Mixed feeding - combining breast and bottle feeding

Breastfeeding your baby at some feeds and giving formula milk at one or more feeds, is sometimes known as mixed feeding. Parents do this for all sorts of reasons but it is important to think through why you are considering doing this as it can make breastfeeding work less well and it reduces the health benefits for you and your baby. It is important to be aware that:

• Your own milk production will decrease if you replace breastfeeds with formula, if you add formula feeds between breastfeeds or if you give some formula after a breastfeed.
• Breastfeeding and bottle feeding require different techniques on the part of the baby.
• Sometimes babies find it difficult to breastfeed after they have been fed with a bottle or to change from one to another, but other babies seem to have no trouble with this.
• Giving any formula milk also reduces the protection against illness that breastfeeding gives to your baby but any amount of breastmilk is still helpful for his health.
• If you change your mind about mixed feeding it is possible to go back to solely breastfeeding.

The recommendation from the Departments of Health in the UK is that babies are exclusively breastfed for the first six months and then continue to breastfeed while solid foods are introduced. Many women in the UK do introduce formula before this time, often because they have problems with breastfeeding. If breastfeeding is uncomfortable or you feel you do not have enough milk, you can talk to a breastfeeding counsellor.

If you want to mix breastfeeding and formula because it will suit you and your family , then it is more likely to work if you wait until beyond the newborn period. You and your baby have a chance to learn about breastfeeding before starting to do both. More about breastfeeding straight after birth.

A cycle of reducing demand

Introducing a bottle of formula once a day can seem like a good idea if you are tired at the end of a busy day and your baby seems to want to feed a lot in the evenings. If you are considering this then it is important to be aware that the more a baby feeds, the more milk your body will make, so giving formula feeds, particularly in the first six weeks, is likely to mean your body will make less milk.

Some babies take more formula than they need, making them less hungry at the next breastfeed so they take less breastmilk and the breasts then respond by making less milk. This can mean that you give more formula feeds and this cycle continues until the baby is not breastfeeding at all.

If you are considering introducing a bottle of formula milk because you don’t believe you have enough breastmilk then you might find it helps to talk it over with a breastfeeding counsellor or health professional. There are ways to increase your breastmilk supply but starting to use formula may make the situation worse.

Sleeping

Some parents are told that giving a bottle of formula makes the baby sleep better at night. There is no evidence that this is true and those night breastfeeds are important to tell the woman’s body to keep making milk – especially in the early weeks. Looking at how family and friends can give practical help so that mum can rest during the day may be a way of helping you through those first weeks until your baby naturally wakes less to feed.

If you want to let others feed your baby

Sometimes mothers decide to use a bottle of formula so that their partner or another family member can be involved with the feeding of the baby. Whilst this is a lovely idea, you need to think about whether the advantages of this are more important to you than the possible problems with the breastmilk supply and the greater risk to the baby of infections and illness.
Many parents prefer fathers to take on other baby care roles such as bathing, calming, massage, changing, reading or singing to the baby. Some  wait until the baby is taking solid foods before partners get involved with feeding and sometimes  mothers express breastmilk to be given to the baby.
It is usually a good idea to get breastfeeding working well over a few weeks before a bottle is introduced, so that the milk supply is well-established and the baby knows how to breastfeed well.

Going from mixed feeding to exclusive breastfeeding

If you have been mixed feeding and want to return to only breastfeeding, it is usually possible to do this and you might find it helps to talk it through with a local breastfeeding counsellor, your midwife or health visitor, or you can call the NCT Breastfeeding Line (0300 330 0771). Whatever your decision, you can take pride in continuing to breastfeed your baby.

Sources of support:

NCT supports all parents, whatever their decisions about breast or formula feeding. Breastfeeding help is available from breastfeeding counsellors on the NCT Breastfeeding Line, 8am–10pm every day, phone 0300 330 0771. There may also be breastfeeding counsellors who are available locally.
Other sources of help:
Midwives in hospital and visiting your home
Breastfeeding specialists based in some hospitals
National Breastfeeding Line (government funded) 0300 100 0212

Healthtalkonline.org- comprehensive library of face-to-face interviews where parents share their experiences about breastfeeding, birth, parenting and many other issues:
http://www.healthtalkonline.org

NHS Choices information on bottle feeding  www.nhs.uk/Planners/birthtofive/Pages/bottle-feeding.aspx

Breastfeeding pathways:
http://www.babyfriendly.org.uk/pdfs/dh_mothers_breastfeeding_journey.pdf

Breastfeeding in public:
http://www.nhs.uk/Planners/breastfeeding/Pages/breastfeeding-in-public.aspx

Best Beginnings Bump to Breastfeeding (watch video clips online):
http://www.bestbeginnings.org.uk