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How to combine breast and bottle feeding

It can take several weeks for you and your baby to feel happy and confident with breastfeeding.

Once you've both got the hang of it, it's usually possible to offer your baby bottles of expressed milk or formula alongside breastfeeding.

This is sometimes called mixed or combination feeding.

Why combine breast and bottle?

You may want to combine breastfeeding with bottle feeding if you:

• are breastfeeding and want to use a bottle to offer your baby some expressed breast milk
• want to breastfeed for some of your baby's feeds, but give bottles of formula for 1 or more feeds
• are bottle feeding your baby and want to start breastfeeding
• need to leave your baby and want to make sure they have some milk while you're away

Introducing formula feeds can affect the amount of breast milk you produce. There is also a small amount of evidence to show babies may not breastfeed as well because they learn to use a different kind of sucking action at the bottle than at the breast.

These things can make breastfeeding more difficult, especially in the first few weeks when you and your baby are still getting comfortable with breastfeeding.

Your breastmilk supply will usually not be affected if you start bottle feeding your baby when they are a bit older, you are both comfortable with breastfeeding, and you breastfeed every day.

Introducing formula feeds

If you're combining breastfeeding with formula feeds both you and your baby can carry on enjoying the benefits of breastfeeding.

If you choose to introduce infant formula:

• it's best to do it gradually to give your body time to reduce the amount of milk it makes – this helps lower your chance of getting uncomfortable, swollen breasts, or mastitis
• if you're going back to work, start a few weeks beforehand to give both of you time to readjust
• if your baby is 6 months old or more and can drink milk from a cup, you may not need to introduce a bottle at all

For more information, see drinks and cups for babies.

Giving your baby their first bottle

It may take a while for a breastfed baby to get the hang of bottle feeding, because they need to use a different sucking action.

• it usually helps to give the first few bottles when your baby is happy and relaxed – not when they're very hungry
• it may help if someone else gives the first bottle feeds, so that your baby is not near you and smelling your breast milk
• you might want to try using a different position for bottle and breastfeeding

See more advice on how to bottle feed.

Restarting breastfeeding

If you want to start breastfeeding more and give your baby fewer bottles, it's a good idea to ask your midwife, health visitor or breastfeeding supporter for support.

These tips may help too:

• Hold and cuddle your baby as much as possible, ideally skin to skin. This will encourage your body to make milk and your baby to feed.
• Express your breast milk regularly. Expressing releases the hormone prolactin, which stimulates your breasts to make milk. About 8 times a day, including once at night is ideal. It may be easier to express by hand to begin with – your midwife, health visitor or breastfeeding supporter can show you how.
• Try bottlefeeding while holding your baby skin to skin and close to your breasts.
• If your baby is latching on, feed little and often. Do not worry if your baby does not feed for long to begin with. See tips on how to get your baby properly positioned and attached.
• Choose times when your baby is relaxed, alert and not too hungry, and do not force your baby to stay at the breast.
• Decrease the number of bottles gradually, as your milk supply increases.
• Consider using a lactation aid (supplementer). A tiny tube is taped next to your nipple and passes into your baby's mouth so your baby can get milk via the tube as well as from your breast. This helps to support your baby as they get used to attaching to the breast. Your midwife, health visitor or breastfeeding supporter can give you more information.

See more tips on boosting your milk supply.

Help and support with mixed feeding

If you have any questions or concerns about combining breast and bottle feeding:

• talk to your midwife, health visitor or breastfeeding supporter
• call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm, every day)
• find breastfeeding support near you

Video: why combine breast and bottle feeding?

In this video, 3 mothers discuss ways to combine breast and bottle feeding.

Media last reviewed: 14 March 2023
Media review due: 14 March 2026

Page last reviewed: 8 October 2019
Next review due: 8 October 2022

Mixed infant feeding: how to start and introduce | Scheme and diet, menu for mixed feeding

Co-author, editor and medical expert - Klimovich Elina Valerievna.

Number of views: 74 793

Date last updated: 12/27/2022

Average read time: 4 minutes

, which means switching to mixed feeding. It is recommended to make a decision on the transfer of a newborn to mixed feeding together with a pediatrician who will help you choose the right mixture.

Contents:

When do mothers switch to mixed feeding?
How to organize mixed feeding?

When do mothers switch to mixed feeding?

1. Lack of own milk

In some cases, even if the mother puts the baby to the breast on demand, the child may still remain hungry and gain weight poorly. This is often evidenced by loud crying after eating. In this case, experts speak of hypolactia, when milk production is reduced due to a hormonal disorder.

The “wet diaper” method will help to make sure that the baby really does not have enough milk. Do not put "diapers" on your baby and count the number of his urination in one day. From two weeks of age to six months, the result is evaluated as follows: if you counted 12 or more wet diapers, then you have nothing to worry about, 8–10 wet diapers indicate that lactation has decreased, 6 or less - the child does not have enough milk, and urgent action should be taken.

Tip! Today there are many ways to increase lactation, but if they do not help, you should consult a pediatrician who will choose the right formula for supplementary feeding.

2. Lack of calories

Some mothers think that their milk is not nutritious enough. Most often, they come to such conclusions by expressing clear milk with a bluish tint. But it cannot be nonnutritive or nutritious. Milk is “rear”, saturated white, thicker and fatter (for a child, this is “food”), and “front”, liquid with a bluish tint (“drink”).

Tip! If the amount of urination is normal, but the baby is not gaining weight, then you need to think about whether your baby is getting "hind" milk. To do this, offer him only 1 breast during 1 feeding.

3. Coming to work

Some mothers have to reduce the number of feedings after going to work. And their first impulse is to switch to mixed feeding. But you should always remember that the best food for a child is mother's milk. If you want to go to work, try to prepare for this in advance. Make a "strategic stock" of breast milk in the freezer so your baby always has food, even when you're not around.

Tip! If you plan to go to work when your baby has started to receive complementary foods, then try to organize meals so that complementary foods are given to him in your absence. So you will have the opportunity to reduce the amount of formula or defrosted in his diet

Up to the content

How to organize mixed feeding?

Mixed nutrition has its own characteristics, which are very important for a nursing mother to know.

Basic rules for mixed feeding:

1. The timing of the introduction of complementary foods depends on the amount of breast milk the baby receives. If it is 50-70%, then it is administered as with breastfeeding (at 6 months). If less than 50% of breast milk is present in the baby's diet, then complementary foods can be introduced at the age of 5 months.
2. Always offer the breast first. Only if you see that the baby is not full, and the breasts are empty, then give him a mixture. It also helps increase lactation. The mixture should be introduced gradually. On the first day - 10 ml / 1 time, the second - 10 ml / 3 times, the third - 20 ml / 3 times. Increase the portion, bringing it to the norm.
3. Only the breast should be given at night and formula should be avoided. This is due to the fact that from 3 to 8 am, prolactin is actively produced, which is responsible for lactation.
4. Feed according to schedule (every 3-4 hours) and breastfeed on demand.
5. Keep water boiled and utensils and formula sterile. You need to cook right before eating.
6. Use a spoon instead of a bottle for complementary foods. Then you can avoid breast rejection.
7. Remember that mixed-fed babies should be given water, as dehydration can lead to poor digestion.

Follow these simple rules and try to keep your baby breastfed for as long as possible. Your milk, even though it's not your baby's only food, contains invaluable trace minerals that will keep your baby healthy and strong.

Back to Contents

The information in this article is for reference only and does not replace professional medical advice. For diagnosis and treatment, contact a qualified specialist.

Rules for mixed feeding - how to maintain lactation, choose a mixture and other questions.

— Polina Aleksandrovna, what is mixed feeding of newborns?

— With mixed feeding, the baby receives breast milk and milk formula in different proportions.

— When does the pediatrician recommend mixed feeding?

— The reasons why a pediatrician partially replaces natural nutrition with formula can be divided into three groups.

1. Mother's lack of milk. Low lactation can lead to weight loss in a baby. With a pronounced lack of weight, additional nutrition is needed.
2. Functional disorders in a child. For constipation, regurgitation, allergic reactions and other conditions, a therapeutic mixture is prescribed.
3. Mom is away for feeding time. If there is no milk bank and it is impossible to form it, supplementary feeding is given.

— Some mothers refuse to breastfeed because of bad environment. Does the environment really affect the quality of breastfeeding?

— It cannot be said that the environment affects the quantity and quality of women's milk. Milk is filtered from the mother's blood. Blood passes through the vessels of the mammary gland and brings useful substances into breast milk, they are no longer taken from anywhere. At the same time, harmful substances from the environment are not allowed to enter the milk.

Due to poor ecology, the mother may be deficient in trace elements, and then the quality of milk will decrease. However, doctors are usually aware of the mother's deficiency conditions, since she had blood tests during pregnancy, and they correct them with nutrition or drugs.

— Polina Aleksandrovna, another fear — mothers are afraid that milk will disappear during mixed feeding.

- This can become a reality if mixed feeding is not rationally approached. True hypogalactia is extremely rare, it is 1-2% in the female population. The body of a woman produces a sufficient amount of milk on the principle of "supply - demand". If the mother begins to increase the volume of the mixture, then the amount of milk in the breast really decreases. The baby will not suck more milk from the breast when he receives an increasing portion of the mixture.

— Will a mixed-fed baby have stomach ache?

- There is no specific link between infant formula and abdominal pain. Yes, when formula is introduced, stools may change. But this does not mean that there will be discomfort for the child. The stool becomes more dense, acquires a greenish tint (it has a yellowish color when breastfed) - this is the norm, which should not be feared.

Liquid stools with mixed feeding are formed for various reasons:

• infant receives special formula;
• mom went too far with the amount of mixture;
• with intolerance to the components of the milk mixture.

For symptoms that bother the baby and mother, you need to see a doctor.

— How does mixed feeding affect the child's immunity?

— The immunity of infants develops independently of the type of feeding. But mother's milk contains antibodies and beneficial substances that enhance the immunity of the baby. With a reduced proportion of breast milk on mixed feeding of these substances, the child will receive less than on breastfeeding. But this does not apply to the formation of immunity, and the child's immunity will not suffer from mixed feeding.

— Polina Alexandrovna, how to maintain lactation with mixed feeding?

- In order to keep breastfeeding, you do not need to give formula more than necessary. The doctor determines the amount of supplementary feeding, and you should not independently increase its volume.

Try to breastfeed more often, breastfeed first and then formula. With the help of a breast pump, you can express after bottle feeding. The goal is not to express a large amount of milk, but to stimulate the nipple, as if applying to the breast, and send a signal to the brain that the baby needs more milk. More milk will come next time.

Table. Mixed feeding of newborns - pros and cons

— Can I choose my own formula for mixed feeding?

- I do not recommend choosing food for the child on your own. With mixed feeding of an infant, it is important to determine not only the type of mixture, but also the nature of supplementary feeding. How much to supplement, so as not to overfeed or leave the baby hungry, so as not to lose breast milk? Should I supplement each time or alternate between breast and bottle feeding, should I formula feed at night? There are many questions. Therefore, even if the mother has made a choice in favor of a certain mixture, she should consult a doctor about the appropriateness of its use and ask how and how much to give the mixture.

See also

• "How to choose the right infant formula"

How to switch to mixed feeding

- It all depends on the chosen scheme of mixed feeding and the method of supplementary feeding.

- How to calculate the amount of formula for mixed feeding?

- You need to start from how much the child should eat per day. The daily amount of food is divided by the frequency of feedings to determine the amount of food at one time.

1. Checkweighing determines how much breastmilk the baby eats and how much the baby is undernourished. He makes up the difference with a mixture.
2. Although formula is usually diluted at a ratio of 1 spoon per 30 ml, supplementation will not necessarily be a multiple of 30. If 40 ml is needed for supplementation, mom prepares 60 ml and only gives 40 ml of them. It is not necessary to give food beyond measure so that lactation does not fade away - when you offer the baby more formula, he asks for less breast milk.

— Is it possible to overfeed a newborn?

- It is always worthwhile to adequately assess lactation and add the amount of formula that the baby really needs. By weighing your baby before and after a feed, you will know how much breast milk he has eaten and how much formula to give him. Given this, the mother will not overfeed the baby.

— Polina Alexandrovna, what dish should I choose for mixed feeding?

- Baby utensils must have the following characteristics:

• material safety - it is confirmed by certificates;
• possibility of processing by high temperatures during sterilization and boiling;
• The right size nipple on the bottle - for the comfort of the baby at each age, a different flow rate of nutrition is needed.

In addition, choose a baby dishwashing detergent that rinses off well and use a separate brush for greater hygiene and convenience.

— The rules for mixed feeding are not limited to formula. What role does mother's nutrition play in this process?

— Scientists have long found out that mother's diet does not affect the child one hundred percent. If the mother is not on a strict diet, does not use preservatives, dyes and heavy fried foods, eats varied, then her diet will not adversely affect the baby's condition. Therefore, the only limitation is a reasonable diet without harmful substances.

How long does expressed breast milk last?

- Expressed milk can be stored in the refrigerator or frozen. Temperature and shelf life of expressed breast milk:

Expressed milk is stored in the refrigerator before freezing, and after cooling it is sent to the freezer. Frozen milk is thawed in the refrigerator and heated in a water bath to a comfortable temperature. You do not need to boil it in order to cool it down and give it to the child.

Mixed feeding rules

— How to properly feed a child with mixed feeding?

- It is advisable to prepare the bottle in advance or pour water heated to the required temperature into it. After breastfeeding and control weighing, it remains to pour the required number of spoons of the mixture into a bottle of water and dilute it.

It is advisable to breastfeed and formula in one meal - first at the breast and immediately after the bottle. When formula feeding, it is best to hold the baby in your arms to maintain physical and emotional contact and minimize the difference for the baby between feeding breast milk and infant formula.

— Do I need a feeding schedule for mixed feeding?

— Yes, when formula appears in a child's diet, there is a need for a feeding regimen. The mixture is quite dense and leaves the baby's stomach 3-4 hours after feeding, so it is recommended to keep breaks between feedings for at least 3 hours on mixed feeding.

— How to feed the baby at night with mixed feeding?

- Everything is individual and depends on the amount of supplementary feeding. If the mother gives 10-20 ml of the mixture, you can not supplement it at night, at this time of the day the need for nutrition is lower. But if the volume of supplementary feeding is large enough, then it is required to supplement the child with a mixture even at night. The most important thing is to come to the required daily amount of food. In addition, to maintain lactation, it is important to put the baby to the breast from 3 am to 7 am: at this time, the hormone responsible for stimulating lactation is most active.

- Should I give my baby water when mixed feeding?

- It is necessary to focus on the amount of supplementary feeding:

• if you supplement 10-20 ml of the mixture - there is no urgent need for water;
• if supplementary feeding is 50% or more in the meal, you can supplement it. Enough 20-50 ml of water per day, depending on the volume of the mixture in the diet, the age of the child and external factors (such as temperature, dry air).

See also

• "How to give water for up to a year"

— When is goat milk formula recommended for mixed feeding?

— Goat milk formula is recommended for supplementary feeding and replenishment of breast milk deficiency or as preventive nutrition for a healthy baby with allergies in relatives.

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