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What is combination feeding?
When it comes to feeding your baby, breastfeeding is best, however for those choosing to use formula, this and combination feeding are also some options. Combination (mixed) feeding simply means feeding your baby both from the breast and from a bottle1. Parents may combine breastfeeding and bottle feeding if they wish to. The bottled milk may be of expressed breast milk or of formula milk, it is your choice as to how you combination feed your baby. For further advice on how to feed your baby and introduce them to combination feeding, you can contact your healthcare professional.
How to combination feed your baby
You can choose to combination feed your baby using expressed breast or formula milk given in a bottle alongside your breastfeeding. You may wish to speak with your midwife or health visitor for support deciding what the best way to combination feed is for you1.
Establishing breastfeeding may take several weeks, normally after 4-6 weeks, and it is advisable to get confident with latching your baby to the breast before moving onto introducing a bottle to your baby and combination feeding. This is recommended because in the early weeks your body is establishing its’ milk supply and introducing bottles during this time may therefore lead to a lower milk supply2.
There are some things you will need to bottle feed your baby3:
• A steriliser
• Feeding bottles
• A breast pump if using expressed breast milk
• Formula if using formula milk
Introducing formula feeding
If you have decided to combination feed your baby using breastfeeding and formula feeding combined, it is important to recognise that your breastmilk supply is determined by your baby’s breastfeeds1. Your breastmilk production will reduce as you start to introduce formula feeds to your baby, but it does not happen instantly, and therefore gradually introducing formula is advised4.
Taking this transition into combination feeding slowly will also help to prevent your breasts becoming engorged, should you notice this happening you can gently hand express just enough milk off to relieve the pressure.
How much formula to use for combination feeding?
The best guide is your baby. Learning and responding to your baby’s feeding cues will help you to work out when your baby has had enough or when they would like some more milk4.
Responsive bottle feeding will also help ensure your baby drinks the right amount of milk for them, you should not force your baby to finish a bottle of milk. Remember that your baby’s needs and therefore appetite for milk will change day by day so do not worry if they take more from the bottle on one day than another.
Allow your baby to take the lead on the amounts for combination feeding and to take how much milk they want at each feed5.
1NHS (2019) How to combine breast and bottle feeding. Available at: https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle feeding/bottle-feeding/combinebreast-and-bottle/ [Accessed: 25th November 2021]
2NHS. Early days: Your baby & you”. Available at:https://www.nhs.uk/start-for-life/baby/feeding-your-baby/bottle feeding/bottle-feeding-your-baby/feeding-on-demand/
3NHS (2021) How to breastfeed. Available at: https://www.nhs.uk/start4life/baby/feeding-your baby/breastfeeding/how-to-breastfeed/burping-your baby/#anchortabs [Accessed: 22nd November 2021]
4UNICEF (2021) Guide to Bottle Feeding Leaflet. Available at: https://www.unicef.org.uk/babyfriendly/baby-friendly resources/bottle-feeding-resources/guide-to-bottlefeeding/ [Accessed: 22nd November 2021]
5NHS Start for Life, Feeding on Demand. Available at: https://www.nhs.uk/start-for-life/baby/feeding-your-baby/bottle feeding/bottle-feeding-your-baby/feeding-ondemand/ [Accessed August 2023].
†Winner Formula Milk Category. Survey of 8000 people by Kantar. Customer survey of product innovation.
