How to Combination feed

How do you combination feed?

We have expert advice from our Midwife Sinead on how to start combination feeding and make it work for you and your baby

Whether you decide to move on from breastfeeding to formula feeding, or are considering combination feeding, the decision can be emotional and is biologically difficult to reverse. Introducing formula will lead to a decline in your breast milk production ,therefore it is important to make the change slowly, giving both your body and your baby time to adjust.

Slowly reducing breastfeeds by one a week will give your body time to learn to produce less milk. It will also prevent your breasts from becoming engorged or leaking, and if they feel full to bursting, expressing a little milk can help relieve the pressure.

Which feeds to stop first

Deciding which feeds you would like to offer from the breast and which from the bottle is a personal choice – the key is to be consistent. This will help your body adapt to the new routine. If you choose to drop a night feed, for example, your body will stop producing milk at this time. A regular combination feeding schedule enables your breasts to produce the right amount of milk at the right time.

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Introducing formula feeds to breastfed babies

If you're combining breastfeeding with formula feeds both you and your baby can carry on enjoying the benefits of breastfeeding. You and your baby will find a combination feeding schedule that works for both of you, but to help you get started our Midwife Sinead has put together her tips on how to introduce your baby to formula feeds:

It is best to introduce infant formula gradually to give your body time to reduce the amount of milk it makes – this helps lower your chance of getting uncomfortable, swollen breasts, or mastitis. If you're going back to work, it can also help to start a few weeks beforehand to give both of you time to readjust.
Don’t forget to express your breast milk regularly. Expressing releases the hormone prolactin, which stimulates your breasts to make milk. About 8 times a day, including once at night is ideal. It may be easier to express by hand to begin with – your midwife, health visitor or breastfeeding supporter can show you how.
Introduce the first bottle when your baby is happy and relaxed, not when they are very hungry or upset, and take the bottle out of your baby's mouth as soon as they begin to show signs that they've had enough.
Allow a partner or family member to give the first bottle feeds, so that your baby is not near you to smell your breast milk

When Mum is feeding, hold your baby as much as possible, ideally skin to skin and close to your breasts. This encourages your body to make milk and your baby to feed, plus it’s a nice excuse to get some extra cuddle time in.
Hold your baby in a semi-upright position and ideally in a different position from your usual breastfeeding one. It may help your baby get used to the new way of feeding.
Hold the bottle at an angle so that baby can suck milk in, avoiding air. It may take a while for a breastfed baby to get the hang of bottle feeding, because they need to use a different sucking action.
Try different bottle teats - this can make a difference. Try softening the teat first with warm, boiled water and then offer the bottle, so that they can draw it into their mouth
When deciding which feeds to swap out you can be flexible within your own schedule - for example if you are a working Mum the key to maintaining your breastfeeding relationship without pumping during work hours is to only nurse when you are with baby. It can help if you have a regular five-day-per-week daytime job, then use no bottles during the evening or on weekends.

Everyone’s experience will be different and settling into a combination feeding schedule that suits you both may take a little time, so be patient. The important thing to remember is to try and enjoy this time you have with your baby, but take advantage of involving family members or a partner too so that you can get some much needed rest!

Important notice

Breastfeeding is best for babies and provides many benefits. It is important that, in preparation for and during breastfeeding, you eat a varied, balanced diet. Combined breast and bottle feeding in the first weeks of life may reduce the supply of your own breastmilk, and reversing the decision not to breastfeed is difficult. The social and financial implications of using an infant formula should be considered. Improper use of an infant formula or inappropriate foods or feeding methods may present a health hazard. If you use an infant formula, you should follow manufacturer’s instructions for use carefully – failure to follow the instructions may make your baby ill. Always consult your doctor, midwife or health visitor for advice about feeding your baby.