Combination Feeding: Things I Wish I Knew

Read time: 4 minutes

What to know about combination feeding

• What is combination feeding?
• How to combo feed
• Tips for combo feeding
• Mom-to-mom combination feeding tips

They say feeding your baby should be easy, but it doesn’t always feel that way! How you feed your little one is personal, and sometimes that journey involves both breastfeeding as well as baby formula.

We know you work hard to get it right, so let’s talk about how to combination feed in a way that works best for you and your baby.

What is combination feeding?

Combination feeding, also called mixed feeding, provides any combination of breastmilk (by nursing or by bottle) and baby formula to your little one.

This can mean mostly nursing and using only one bottle of formula per day, or it can mean five bottles of formula per day with two bottles of expressed breastmilk, or anything in between!

If you choose to combo feed, know that it may impact your breastmilk supply.

Breastmilk Supply

Many parents who choose to combination feed do so because breastfeeding isn’t quite working out. Maybe their supply is low, maybe they want to give a parent or caregiver the opportunity to feed and be with baby at night, or maybe it’s just their preference.

No matter the reason, understanding how to best manage your breastmilk supply is part of this equation, especially if you’d like to continue breastfeeding to some extent.

The first thing to know is that breastmilk is mainly based off supply and demand. So, the more you breastfeed or pump, the more breastmilk your body will make. Similarly, the less you breastfeed or pump, the less your body will make.

To help you maintain your breastmilk supply, make sure to pump as many times as baby gets a bottle of breastmilk.¹¹ Since pumping sometimes doesn’t produce as much as nursing at the breast, some parents consider pumping one extra time as well.

Wondering how best to combo feed your baby? Reach out to our team of registered dietitian nutritionists and lactation consultants for free! They’re here to help on our free live chat from Monday – Friday 8am - 6pm (ET). Chat Now !

Why do families combo feed?

Some families choose to combination feed due to work, living situations, preferences, previous experiences, and support.

On the other hand, sometimes the choice is made due to outside factors, such as medical issues affecting the ability to breastfeed exclusively.

Remember that no matter how you feed your little one, as long as they are thriving and healthy, your feeding journey is perfect for you and your baby.

When to start combo feeding

While there is no specific time when it’s best to start combination feeding, if possible, it may be best to start mixed feedings once breastfeeding is established.

The first 4 to 6 weeks are the most important when it comes to establishing your milk supply.¹² Starting combination feeding earlier than this may impact how much milk your body makes in the long run.

With that said, some parents need to start mixed feedings earlier for any number of reasons. This is absolutely fine! As long as the schedule works for you and your family – and your baby is gaining weight appropriately – then you can start combo feeding at whatever age you feel is best.

Top 9 tips for combination feeding

First: Know that it’s OK to combo feed

Your feeding decision may come from a long-held resolve or from circumstances outside of your control, but how you feed your little one can feel more difficult if your family and friends have opinions of their own.

Remember that what works best for you may not be what works for someone else, and that’s okay! As long as your baby is well-fed and gaining weight appropriately, that’s all that matters.

2. Bonding still happens when you use bottles

Although breastfeeding is often promoted for nurturing a strong mom-and-baby bond, you can and will bond with your baby regardless of the feeding method.

Meeting baby’s needs for food, diaper changes, and cuddles helps your baby form secure attachments with their caregiver – you!^{1, 6}

3. Bottle feeding isn’t quick

Many families choose to bottle or combo feed because of the flexibility that it could give them. However, to help your baby not overfeed, feed safely, and reduce the potential for spit-up and gas, a lot of parents follow the advice of lactation consultants and implement paced or responsive bottle feeding with slow-flow nipples.²

This slows down the feeding and allows baby to better control how much breastmilk or formula they get.

Not only that but then there’s the clean-up, especially if you are pumping breastmilk! Don’t forget to build in some time to clean bottles, breast pump, and parts if needed.

4. Baby will let you know how much breastmilk or infant formula they need

While it may feel reassuring to have set feeding amounts and times when using a bottle, babies are not little robots. Even with a bottle, it’s important to pay attention to their hunger and feeding cues.

Babies are born with an innate ability to understand how much milk they need, so once you notice baby’s cues that they are finished eating, stop the feed even if the bottle is not empty.⁵

Using the paced bottle feeding technique mentioned above will help a lot with this!

5. You may still have to deal with bottle refusal

If baby is sick, goes some time without a bottle, or if there is a change in routine (like mom going to work), this may cause a refusal of either the bottle or breast.

It may require some patience and creativity to work through this – things like sippy cup or open cup feeding, solids if baby is older, or feeding while in motion are strategies that may help.⁷

Our Happy Experts are available to help with breast or bottle refusal troubleshooting. They’re available for free Monday – Friday, 8am – 6pm ET. Chat Now!

Introducing Formula to a Breastfed Baby (Read this for tips on bottle refusal)

6. Bowel movements will change when infant formula is introduced

If infant formula is part of your mixed feeding journey, then expect some differences in baby’s poop!

Sometimes formula can cause some brief constipation-like symptoms at first such as increased straining, harder and more solid poops, less frequent poops, and even changes in poop color!^{8, 9}

But know that these are usually short-lived as your baby gets used to the new formula and will typically resolve on their own within a couple weeks.

Some formulas include prebiotics and probiotics, which may help with baby’s stool consistency and regularity.

Most families notice things start to even out within a few weeks.

7. You may still have feelings – or you may not!

Introducing formula may all lead to mixed feelings about your combo feeding journey. This is normal!

Breastfeeding grief is a real thing, and even though your baby may be fed and happy and thriving, there can still be pangs of sadness about the loss of an exclusive breastfeeding relationship.

8. Donor milk is an option

Depending on what is available in your area and your comfort level with milk sharing, breastmilk donated from another mom is an option that not a lot of people think about.

Choices could include pasteurized donor milk from a milk bank, informal milk sharing, or formal groups for informal milk sharing. It’s also possible to pasteurize milk you receive from someone else.^{3, 4}

Note that if you do decide to informally share breastmilk rather than work through a formal milk bank, there may be some risks involved. The breastmilk (and the person producing it) is usually not adequately screened for infectious diseases and contamination risk, and the breastmilk may not be handled and stored properly.¹⁰

Here are some resources to get started:

• Human Milk Banking Association of North America ( https://www.hmbana.org/ )
• Human Milk 4 Human Babies Global Network ( https://www.facebook.com/hm4hb/ )
• Eats on Feets ( https://eatsonfeets.org/ )

Speak with your healthcare provider to help you decide what may be best for you and your little one.

9. Weaning may come early

For some women, decreased breastfeeding or pumping can lead to severely reduced supply quicker than others.

As you embark on your combo feeding adventure consider that this may be a possibility and how this may affect your decision. Be sure to read more about how to protect your breastmilk supply if this is important to you!

Our Favorite Mom-to-Mom Combo Feeding Tips

See a lactation consultant

A lactation consultant can help you reach your combo feeding goals and keep breastfeeding or pumping for your intended amount of time.

Pick the schedule that works for you

Everyone’s combo feeding routine is different and that’s OK! Try not to compare yourself with other combo feeding families as circumstances, baby’s preferences, and your milk production can all affect what your routine looks like.

Listen to your baby’s cues

Remember that your baby will do best when fed on demand and being allowed to finish when they are done. Discuss this with your partner and anyone else who will play a part in taking care of baby.

Use responsive bottle feeding

Even when we are feeding baby on cue, it can sometimes be hard to determine when baby is full when you are bottle feeding. Paced bottle feeding helps you stay on track with your baby’s needs.

Try some power pumping to help maintain milk supply

Power pumping is a method of pumping that involves alternating quick pumping sessions with bouts of rest. Power pumping is meant to mimic the cluster feeding a baby does to boost mom’s milk production during a growth spurt.

Instructions on power pumping can be found in this article.

Let's Chat!

We know parenting often means sleepless nights, stressful days, and countless questions and confusion, and we want to support you in your feeding journey and beyond.

Our Happy Experts are a team of lactation consultants and registered dietitian nutritionists certified in infant and maternal nutrition – and they’re all moms, too, which means they’ve been there and seen that. They’re here to help on our free, live chat platform Monday - Friday 8am - 6pm (ET). Chat Now!

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