Combination Feeding: What it is and Getting Started
The way you feed your child is a personal choice that only you and your baby can discover together. Some families find exclusive breastfeeding to be the best option, and others want or need to exclusively bottle feed. Combination feeding is a third option that encompasses several feeding styles that many families find to be the most versatile option.
What is Combination Feeding?
Combo feeding or mixed feeding is when you feed your baby with a combination of breastfeeding and bottle feeding. With combination or mixed feeding, some families will breastfeed and feed baby with bottles of pumped breast milk. Others may feed their baby with a combination of breast milk and formula. Combo feeding isn't one-size-fits-all—it’s all about finding what works best for your family's unique needs. With a bit of experimentation, you can discover the feeding style that suits both you and your baby.
Reasons to Choose Combination Feeding
Families choose combo feeding for various reasons, often to maintain some level of breastfeeding without depending solely on it. Common reasons include:
- The breastfeeding parent returning to work or needing to be away from baby during the day
- Sharing feeding responsibilities, allowing partners, grandparents, or other caretakers to help when the breastfeeding parent isn't available
- Needing to supplement with formula due to low milk supply
- Supporting baby's weight gain using formula
Exclusive breastfeeding can be demanding, and many families find that mixed feeding helps free up time and energy for the breastfeeding parent. Whatever the reason, combo feeding ensures the baby receives adequate nutrition and enough to eat.
How to Begin Combo Feeding
If possible, experts recommend exclusive breastfeeding for at least 4-6 weeks before introducing a bottle. This is the amount of time it usually takes to establish your breast milk supply and feeding routine.1
To introduce a bottle, you can start by replacing one breastfeeding session in the day with a bottle feeding. Try offering the bottle an hour or two after breastfeeding – this way baby may be starting to get hungry but won't be so hungry that they are unwilling to try something new and get frustrated and fussy. This method can be especially helpful if you’re introducing formula. After a few days of a single daily bottle feed, you can gradually start replacing more breastfeeding sessions with bottle feeds until you've found your new routine.
Your baby may not drink a lot of milk or formula from a bottle at the beginning. That's ok, it may take time for baby to get used to and accept the bottle. Think of the first few bottle feeds as practice rather than expecting it to be a full feed right away.
Choosing Formula
There is a wide variety of baby formulas on the market, and it can be confusing figuring out which is best for your baby. Your doctor can help you decide what kind of formula would be best for your baby.
Most baby formulas are cow's milk-based and fortified with iron. There are also non-dairy and non-cow's milk options available (like goat's milk).2 Milk-based formula is very different from regular milk. It's formulated specifically to be safe and easy for infants to digest and to include all the nutrition necessary for their health and development. You should not give a baby cow's milk until they are at least a year old.
When choosing a formula, you can consider your baby's specific needs. Some formulas have added probiotics and can help reduce gas, fussiness, and spit-up, some aid with promote easier digestion and help baby have softer poops (formula contains essential iron, but this can also add to constipation), there are soy-based formulas for babies that can't digest lactose, and there are specialty formulas for babies with specific health concerns. Talk to your doctor if you think your baby needs specialty formula.
Important Combination Feeding Tips
Board Certified Lactation Consultant and RN Erica Campbell recommends the following tips for safe and successful combo feeding:
- Employing a paced bottle-feeding method is helpful for encouraging intuitive eating and self-regulation during feedings.
- Remember the recommended CDC guidelines for preparing and storing breast milk and formula whenever bottle feeding.
- You can mix breast milk and formula in the same bottle! The biggest risk is wasting any milk if the baby does not finish the bottle. If you choose to mix, make sure to prepare the formula with water FIRST, and then add in the breast milk. Because the milk storage guidelines differ between breast milk and formula, it’s necessary to follow the guidelines for whichever milk would expire the soonest. Learn more about mixing breast milk and formula here.
Many people have strong opinions about the "best" way to feed an infant, but it all comes down to what your capabilities and doing what's best for you and your baby. And you can change your feeding style at any time. You can go back to exclusive breast or bottle feeding (depending on baby’s willingness and/or breast milk supply) as your situation changes, and return to combo feeding as needed – there's no need to limit your options! Combo feeding can help ease the pressure on you, providing peace of mind that your baby is well-fed and getting optimal nutrition.
DISCLAIMER: THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE
The information contained is for informational purposes only and is NOT intended to be a substitute for professional medical advice, diagnosis, or treatment. You should not rely solely on this information. Always seek the advice of your healthcare provider.
Sources
- Patterson, Terressa. Sweetie Pie. "Breast Milk Supply from Birth and Beyond." https://sweetiepieorganics.com/blogs/blog/breast-milk-supply-birth-beyond
- Fuchs III, George J, Abrams, Steven A. Healthy Children.org. "Choosing a Baby Formula." 20 October 2023. https://www.healthychildren.org/English/ages-stages/baby/formula-feeding/Pages/choosing-an-infant-formula.aspx