Mixed feeding: combining breastfeeding and bottle feeding | Baby & toddler, Feeding articles & support | NCT (2023)

Here we look at mixed feeding your baby, which is combining breastfeeding and bottle feeding

When it comes to feeding their baby, some parents decide to exclusively breastfeed and some to exclusively formula feed.Many families decide to combine breastfeeding and formula feeding; this often called combination feeding or mixed feeding (NHS, 2019).

What is mixed feeding?

Mixed feeding usually means mixing breast and bottle feeding. The content of the bottle can be either breastmilk or formula milk.

Watch our video to find out more about mixed/combination feeding.

Why do some families combination feed?

You might start mixed feeding for a variety of reasons.

  • If you and your baby have some difficulties getting breastfeeding established or if there are concerns about your baby's weight, you might be advised to give some formula feeds alongside breastfeeding.

  • You might need to leave your baby for periods of time (for example, if you are returning to work).

  • Your partner might want to be involved with feeding.


  • You might be bottle feeding and want to start or resume breastfeeding.

(NHS, 2019)

It can be helpful to talk to a breastfeeding counsellor, a midwife orhealth visitor about your options andthe potential impact on breastfeeding of mixed feeding (see below). You could also callour infant feeding lineon 0300 330 0700.

How do Icombine bottle feeding and breastfeeding?

Some families choose to express milk and feed it to their babies through a bottle. They might do this if someone else would like to feed the baby or if the mum has to be away from their baby for a while.

Others choose to substitute some breastfeeds for formula. If you want to do this, you and your baby will adjust more easily if you reduce the number of feeds gradually (NHS, 2019).

You can offer formula feeds before, during, after or instead of a breastfeed. Talk to your midwife, health visitor or a breastfeeding counsellor about this, as different options will suit different circumstances. And will also depend on what you wish to achieve ultimately.

There are some cases when formula might be given before a breastfeed (for example, with babies who are not breastfeeding well). In other cases, the formula feed might be given instead of a breastfeed. This might happen if you’re not with your baby and can’t breastfeed or if someone else is sharing the feeding.

Gradually cutting down breastfeeding reduces the chance of your breasts becoming uncomfortably engorged. It will also reduce your risk of developing mastitis (NHS, 2019).It helps to reduce the number of breastfeeds slowly, starting with the one which is convenient for you (NHS, 2020).If you substitute a breastfeed with a formula feed, it may take around five to seven days for the amount of milk your breasts are producing to adjust to missing that one feed (NHS, 2017).

If you ‘top up’ with formula during one or more feeds, rather than replacing an entire feed, this is likely to extend the gap between breastfeeds. It will alsosignal to your breasts to make less milk (NHS, 2020).

(Video) 9.6 Supporting Breastfeeding: Bottles, Draughts & Medications #MidwiferyHour

On the other hand, if you've beenadvised to ‘top up’ as a temporary measure and want to return to exclusive breastfeeding, it is important to express milk between feeds to prevent a decrease in the amount of milk you make (NICE, 2017). Try andfeed your baby any available breastmilk before each formula feed.

What effect will combining breastfeeding and formula feeding have?

Your baby will enjoy the benefits of breastmilk, even if you’re not exclusively breastfeeding. For instance, they will still gain some of the antibodies that will protect them against infection (NHS, 2019).

If you want to feed your baby with both breastmilk and formula milk, it is recommended to wait until feeding is firmly established before introducing a bottle (NHS, 2019). This can take up to a month (La Leche League, 2019).

It's best to wait until breastfeeding is established because breastmilk supply is generally driven by frequent, effective removal of milk from the breasts. Giving your baby formula reduces your milk supply, which is particularly important when you are both getting used to breastfeeding. If your baby breastfeeds less often, your breasts produce less milk (Daly and Hartmann, 1995).

You might have heard that babies can get ‘nipple confusion’ but there is no evidence that this exists (Kotowski et al, 2020).

How many breastfeeds does an older combination-fed baby need?

Older babies, beyond the newborn stage, can maintain your breastmilk supply alongside formula feeding as long as you breastfeed several times a day. Much older babies – from eight or nine months – can breastfeed just a handful of times a day, and there is still a supply.

Very well-established breastfeeding, with a baby who is one year or older, can continue with as few as one or two feeds in 24 hours.

If your baby is over sixmonths they can use a beaker or cup rather than a bottle (NHS, 2020).

Tips to introducea bottle to a breastfed baby

You might find your baby does not want to take a bottle at first. The different sensations may confuse them and they don’t know the bottle contains food. But there are lots of different things you can try to help your baby:

(Video) 9.6 Dr Wendy Jones MBE - Supporting Breastfeeding: Bottles, Draughts & Medications #MidwiferyHour

  • Offer a bottle when your baby is relaxed and happy, rather than very hungry.
  • Maybe ask someone else to offer a bottle so they can't smell their mother’s milk.

  • Try softening the teat with warm, boiled water.

  • Hold your baby in a different position from their usual breastfeeding one. It might help your baby get used to the new way of feeding.

  • Try a different bottle or teat, this might make a difference.

    (La Leche League, 2019)

Unicef (2016) recommend feeding responsively, which means following your baby’s cues, whether breastfeeding or bottle feeding. They also recommend using paced bottle feeding. The way a baby is fed with the bottle can affect their comfort, their control of the amount of milk they drink, and the transition between breast and bottle (Kotowski et al, 2020).

Tips for paced bottle feeding

  • Hold your baby upright, close to your body. (If your baby is lying back, they are less able to control how much milk they swallow, so they can overfeed.)

  • Touch the teat against the baby’s top lip to encourage them to pull it into their mouth.

  • Hold the bottle horizontal, so that when the baby is actively sucking, they get milk and when the baby is pausing, they don’t get milk.

    (Video) Strategies to Overcoming Common Breastfeeding Barriers Online Lecture

  • Give the baby several breaks by removing the bottle from their mouth.

  • Watch what the baby is doing, rather than how much milk they have drunk. End the feed when the baby is no longer drinking.

    (UNICEF, 2016; La Leche League, 2019)

This all helps to build a close, loving relationship, a responsive feeding relationship, and avoids overfeeding your baby.

Where can I go for breastfeeding support?

If you have questions, concerns or need support, you can speak to one of our breastfeeding counsellors by calling our infant feeding line on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions.

Further information

Healthtalkonline.org has a comprehensive library of face-to-face interviews where parents share their experiences about breastfeeding, birth, parenting and many other issues.

Best Beginnings has video clips from the 'Bump to Breastfeeding' DVD.

UNICEF have produced a summary guide for parents on how to responsively bottle feed babies.


Why do mothers prefer mixed feeding breast and bottle-feeding in feeding their baby? ›

Some parents choose to combine breastfeeding, expressing and formula feeding. This means that your baby benefits from having breastmilk, you are more likely to produce enough milk because you're expressing between feeds and your partner or other family member can help out with feeds when you use formula.

Can you mix breastfeeding and bottle-feeding? ›

It can take several weeks for you and your baby to feel happy and confident with breastfeeding. Once you've both got the hang of it, it's usually possible to offer your baby bottles of expressed milk or formula alongside breastfeeding. This is sometimes called mixed or combination feeding.

Why is mixed feeding not recommended? ›

Regular mixed feeding might make it more difficult to keep breastfeeding because it can interfere with keeping up a good supply of breastmilk. So if you're thinking about supplementing with formula, it's important to talk about it first with your midwife, child and family health nurse, lactation consultant or GP.

How does combination feeding help the baby? ›

Combination feeding using only breast milk gives your baby the best nutrition, but allows mum some breaks between feeds to get much-needed resting time and allows your baby's other family members to much-needed bonding time.

Is it good to feed baby both formula and breastmilk? ›

It's completely fine and perfectly safe to do. Many families choose this type of combination feeding method, whether out of necessity (e.g. low breast milk supply), convenience, or simply personal choice. In some cases, breastfeeding and providing formula may be recommended by a doctor for medical reasons.

Why is mixed feeding important? ›

Breast milk is the best source of infant nutrition for your baby. But if feeding your baby only breast milk is not an option for you, combination feeding lets you keep giving your baby the important nutrients in your breast milk. The more breast milk your baby gets, the greater the health benefits.

What are the disadvantages of combination feeding? ›

Are there any disadvantages of combination feeding? If exchanging some breastfeeds for formula milk then your baby will not receive as many antibodies and so their immune system may not be as well protected from certain infections.

What's the best way to combination feed? ›

You can successfully 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.

How does combination feeding work? ›

Combine feeding is when you offer your baby bottles of expressed breast milk or formula alongside breastfeeding. It's sometimes called combination or mixed feeding, or partial breastfeeding.

What is the best bottle for combination feeding? ›

NUK First Choice Plus baby bottles

If you're combination feeding, or even if you're finding it hard to find the best bottle for your baby, parents in the BabyCentre community have found the NUK First Choice bottles to be a big success with their newborn.

How often should a mix fed baby poop? ›

Expect at least 3 bowel movements per day, but may be up to 4-12 for some babies. After this, baby may only poop every few days. Baby will usually pass more stool after starting solids. Newborn will pass meconium by 24-48 hours after birth.

What is the best formula for supplementing breastfed babies? ›

What is the best formula to supplement a breastfed baby? Similac Pro-Advance is ideal for supplementing breastfed babies. Similac Pro-Total Comfort and Similac Pro-Sensitive® are also good choices.

How do you combo feed without losing supply? ›

It's best to make the transition to combo feeding from pure breastfeeding slowly if you're able to, first introducing a formula bottle an hour or two after a breastfeeding session (when baby's hungry, not starving) and then gradually building up to more frequent bottle feedings depending on how much formula you want to ...

What formula is closest to breastmilk? ›

Similac 360 Total Care Non-GMO Infant Formula Powder

Key features: Similac claims that this formula is their closest in composition to human breast milk. It includes a blend of DHA, lutein, and vitamin E — all nutrients found in breast milk.

What should mixed fed baby poop look like? ›

The first 6 weeks

During their first 6 weeks of life, both breast-fed and formula-fed babies will have generally have poo that is either yellow or green. Breast-fed babies tend to have softer, runnier poo while formula-fed baby poo is a little bit firmer.

Should I pump every time I breastfeed? ›

Ideally, you would pump as often as your baby would nurse. This may not be possible with your work/ school schedule. Most mothers find that pumping every 2-3 hours maintains their milk supply and does not cause them to become uncomfortably full.

Does combination feeding confuse babies? ›

The different sensations may confuse them and they don't know the bottle contains food. But there are lots of different things you can try to help your baby: Offer a bottle when your baby is relaxed and happy, rather than very hungry. Maybe ask someone else to offer a bottle so they can't smell their mother's milk.

What are 3 advantages of formula feeding? ›

Many moms choose formula for a variety of reasons:
  • It's convenient. ...
  • It's flexible. ...
  • Your partner can help out with nighttime feedings and share that bonding experience with your baby.
  • Scheduling feedings may be easier.
Jun 17, 2021

What are the problems of complementary feeding? ›

Early introduction of complementary feeding before 6 months was associated with a higher risk of stunting, wasting, and underweight.

What are three disadvantages of bottle feeding? ›

Bottle-Feeding: Disadvantages for Babies
  • Feeding frequency. Babies who take infant formula usually want to feed less often than babies who are breastfeeding.
  • Bowel movements. Infant formula causes formed, brown stools that have a noticeable odor. Breast milk causes loose, yellow stools that have less odor.

Can I formula feed at night and breastfeed in the day? ›

Is it OK to breastfeed during the day and formula feed at night? Yes! Combo feeding is a great way to extend your breastfeeding journey. Feeding your baby can happen many different ways.

What equipment do you need for combination feeding? ›

You will need the following items:
  • Bottles with teats and bottle caps.
  • Brushes to clean the bottles and teats.
  • Sterilising equipment (such as a cold-water steriliser, microwave or steam steriliser).
  • Formula milk powder or ready-to-feed liquid formula.

What is the closest bottle to breastfeeding? ›

If you're looking to introduce a bottle to a breastfeeding baby, consider these five options, which get top reviews from experts and real moms.
  1. Comotomo Natural Feel Baby Bottle. BUY NOW. ...
  2. Dr. ...
  3. Lansinoh Breastfeeding Bottles. ...
  4. Tommee Tippee Closer to Nature Baby Bottles. ...
  5. Munchkin Latch Anti-Colic Baby Bottles.
Mar 23, 2021

Which feeding bottle is best for 2 year old? ›

9 Best Milk Bottle For 2 Year Old Boys
  • 50% off. RJ ROJENO. ...
  • 23% off. LuvLap. ...
  • 26% off. R for Rabbit. ...
  • 26% off. R for Rabbit. ...
  • 31% off. Mee Mee. ...
  • Luv Lap. LuvLap Anti-Colic Slim / Regular Neck Essential Baby Feeding Bottle, 250ml. ...
  • 38% off. Koochie-Koo. ...
  • 38% off. Koochie-Koo.

What are the black specks in breastfed baby poop? ›

Oftentimes, if your baby's poop has little specks of black blood in it, it means a baby has digested blood while breastfeeding on his or her mother's cracked and bleeding nipples.

What are the seeds in baby poop? ›

These little “seeds” are undigested milk fat, which is entirely normal. Formula-fed babies' stools are usually a little firmer, often the consistency of peanut butter. Extremely loose, watery stools may indicate that the baby is not absorbing nutrients as well as they should.

Will supplementing decrease my milk supply? ›

Supplementing won't decrease your milk supply if your breasts are still being stimulated. For example, if your baby typically breastfeeds every three hours, you'll need to pump every three hours when you're at work to keep your body on its production schedule. Not doing so will reduce your supply over time.

Does mixing formula and breastmilk cause constipation? ›

Does mixing breastmilk and formula cause constipation? Due to the fact that formula-fed babies tend to pass fewer stools than breast milk-fed babies, constipation may occur when you mix them together.

Can you go braless while breastfeeding? ›

It's totally up to you and your comfort. If you usually go braless, you do not need to wear one during breastfeeding. Moms often have concerns about leaking a lot at night, so this may be another reason why wearing a bra at night might be helpful.

Is mixed feeding better than breastfeeding? ›

#4: Mixed feeding might mean breastfeeding continues longer

Feeding a baby doesn't have to be only formula or only breastmilk. It is beneficial for a baby to be fed even a small amount of breastmilk. Instead of fully formula fed, babies who have mixed feeds will continue to breastfeed for longer.

What is a reason a mother may chose to formula feed instead of breast feed? ›

If you choose to feed your baby formula, there are some benefits: Anyone can feed your baby. Grandparents or babysitters can feed your baby while you work or get some well-deserved time with your partner. You can get round-the-clock help.

What is the closest formula to breast milk? ›

Similac 360 Total Care Non-GMO Infant Formula Powder

Key features: Similac claims that this formula is their closest in composition to human breast milk. It includes a blend of DHA, lutein, and vitamin E — all nutrients found in breast milk.

What are 3 disadvantages of formula feeding? ›

formula fed are 16.7 times more likely to have pneumonia than children who are given only breast milk. harmful bacteria in contaminated formula. increase respiratory and food allergies which can cause eczema, rashes and diarrhea. likely to have asthma and wheezing.

Can mixing formula and breastmilk cause upset stomach? ›

If your baby tolerates both breastmilk and formula separately, then mixing them together should not cause an upset stomach, according to Dr. Crosby. If, for any reason, your baby does have an upset stomach, try burping them or bicycling their legs to alleviate any gas that might be built up.

How often should a combination fed baby poop? ›

Expect at least 3 bowel movements per day, but may be up to 4-12 for some babies. After this, baby may only poop every few days. Baby will usually pass more stool after starting solids. Newborn will pass meconium by 24-48 hours after birth.


1. Oshwal Health Talk - Breastfeeding - Good Health v Lifestyle
(Oshwal UK)
2. What You Need to Know About Feeding Your Baby And Toddler
(Dr Orlena)
3. How to stop breastfeeding without pain & make your baby to sleep throughout the night
(Lifestyle of Gladyes Alben)
4. The Importance of a Niche: OTs Role in Lactation and Infant Feeding
(Next Level Occupational Therapy)
5. Expressing, Storing & Feeding Breastmilk and Returning to Work | Isis Parenting
6. Responsive Feeding: Understanding when and how to develop a feeding relationship with infants


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