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Here's how to do combination feeding with your baby

How do I find the right balance between breastfeeding and bottle-feeding?

combination-feeding

Should I breastfeed or bottle-feed? That is the big question many mamas struggle with during pregnancy and after the baby is born. But there's a third option: combination feeding.

Many moms end up choosing combination feeding, meaning that they feed their baby by both breastfeeding and bottle-feeding either pumped milk or formula, or a combination of both in the same bottle.

Combination feeding usually involves a period of experimenting and learning—mostly about your baby. After some trial and error, you will determine exactly how much milk your baby needs every day, their favorite bottle and nipple type, and what feeding schedule works best for your family. I know it sounds daunting now, but you will get it—we promise.


All three feeding options (breast, bottle and combination feeding) are good choices. It's all about finding what works best for you and your baby, mama.

Here are the answers to some of your commonly asked questions about combination feeding.

How do I find the right balance between breastfeeding and bottle-feeding?

According to the Centers for Disease Control and Prevention (CDC), one out of three breastfeeding mamas in the United States supplements her breast milk with formula by the time her baby reaches 6 months of age.

Combination feeding is all about finding the right balance between breastfeeding and bottle feeding using pumped milk or formula. This is going to vary by baby and by family, based on your specific variables. Here are a few example scenarios:

  • A mother works outside of the home full-time. When she is away, her baby gets formula from a bottle and when she is home, the baby breastfeeds; it works out to be a 50-50 split between breast and bottle-feeding.
  • A mother mostly breastfeeds, but when she runs errands or takes care of her elderly relative, her partner gives the baby a bottle of formula.
  • A mother mostly bottle-feeds but still nurses her baby to sleep every night.

There are so many ways to do combination feeding! The beauty is that you get to decide what works best for you.

As you start experimenting and getting more experience feeding your baby, it will get easier to figure out what balance of bottle-feeding and breastfeeding you and your baby need.

How much milk does my baby need?

Figuring out how much bottled milk to give your baby requires a bit of math. The average 1 to 3-month-old baby consumes 25 ounces of milk per day over eight to 12 feedings, so start with that and adjust as you get to know your baby.

So, say your baby eats 10 times per day: Dividing 25 ounces by 10 feedings is 2.5 ounces per feeding, so each of the bottles would be about 2.5 ounces.

When you nurse, there's no need to track how much they get. Here's how your baby will let you know that they are done breastfeeding:

  • Falling asleep at the breast and staying asleep when you take the nipple out of their mouth
  • Declining to re-latch
  • Showing open, relaxed hands. Look at your baby's hands when they are done nursing. If they are clenched into fists they are likely still hungry, but if they are relaxed and open, they are likely full.

Every baby is different, though. For specific recommendations for your baby, check with your pediatrician.

How do I start bottle-feeding?

When introducing a bottle to your baby, there seems to be a golden window between four and six weeks. Earlier than four weeks can cause nipple confusion, which may make them prefer a bottle over the breast because drinking from a bottle is easier.

It's worth noting that for cases when bottle feeding needs to be introduced earlier, some lactation consultants recommend using special newborn slow-flow nipples anytime you bottle-feed—even beyond the newborn phase—to restrict the flow of milk so that babies need to exert a similar level of effort for both bottle and breast.

In The Motherly Guide to Becoming Mama, Sharen Medrano, IBCLC, writes, "If the baby does need to be fed pumped milk or formula, know that there are other ways to feed a baby besides a bottle! Medicine cups, shot glasses, syringes and even spoons can be used to give milk to a baby. Just put the spoon (for example) right up to the baby's lips, offer slowly, and they'll start to eat. This will lead to a better transition to the breast when you move to breastfeeding. Be sure to feed them slowly, though, giving small amounts at a time and allowing them to swallow completely before offering the next sip."

(See? There are just so many ways to do combination feeding!)

But you don't want to wait too long before giving that first bottle. Introducing a bottle later than six weeks risks having the baby refuse the bottle because they have grown fond of breastfeeding.

When you do give the first bottle, if possible, ask your partner or a friend to feed your baby their first bottle. They are more likely to take it if they don't think mama is around to feed them.

How do I get started with pumping?

If you're choosing to supplement bottle feeding but still want to use your own milk, pumping is a good option.

When you pump, you have the option to do both breasts at the same time or one breast at a time. What you choose will likely depend on why you are pumping and when you last fed your baby.

For example, if you will be away from the baby for a period of time and are pumping to maintain your supply and bring milk home, you will probably choose to pump both breasts. If you are home with the baby and they have just nursed on the left side only, you may choose to then pump the right side to increase your supply or to add some milk to your freezer stash.

Be sure to consult your pump's instruction materials to confirm that you're operating the pump correctly and that the flanges are optimally positioned for you.

When you're done pumping, follow the manufacturer's instructions for cleaning the pump and accessories. If your baby is younger than 3 months old or has specific health concerns, your baby's provider may advise sterilizing the equipment between uses, so be sure to ask.

How often you pump will depend on why you are pumping, so there will be a lot of variation here. The most important thing to know, though, if you want to maintain your milk supply, is to try to pump as frequently as your baby eats.

Breast milk is made on a supply-and-demand system, so the more you pump, the more milk you will make.

If you will be exclusively pumping, or away from your baby for a period of time, pump as frequently as the baby eats—about every two to three hours. This will maintain your supply and help prevent clogs and engorgement.

If you are pumping once per day to increase your freezer stash, you might try to pump in the morning, as many moms find that they have the most milk early in the day.

Mamas who exclusively pump will generate anywhere from 19 to 30 ounces of milk per day (though this can vary a lot). If you pump eight times per day, you can expect anywhere from 2.5 to 3.75 ounces per pumping session (and again, your own amounts may be different).

How do I store breast milk?

If you are going to give your pumped milk to your baby within the next three to eight days, you can simply keep it in the fridge. If you plan to store it longer, you can freeze it. In cases where you plan to store the breast milk for later, it's recommended that you refrigerate or freeze the milk immediately after pumping to ensure maximum freshness down the road.

Here's how long pumped milk can be stored:

  • Room temperature: 4 hours. Keep covered.
  • Cooler bag: 24 hours. Keep ice packs in contact with milk, and avoid opening the cooler.
  • Refrigerator: Three to eight days. Store in the back of the fridge. Clean hands, pump and pumping surface will increase shelf life.
  • Freezer inside refrigerator: 2 weeks. Store in back, away from sides.
  • Separate freezer: 3 to 6 months. Store in back, away from sides.
  • Deep freezer: 6 to 12 months. Store in back, away from sides.

How do I start feeding with formula?

If you need to go the formula route, do so with confidence. Formulas are getting better all the time and are highly regulated, so they are perfectly safe and healthy for your baby.

There are tons of options out there. Some moms choose organic formulas, as they want to be extra careful about pesticides. Some mamas are even sourcing formulas from European countries since they don't include synthetic ingredients like those found in the United States (note that this option can be quite expensive). Your pediatrician can give you guidance on what the best formula for your baby is.

Once a bottle of formula has been prepared, it should be stored in the refrigerator and used within 24 hours. Once the baby has eaten from the bottle, though, it should be discarded within an hour.

Can I combine breast milk with formula in the same bottle?

It's okay to combine breast milk and formula in the same bottle—it doesn't have to be one or the other).

There are a few reasons a mother might choose to do this: to increase the milk volume of a feed or to stretch out her supply of pumped milk over a few feedings.

When you combine pumped milk and formula in a bottle, don't worry about the ratio—just combine as much of each as you have, up to the total number of ounces you're going to feed your baby (see ounce guidelines above). There's no magic formula for how much of each.

When preparing the bottle, make the formula first and then add in the breast milk. Breast milk should not be used instead of the water used to make formula—this can cause dangerous health problems for the baby.

One last note: Once pumped milk has been mixed with formula, it must be used within 24 hours, or within an hour after the baby has started drinking from the bottle—bacteria enters the bottle as the baby eats and can make the milk start to turn if left for too long.

You're doing great mama

It may take a period of experimenting to figure out exactly what's right for you and your baby, and that's okay. As with all areas of parenting, feeding your baby can be highly complex. Ultimately, you must trust yourself and your decisions. Your baby will be fine because they have you. That is what matters most.

A portion of the article has been excerpted from The Motherly Guide to Becoming Mama.

For mamas who are using combination feeding, these are our favorite products to make nourishing your baby a breeze:

Portable bottle warmer

bottle warmer

For warming up pumped milk or formula, we love the Baby's Brew Warmer. It runs on batteries and attached directly to the bottle—it even has a formula dispenser. Feeding your baby on the go has never been easier.

$85

Double electric breast pump

electric breast pump

Adjusting to pumping your milk is so much easier with the right gear. The Luna is super quiet (no waking the baby) without compromising on power. It has both expression and massage modes so you can adjust the flow as needed, all while staying comfortable (and proud of the work you are doing!).

$260

Bottle holder

bottle holder

You know those products that make you want to scream, "Where was this when I first had my baby?" This is one of them. It secures to your counter to hold the bottle or sippy cup while you prepare with one hand and hold your baby with the other.

$20

Nursing sweater

nursing sweater

Breastfeeding and pumping are so much easier when you don't have to struggle with clothing that gets in the way. And mama, you deserve to love your outfit, too. Oriane makes both possible with their stunning line of women-centered, easy-access nursing clothing. (Psst: This also works as a maternity sweater.)

$36


We independently select and share the products we love—and may receive a commission if you choose to buy. You've got this.

By its very nature, motherhood requires some lifestyle adjustments: Instead of staying up late with friends, you get up early for snuggles with your baby. Instead of spontaneous date nights with your honey, you take afternoon family strolls with your little love. Instead of running out of the house with just your keys and phone, you only leave with a fully loaded diaper bag.

For breastfeeding or pumping mamas, there is an additional layer of consideration around when, how and how much your baby will eat. Thankfully, when it comes to effective solutions for nursing or bottle-feeding your baby, Dr. Brown's puts the considerations of mamas and their babies first with products that help with every step of the process—from comfortably adjusting to nursing your newborn to introducing a bottle to efficiently pumping.

With countless hours spent breastfeeding, pumping and bottle-feeding, the editors at Motherly know the secret to success is having dependable supplies that can help you feed your baby in a way that matches lifestyle.

Here are 9 breastfeeding and pumping products to help you no matter what the day holds.

Customflow™ Double Electric Breast Pump

Dr. Brown's electric pump

For efficient, productive pumping sessions, a double electric breast pump will help you get the job done as quickly as possible. Quiet for nighttime pumping sessions and compact for bringing along to work, this double pump puts you in control with fully adjustable settings.

$159.99

Hands-Free Pumping Bra

Dr. Brown''s hands free pumping bra

Especially in the early days, feeding your baby can feel like a pretty consuming task. A hands-free pumping bra will help you reclaim some of your precious time while pumping—and all mamas will know just how valuable more time can be!

$29.99

Manual Breast Pump with SoftShape™ Silicone Shield

Dr. Brown's manual breast pump

If you live a life that sometimes takes you away from electrical outlets (that's most of us!), then you'll absolutely want a manual breast pump in your arsenal. With two pumping modes to promote efficient milk expression and a comfort-fitted shield, a manual pump is simply the most convenient pump to take along and use. Although it may not get as much glory as an electric pump, we really appreciate how quick and easy this manual pump is to use—and how liberating it is not to stress about finding a power supply.

$29.99

Nipple Shields and Sterilization Case

Dr. Brown's nipple shields

There is a bit of a learning curve to breastfeeding—for both mamas and babies. Thankfully, even if there are some physical challenges (like inverted nipples or a baby's tongue tie) or nursing doesn't click right away, silicone nipple shields can be a huge help. With a convenient carry case that can be sterilized in the microwave, you don't have to worry about germs or bacteria either. 🙌

$9.99

Silicone One-Piece Breast Pump

Dr. Brown's silicone pump

When you are feeding your baby on one breast, the other can still experience milk letdown—which means it's a golden opportunity to save some additional milk. With a silent, hands-free silicone pump, you can easily collect milk while nursing.

$14.99

Breast to Bottle Pump & Store Feeding Set

After a lifetime of nursing from the breast, introducing a bottle can be a bit of a strange experience for babies. Dr. Brown's Options+™ and slow flow bottle nipples were designed with this in mind to make the introduction to bottles smooth and pleasant for parents and babies. As a set that seamlessly works together from pumping to storing milk to bottle feeding, you don't have to stress about having everything you need to keep your baby fed and happy either.

$24.99

Washable Breast Pads

washable breast pads

Mamas' bodies are amazingly made to help breast milk flow when it's in demand—but occasionally also at other times. Especially as your supply is establishing or your breasts are fuller as the length between feeding sessions increase, it's helpful to use washable nursing pads to prevent breast milk from leaking through your bra.

$8.99

Breast Milk Storage Bags

Dr. Brown's milk storage bags

The essential for mamas who do any pumping, breast milk storage bags allow you to easily and safely seal expressed milk in the refrigerator or freezer. Dr. Brown's™ Breast Milk Storage Bags take it even further with extra thick walls that block out scents from other food items and feature an ultra secure lock to prevent leaking.

$7.99


Watch one mama's review of the new Dr. Brown's breastfeeding line here:

This article was sponsored by Dr. Brown's. Thank you for supporting the brands that support Motherly and mamas.

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