Mixed Feeding: A Guide to Combining Breastmilk and Formula

Highlights

• Mixed feeding is a combination of formula and breastmilk.
• Frequent use of formula can affect breastmilk supply.
• Parents may choose mixed feeding due to breastfeeding difficulties or concerns about baby’s weight.

In This Article

1. What is mixed feeding?
2. Why might mixed feeding be necessary?
3. Common breastfeeding difficulties
4. Dealing with low milk supply
5. Addressing concerns about baby’s weight
6. Transitioning back to breastfeeding
7. Tools and assistance

What is Mixed Feeding?

Mixed feeding involves giving a baby both breastmilk and formula. Some parents choose this method to combine breastfeeding with bottle feeding for various reasons.

Mixed feeding options include:

• Breastfeeding and formula feeding.
• Breastfeeding and a combination of expressed breastmilk and formula.
• Breastfeeding with donor breastmilk.
• Bottle feeding expressed breast milk, formula, or donor milk.

However, introducing regular mixed feeding can make breastfeeding more challenging, as it might interfere with the milk supply. Some babies may develop a preference for bottle feeding over breastfeeding.

Choosing how to feed your baby is a personal decision, and speaking with a healthcare professional can be helpful in making that choice.

Why Might Mixed Feeding Be Necessary?

Exclusive breastfeeding is recommended for the first six months, but mixed feeding might be considered for the following reasons:

• Breastfeeding difficulties.
• Low milk supply.
• Concerns about baby’s weight gain.

Common Breastfeeding Difficulties

Breastfeeding can be a learning process for both parents and babies. Some common challenges include:

• Sore, cracked, or bleeding nipples.
• Blocked ducts leading to pain.
• Mastitis (inflammation of the breast with flu-like symptoms).
• Oral or nipple thrush.
• Nipple vasospasm (pain from tightening blood vessels in the nipple).
• Inverted or flat nipples (nipple shields can help).
• Difficulty with the baby latching, possibly due to tongue-tie or cleft palate.
• Fussiness at the breast or refusal to feed.
• Discomfort breastfeeding in public.
• Returning to work, which may lead some parents to choose mixed feeding.

Most breastfeeding challenges can be addressed with the right support. Many parents can return to exclusive breastfeeding with the help of lactation consultants or healthcare providers.

If mixed feeding is introduced, it’s essential to maintain support to help continue breastfeeding.

Dealing with Low Milk Supply

Low milk supply is a common concern for some parents. It is often temporary and can be addressed with the right guidance.

Ways to increase milk supply include:

• Breastfeeding frequently.
• Ensuring the baby latches properly and empties the breasts.
• Seeking advice from a healthcare professional.

Signs that the baby is getting enough milk after the first week:

• 6 to 8 wet nappies (or 4 to 5 heavy disposable nappies) daily.
• 8 to 12 breastfeeds per day.
• Soft yellow stools 3 to 4 times daily (for babies under 6 to 8 weeks).
• Baby settles and sleeps between feeds.
• Returning to birth weight within 2 weeks.
• Gaining 150g or more per week in the first 3 months.

In some cases, low milk supply may result from past breast surgery, insufficient breast tissue, or medical reasons. If this is the case, mixed feeding with donor milk or formula may be considered.

Addressing Concerns About Baby’s Weight

Parents often worry about their baby’s weight. Babies grow at different rates, and occasional weight fluctuations are normal.

A healthcare professional may suggest supplemental feeding if:

• The baby isn’t gaining enough weight.
• Expressed breastmilk is insufficient, leading to the introduction of formula.

In some cases, temporary weight loss is not a significant concern and may resolve as milk supply increases.

Mixed feeding may be recommended if:

• The baby was born prematurely (before 32 weeks).
• The baby has a very low birth weight (under 1,500g).
• The baby has a medical condition that requires additional nutrition.

Transitioning Back to Breastfeeding

If you plan to return to exclusive breastfeeding after using mixed feeding, maintaining a stable milk supply is essential. Healthcare professionals can offer practical advice and support to help transition back to breastfeeding.

Tools and Assistance

Many concerns regarding breastfeeding and baby weight can be addressed with professional guidance.

Consulting a registered lactation consultant, midwife, maternal child health nurse, or doctor can help with:

• Strategies for returning to exclusive breastfeeding.
• The right amount of formula to offer.
• How often to supplement with formula.