Combination Feeding

When it comes to feeding your baby, it’s not always a question of only breastfeeding or only formula feeding; many women do a combination of both. You may want to try mixed feeding because you want to breastfeed for some of your baby’s feeds, but give infant formula for one or more feeds, or because you’re bottle feeding your baby and want to start or resume breastfeeding.

It can be helpful to talk to your midwife, health visitor about your options when it comes to combining breastfeeding and bottle feeding, as well as find out about the potential impact of mixed feeding.

What effect will combining breastfeeding and formula feeding have?

One thing to consider is that breastmilk supply is generally driven by frequent, effective breastfeeding. This means feeding your baby as often as they show they need to by responding to their feeding cues. You can tell a feed is effective if your baby is well attached to the breast, you are both comfortable and your baby often starts with rapid sucks then slows to a more rhythmic suck, swallow pattern and comes off the breast looking full.

Giving your baby formula can affect the frequent feeds needed to ensure you're making the right amount of milk, especially when you first start breastfeeding. It usually means your baby breastfeeds less often, and therefore you make less milk.

However, if your baby is older, beyond the newborn stage, you can usually maintain your breastmilk supply alongside formula feeding, as long as you breastfeed every day. Much older babies – from eight or nine months – can breastfeed just a handful of times a day, and there is still a supply. Very well-established breastfeeding, with a baby of a year or so or more, can continue with as few as one or two feeds in 24 hours.

Your baby will enjoy the benefits of breastmilk, even if you’re not exclusively breastfeeding. For instance, they will still gain some of the antibodies that will protect them against infection.

How can I combine formula feeding and breastfeeding?

If you want to cut down on breastfeeds to introduce formula milk, you and your baby will adjust more easily if you reduce the number of feeds gradually.

You can offer formula feeds before, during, after or instead of a breastfeed. Do talk to your midwife or health visitor about this as different options will suit different circumstances. There are some cases when formula might be given before a breastfeed (for example, with sick babies who are not breastfeeding well). In other cases, the formula feed might be given instead of a breastfeed. This might happen if you’re separated from your baby and can’t be there to breastfeed. Sometimes, formula given in the middle of a breastfeed is an option, if the baby needs the comfort and closeness of a breastfeed to settle.

Gradually cutting down breastfeeding reduces the chance of your breasts becoming uncomfortably engorged and leaky. It will also reduce your risk of developing mastitis.

If you ‘top up’ with formula at one or more feeding sessions, rather than replacing an entire feed, this is likely to extend the gap between breastfeeds, which will signal to your breasts to make less milk. You can then drop the breastfeeds you want to drop, replacing them with formula. On the other hand, if you are advised to ‘top up’ as a temporary measure and want to return to exclusive breastfeeding, you can express milk between feeds to increase the amount of milk you make.

Breastfeeding information for parents