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.
It can be helpful to talk to a midwife or health visitor about your options.
Some families choose to express and feed it to their babies via 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.
You can offer formula feeds before, during, after or instead of a breastfeed. Talk to your midwife, health visitor 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. It helps to reduce the number of breastfeeds slowly, starting with the one which is convenient for you. 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.
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 also signal to your breasts to make less milk.
On the other hand, if you’ve been advised 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. Try and feed 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
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. This can take up to a month.
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.
You might have heard that babies can get ‘nipple confusion’ but there is no evidence that this exists.