Parent mixing formula

All About Combination Feeding

Erica Campbell, RN, IBCLC

Take it from this lactation consultant: the way you feed your baby does not have to be “all or nothing.” You don’t have to choose one specific way to feed, 100 percent of the time. There are many different paths to reach your feeding goals, including combination feeding.

Combination feeding is just that: feeding your baby in a combination of ways. This could mean that sometimes you breastfeed, and other times you feed baby with a bottle. It could also mean that sometimes you give pumped breastmilk, and formula other times. Combination feeding means experiencing your infant’s feeding journey in a way that best supports you, your baby and your family.

How does it work?

Once caregivers discover that combination feeding exists, the next question is usually, “How do I make it work?” The best way will ultimately be determined by you, your supply, and your schedule. This can be done in several different ways. Some parents benefit from nursing throughout the day and supplementing with pumped breastmilk or formula by bottle during the evenings. Some parents nurse once or twice a day and supplement the rest of the time. Another option is to pump a few times a day and then offer formula at the other feedings. Truthfully, the combination of different feeding methods is up to you, and it is not one-size-fits-all. As long as your baby is well-fed, then whatever works for you, your supply, and your ultimate feeding goals is what will help determine your overall plan.

Will this impact my breast milk supply?

This question can be answered a lot better under the guidance of an International Board Certified Lactation Consultant (IBCLC). Working with a trusted lactation consultant can help determine how to manage your version of combination feeding. For a majority of milk producers, supply will likely be impacted if you shift from 100 percent breastfeeding to incorporating some pumping or feeding with formula. It is difficult to anticipate the exact impact that combo feeding can have on breastmilk supply, as it’s different for each body and every situation. It’s helpful to have the mindset that your supply will ultimately regulate to meet the demands (from breastfeeding and/or pumping) on it. In other words, your body will adjust to how often and how much you’re feeding baby by breast. If you choose to, you can then incorporate bottles—with pumped breastmilk or formula—to meet baby’s additional needs.

Why combination feeding?

Combination feeding can be beneficial for many families for many reasons. Commonly, combination feeding can help continue breastfeeding in some amount while also:

  • Preparing to return to work
  • Dealing with a history of low milk supply
  • Looking to incorporate bottles for personal reasons
  • Desiring to sustain your nursing relationship with limited milk supply
  • Wanting to feed by bottle and breast, and/or with breastmilk and formula—whatever the reason!

Important tips for practicing combination feeding

As you head down the path of combination feeding, keep these tips in mind:

  • Employing a paced bottle-feeding method is helpful for encouraging intuitive eating and self-regulation during feedings. You can learn more about paced bottle feeding here.
  • Remember the recommended CDC guidelines for preparing and storing breastmilk and formula whenever bottle feeding.
  • You can mix breastmilk 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 breastmilk. Because the milk storage guidelines differ between breastmilk and formula, it’s necessary to follow the guidelines for whichever milk would expire the soonest.

Combination feeding may feel like a new concept because we’re still surrounded by messages of feeding babies by breast OR bottle. The option of “both” is rarely, if ever, discussed. But that “secret option C” of combination feeding may be the right fit for you and your family.

No matter how you nourish your baby, working with a trusted lactation professional can help you reach your feeding goals on your combination feeding journey. The more we talk about combination feeding, the more we can learn about the benefits of this feeding method for families everywhere.

Sources:
https://www.llli.org/breastfeeding-info/mixing-milk/


Erica Campbell, RN, IBCLC, is a former Mother/Baby Registered Nurse and current Lactation Consultant (IBCLC). She founded The Milk Manual as a resource for all parents experiencing their infant feeding journeys. She is on the Dr. Brown’s Medical Expert Panel.

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