My baby is breastfeeding, but I’m thinking about introducing some formula too. Can I do both?
Yes! It doesn’t have to be all or nothing. Every ounce of breast milk benefits your baby, so we encourage you to continue breastfeeding as long and as often as you’d like to maximize the health benefits for both of you.
Exploring Reasons to Combination Feed
Combination feeding, also known as mixed feeding, is when your baby receives both breast milk and infant formula. Mothers choose to combination feed for several reasons. Perhaps they are going back to work or school, and while there are laws that protect pumping rights, they may not wish to pump while separated from their baby.
Some mothers worry that their milk supply may not be sufficient to meet all their baby’s needs. When doctors are concerned about a baby’s weight gain, they may encourage formula supplementation to ensure the baby is getting enough to eat. In this case, combination feeding may only be needed for a short time until the mother’s milk supply has increased, and the baby's weight has stabilized. Click here for common causes and solutions for low milk supply. Click here for information on triple feeding.
When Formula is Needed Short-Term
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- Work with your doctor to determine the appropriate amount of formula to supplement with. Keep your doctor informed about any changes in your breast milk supply, and discuss when it would be safe to eliminate formula feedings. This process is often gradual.
- A weighed feeding is an effective way to assess how much milk your baby transfers during a breastfeeding session. During this process, your baby is weighed both before and after nursing. This can be done at your clinic or local WIC office. Click here for information on the average intake for breastfed babies. Ensuring your baby is transferring enough milk is a good indicator that it’s safe to start reducing formula supplementation.
When to Introduce Formula
It’s recommended to exclusively breastfeed as long as possible before introducing formula to help establish your milk supply. If you’re able, plan to devote the first month or so to nursing at the breast only. Once your milk supply is established, it can fluctuate up or down, based on how often the breasts are emptied.
Another reason to wait to introduce formula is to ensure that your baby develops a preference for the breast. It is recommended to wait 2–4 weeks before introducing a bottle so that your baby can go back and forth from breast to bottle without issues.
How to Combination Feed
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- Option 1: Breastfeed for one feeding, then offer formula at the next feeding, alternating throughout the day.
- Option 2: Breastfeed during the day and formula feed at night—or the other way around.
- Option 3: Breastfeed while together and formula feed while apart.
- Option 4: Breastfeed at home but use formula when out and about.
If both breast milk and formula are offered at the same feeding, prioritize breast milk.
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- Nursing Moms: Breastfeed first, then follow with formula.
- Pumping Moms: Offer expressed breast milk first, then follow with formula. Do not mix in the same bottle to prevent waste if your baby doesn’t finish the whole bottle.
Maintaining Milk Supply
Your milk supply will be determined by how frequently and effectively breast milk is removed. Once you determine the breast milk-to-formula ratio, keep your schedule consistent. Empty the breasts by nursing or pumping the same number of times (and durations) each day. If your schedule needs adjusting, emptying the breasts more often will increase milk supply, while emptying them less often will decrease it.
Paced Bottle-Feeding
There are many benefits from using the paced bottle-feeding method, and we encourage it whether breast milk or formula is offered.
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- Makes the transition from breast to bottle smoother by mimicking breastfeeding.
- Helps prevent waste and overfeeding.
- Reduces baby’s gas and tummy upset from drinking too much, too quickly.
- Lessens feeding-related stress by mimicking a natural rhythm that helps the baby stay calm and in control.
How To Pace Feed
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- Sit your baby partly upright and hold the bottle by their lips but angled partially downward.
- When baby starts to draw the bottle nipple (use a slow-flow nipple) into their mouth and suck, angle the bottle slightly upward filling half of the nipple with milk.
- When sucking slows or stops, angle the bottle downward again until sucking continues.
WIC Can Help
Check with your doctor about which formula is best for your baby. Inform the WIC office if you’ve introduced formula, so they can help determine how much to add to your food package.
Introducing formula doesn’t mean the end of your breastfeeding journey. There’s no one-size-fits-all approach, and with a balanced approach, you can continue to enjoy the benefits of breastfeeding. The best feeding plan is the one that works for you and your family. WIC and your breastfeeding peer counselor are here to support you every step of the way.
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