Combination feeding

Should I supplement with formula? (mixed feeding) 

Many breastfeeding mothers ask whether it is ok to offer some formula as well as breastfeeding.

One of the most common reasons why many women start to consider doing this is because they suddenly notice an increased pattern of feeding at the breast, for instance, and are concerned that their milk supply is dropping.

Many women also feel that they would like their partner to be able to give at least one bottle of milk to the baby per day so that they can have a bit more rest, and I fully understand this.

The truth is that it IS possible to combine breastfeeding and formula feeding, as it doesn’t have to be all breastmilk or no breast milk.

However, what I would encourage you to do is to look at the information relating to how you can know that your baby is getting enough milk, and also information pertaining to normal patterns and false alarms.

Many false alarms can make you think that you are not producing enough milk, when, in fact, your supply is perfectly fine. Also, look at the information relating to how you can be supported while you are breastfeeding.

You must make those decisions with knowledge.

You can then move forward in any way that you choose.

The reason I am saying these things is that, in my work with breastfeeding mothers, I see all too often, women losing confidence in breastfeeding – and reaching for formula as a means to solve the problem.

This is what used to happen in the past here in the UK, particularly when we had very little knowledge regarding breastfeeding and how it all works, and so you should get that information for yourself to be able to make an informed choice.

It’s also important to know that if you offer formula in place of a breastfeed, your supply will drop – and that’s fine.

You would expect it to drop because there will be less stimulation happening at the breast at that time unless you pump your milk to keep up your supply.

Also, some babies have a degree of nipple confusion when they go from breast to taking milk from a bottle, for instance.

It is fair to say, however, that some babies don’t show that nipple confusion, so it is quite variable from baby to baby. 

What is important to know too is that if you are offering formula, your baby will receive less protection because, unfortunately, formula milk doesn’t have any antibody protection.

Some studies have shown that combined feeding, i.e., giving formula and breast milk, can impact on reaching a full supply, and can reduce confidence in breastfeeding.

To increase your chances of success in this situation, exclusively breastfeed for the first three to four weeks if you can (ideally up to six weeks) and then gradually reduce those nursing sessions, offering formula instead.

Usually, around four to six weeks, your breast milk will be fully established, and there is a bit more flexibility thereon in.

Be assured that if you are only offering one, two, or three feeds a day and providing formula at the other feeds, your body will continue to produce that milk at those particular feedings.

This can carry on for years; some women have breastfed just morning and night for a long time and have not offered the breast in between those times.

The great news is that any amount of breast milk is good for your baby.

Studies have shown that it is dose-related, so the more breast milk you give, the greater the benefit, but even a small amount of breast milk will still have benefits for your baby.

Finally, it’s encouraging to know that nothing is set in stone, and the good news is that your body can make milk again, i.e., your supply can be boosted back up.

There is much flexibility with milk production, especially if you have already established your milk supply in those first four to six weeks.

I have seen mothers relactate. They had stopped breastfeeding completely but then wanted to get that supply back in again and started to allow their baby to feed at the breast again, maybe with some extra pumping, and their body started to make milk again. 

So there is lots of flexibility for combined feeding, and it’s good to have all of that information at your fingertips so that you can go forward in whatever way you choose.

Review dates, references & further resources

Review Dates

Version 1.1 published in March 2019. Next review date: Jan 2022

References

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