Combination feeding, also known as mixed feeding, involves feeding your baby breast milk and infant formula. Pediatricians recommend babies be exclusively breastfed for their first six months, but some parents may choose to introduce formula as well. Parents make this decision for a variety of reasons. If you are considering this due to concerns regarding latching or milk supply but would like to continue exclusively breastfeeding, you should reach out to a certified lactation consultant who can help address concerns and support this goal. If you feel that combination feeding would work better for your family, here is what pediatricians suggest for parents to ensure successful combination feeding.
It’s important to not rush into switching to bottle feeding your baby. It’s best to wait until breastfeeding is well established before introducing a bottle. That’s usually around 4 to 6 weeks. By this point, the baby has learned to latch well, and mom’s milk supply is more established as well.
When you start feeding your baby from a bottle, choose a slow flow or newborn size nipple. This will give an experience closer to the flow of milk from breastfeeding. Avoid propping the bottle in the baby’s mouth, as this could lead to choking. Hold the bottle at a slight angle, so that the nipple is about half full. When you start to feed, hold the bottle to the baby’s lips and wait for the baby to open and pull the nipple into the mouth. Don’t force the bottle into the mouth. Let the baby feed at its own pace. Look for signs the baby is getting full, such as a slower pace of feeding and turning the head away. When this happens, stop feeding, even if the bottle isn’t empty.
When mothers begin supplementing with formula, they risk lowering their milk supply. This is because milk production is dependent upon how much milk is removed from the breast. To maintain a stable milk supply, pump on a frequent schedule, ideally every two or three hours, including at least once at night. Also, pump after a skipped feeding, or whenever your breasts feel full. You can safely store breast milk in the refrigerator for up to four days, or in the freezer for up to six months.
Combining breastfeeding with bottle feeding requires learning a new rhythm for both you and your baby. But, with the right support, you can make the change that’s best for you and your little one. That’s why it’s crucial to build a relationship with a pediatrician and certified lactation consultant who can share practical advice for protecting your milk supply and ensuring your baby feeds successfully.
About Leticia B. Dirks, MD, FAAP
Dr. Leticia Dirks is a Fellow of the American Academy of Pediatrics. She grew up in Richmond, KY, but fell in love with Lexington during her time at the University of Kentucky. She went on to complete her medical training in Louisville at the University of Louisville and Norton Children’s Hospital.
Dr. Dirks provides services in general pediatrics, including immunizations, well-child checkups, sports physicals, and visits for acute and chronic illnesses. She is also a certified lactation consultant and enjoys spending extra time with new parents during lactation counseling visits.
Dr. Dirks can be reached at (859) 277-6102. For help scheduling an appointment, or to find the location closest to you, call (859) 258-4362, or visit LexingtonClinic.com.
