a black-and-white choice between breastfeeding and bottle feeding.

However, it is possible to do a mixture of both, which is called combination feeding or mixed feeding. There are a number of reasons parents may choose to do this, and it can involve giving bottles of either formula or expressed breastmilk alongside breastfeeding.

What is combination feeding?

If your baby receives all their milk straight from the breast, this means they are exclusively breastfed. However, if you choose to give them some of their feeds using a bottle or cup, this is known as combination feeding.

For some parents, combination feeding involves giving bottles of formula, while for others it may mean expressing milk using a breast pump. Combination feeding can be done from birth, but for many people, it is something they introduce as their baby gets older to fit in with their circumstances.

This could be because you are returning to work but want to continue to breastfeed, or it may be a decision you make to allow another family member to help out with the feeding routine. There are also some situations where a medical professional may recommend combination feeding, often when a baby isn’t gaining weight well from breastfeeding alone.

Whether you opt for mixed feeding is a completely personal choice that only you can make. But as with all decisions, it is important to have all the information about the benefits and disadvantages so you can weigh the pros and cons.

What are the benefits of combination feeding?

Mixed or combination feeding allows you to share feeding responsibilities with someone else. This could be useful if you will need to be apart from your baby for any reason or if you are finding the demands of exclusive breastfeeding overwhelming.

Some parents start combination feeding because they return to work, go away on a trip, or are unable to physically care for their baby because they are unwell. 

If your baby is struggling to gain weight or they are finding it difficult to breastfeed, combination feeding can offer an alternative to giving up breastfeeding and switching to bottle feeding completely. Continuing to breastfeed, even if it is only for some feeds, means your baby will continue to benefit from the antibodies and nutrients in your breastmilk, and you will be able to maintain your milk supply.

Feeding with a bottle allows you to measure how much milk your baby takes, and if your baby has lost a lot of weight after birth, you may be encouraged to give expressed milk via a cup or bottle in addition to breastfeeding to make sure your little one is getting enough. It is common practise to offer the breast first, followed by the bottle after the breastfeed has finished.

What are the disadvantages of combination feeding?

Breastfeeding works on a supply-and-demand basis, so if you introduce formula to your baby’s diet, your milk supply will start to fall. Sometimes people start mixed feeding because they are worried they are not producing enough breastmilk, but the only way to increase your supply is to feed your baby as much and as often as possible.

There is also a risk that introducing another feeding method will make a baby more reluctant to breastfeed. This can be a problem in the early days when breastfeeding is not yet well established.

Babies need to learn a different feeding method to drink from a bottle than they do to breastfeed. While some infants switch between the breast and a bottle with ease, others find the transition more difficult and may refuse to take a bottle or start refusing to breastfeed.

If you are thinking of using combination feeding as a way of giving your baby expressed breastmilk, it is worth remembering that not all women are able to pump large amounts of milk, even if they have an abundant milk supply. Pumping can be very time-consuming and requires a bit of planning, and you may find that you express very little gratitude for the amount of effort you have had to put in.

Don’t worry, though; the amount you express does not reflect what your baby would be able to extract during a breastfeeding session. Some women find they have to experiment with different pumping speeds and techniques to express efficiently, while others may never be able to pump as much milk as they would like to, no matter what they try.

How do I get my baby to take a bottle?

Babies who are used to breastfeeding may find feeding from a bottle challenging at first. Be patient, and don’t expect them to take to it right away.

Your baby will be able to smell your milk, so it is a good idea to ask someone else to give your baby the bottle when you first introduce it. Otherwise, they may get frustrated that they cannot just breastfeed from you as usual.

When offering a bottle for the first time, don’t wait until your baby is tired or hungry. Choose a moment when they are calm, alert, and happy, as they are more likely to try something new.

It is important not to become fixated on getting your baby to finish the bottle. Give them control over their milk intake in the same way you would when they are breastfeeding.

It is important to read the instructions carefully when making up a bottle of formula and make sure you clean and sterilise the bottles you use every time, regardless of the type of milk you are using.

When you start using formula alongside breastfeeding, introduce it gradually to allow your breasts to adapt to the fall in demand. Stopping suddenly can cause your breasts to become engorged and may put you at risk of developing mastitis, a painful and unpleasant inflammation.

Can I switch back to exclusive breastfeeding once I have introduced a bottle?

If you have started combination feeding and then decided you would like to switch back to just breastfeeding, it is possible, but it will take some effort and patience. Some babies are more reluctant to latch on and breastfeed when they have become used to using a bottle.

To re-establish breastfeeding so you no longer need to use any other methods, you will need to persevere and keep offering the breast first. Have lots of skin-to-skin cuddles to encourage your little one to latch on and help boost your milk supply.

If you have been using formula as part of your combination or mixed feeding, reduce this gradually. Always offer the breast first at every feed so that your body knows to produce more milk to meet your baby’s needs.

It is also a good idea to get support and advice from a breastfeeding specialist. Speak to your midwife, health visitor or breastfeeding support worker and ask for help rather than struggling on your own.

Is it normal to have mixed feelings about mixed feeding?

Many of the parenting decisions we make are challenging and loaded with emotion. Everyone wants to do the best they can for their baby, and if things don’t work out as you might have hoped, it can be upsetting.

If you had originally hoped to breastfeed exclusively, you may feel disappointed or even guilty about combination feeding. These feelings are common among new parents, but there really is no reason to feel guilty—everyone must make the decisions that work best for their own situation.

Try not to compare yourself with other people and focus on making sure you and your baby are healthy and happy.