Combined feeding babies


How to combine breast and bottle feeding

It can take several weeks for you and your baby to feel happy and confident with breastfeeding.

Once you've both got the hang of it, it's usually possible to offer your baby bottles of expressed milk or formula alongside breastfeeding.

This is sometimes called mixed or combination feeding.

Why combine breast and bottle?

You may want to combine breastfeeding with bottle feeding if you:

  • are breastfeeding and want to use a bottle to offer your baby some expressed breast milk
  • want to breastfeed for some of your baby's feeds, but give bottles of formula for 1 or more feeds
  • are bottle feeding your baby and want to start breastfeeding
  • need to leave your baby and want to make sure they have some milk while you're away

Introducing formula feeds can affect the amount of breast milk you produce. There is also a small amount of evidence to show babies may not breastfeed as well because they learn to use a different kind of sucking action at the bottle than at the breast.

These things can make breastfeeding more difficult, especially in the first few weeks when you and your baby are still getting comfortable with breastfeeding.

Your breastmilk supply will usually not be affected if you start bottle feeding your baby when they are a bit older, you are both comfortable with breastfeeding, and you breastfeed every day.

Introducing formula feeds

If you're combining breastfeeding with formula feeds both you and your baby can carry on enjoying the benefits of breastfeeding.

If you choose to introduce infant formula:

  • it's best to do it 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, start a few weeks beforehand to give both of you time to readjust
  • if your baby is 6 months old or more and can drink milk from a cup, you may not need to introduce a bottle at all

For more information, see drinks and cups for babies.

Giving your baby their first bottle

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.

  • it usually helps to give the first few bottles when your baby is happy and relaxed – not when they're very hungry
  • it may help if someone else gives the first bottle feeds, so that your baby is not near you and smelling your breast milk
  • you might want to try using a different position for bottle and breastfeeding

See more advice on how to bottle feed.

Restarting breastfeeding

If you want to start breastfeeding more and give your baby fewer bottles, it's a good idea to ask your midwife, health visitor or breastfeeding supporter for support.

These tips may help too:

  • Hold and cuddle your baby as much as possible, ideally skin to skin. This will encourage your body to make milk and your baby to feed.
  • 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.
  • Try bottlefeeding while holding your baby skin to skin and close to your breasts.
  • If your baby is latching on, feed little and often. Do not worry if your baby does not feed for long to begin with. See tips on how to get your baby properly positioned and attached.
  • Choose times when your baby is relaxed, alert and not too hungry, and do not force your baby to stay at the breast.
  • Decrease the number of bottles gradually, as your milk supply increases.
  • Consider using a lactation aid (supplementer). A tiny tube is taped next to your nipple and passes into your baby's mouth so your baby can get milk via the tube as well as from your breast. This helps to support your baby as they get used to attaching to the breast. Your midwife, health visitor or breastfeeding supporter can give you more information.

See more tips on boosting your milk supply.

Help and support with mixed feeding

If you have any questions or concerns about combining breast and bottle feeding:

  • talk to your midwife, health visitor or breastfeeding supporter
  • call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm, every day)
  • find breastfeeding support near you

Video: why combine breast and bottle feeding?

In this video, 3 mothers discuss ways to combine breast and bottle feeding.

Media last reviewed: 14 March 2023
Media review due: 14 March 2026

Community content from HealthUnlocked

Page last reviewed: 8 October 2019
Next review due: 8 October 2022

Mixed feeding | Pregnancy Birth and Baby

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Key facts

  • Mixed feeding is when your baby is fed formula and breastmilk.
  • Regular mixed feeding can interfere with your milk supply.
  • Sometimes there are good reasons to consider mixed feeding. These include breastfeeding problems and a baby with a low weight.

What is mixed feeding?

Mixed feeding is when your baby is fed formula as well as breastmilk.

Some parents decide to start mixed feeding and combine breastfeeding and bottle feeds. This can be for a range of reasons.

Mixed feeding can involve:

  • breastfeeding and giving your baby formula
  • breastfeeding and giving your baby a combination of expressed breast milk and formula
  • breastfeeding and giving your baby donor breastmilk
  • bottle feeding expressed breast milk, formula, and/or donor milk

Regular mixed feeding with formula can make breastfeeding more challenging as it can interfere with your milk supply. Some babies may start to prefer drinking from a bottle.

The way you feed your baby is a personal choice. You may choose to feed your baby just expressed breastmilk as you prefer to feed using a bottle.

It’s a good idea to talk to a health professional if you are thinking about introducing formula.

From birth your baby needs to be fed regularly to have good weight gains. Newborns need to feed about every 2 to 3 hours (8 to 12 times in a 24-hour period).

Why might I think about mixed feeding?

Although exclusive breastfeeding for the first 6 months is the ideal start for your baby, there are reasons why you may consider mixed feeding. These may include:

  • issues with breastfeeding
  • low breastmilk supply
  • baby with a low weight

Issues with breastfeeding

Sometimes breastfeeding can be challenging (it’s important to remember that you and your baby are learning). Some of the challenges can include:

  • having sore, cracked or bleeding nipples
  • painful, blocked ducts in your breasts
  • mastitis — an inflammation of your breast that can cause pain and flu-like symptoms
  • oral thrush and/or breast and nipple thrush
  • nipple vasospasm — where the blood vessels in your nipple tighten and go into a spasm, preventing blood from flowing normally
  • inverted or flat nipples — consider getting advice from a professional about trying a nipple shield
  • difficulty with baby attaching to your breast — this can often be resolved with positioning and attachment advice or it could be due to issues such as tongue-tie, or a cleft palate
  • your baby becoming 'fussy' at the breast or refusing to feed
  • being uncomfortable about breastfeeding in a public
  • returning to work — while some people successfully combine breastfeeding with returning to work, others may prefer not to

You can get help for many of these issues. This might allow you to continue breastfeeding or return to exclusive breastfeeding.

If you are having troubles breastfeeding, get support early. Talk to your midwife, child health nurse or organise a visit with a lactation consultant.

If you decide to move to mixed feeding, getting support can help you to continue with some breastfeeding as well.

Low breastmilk supply

You might worry that you don’t have enough breastmilk for your baby. Low milk supply may be temporary. Many people can build up their milk supply with the right help and support.

There are different things you can do to increase the amount of breastmilk you are producing. The best way to establish a healthy supply of breast milk is to start breastfeeding frequently. Make sure your baby is latching on correctly and emptying your breasts. Make sure you ask for help from a health professional.

Your baby’s weight and other measurements are recorded in your baby’s health record book. This helps check your baby’s health, growth and development against what is expected.

Signs that your baby is getting enough milk (after the first week of birth) include:

  • 6 to 8 wet nappies (4 to 5 heavy disposable nappies) in a 24-hour period
  • having 8 to 12 breastfeeds in 24-hours
  • passing soft yellow poo (3 to 4 times a day if younger than 6 to 8 weeks)
  • settling and sleeping between most feeds
  • is back to birth weight in about 2 weeks
  • gaining on average 150g or more every week for their first 3 months

A small number of people may have low supply due to: previous breast surgery, not having enough breast tissue or another medical reason. You may be able to produce some breastmilk and choose mixed feeding for your baby with donor milk or formula.

Baby with low weight

A parent who is considering mixed feeding may be worried that their baby is losing or not gaining enough weight. All babies grow differently, and their weight may change at different times.

Depending on the situation, a health professional might suggest that you need to introduce supplementary feeds for your baby. You can often give your baby expressed breastmilk or you may begin mixed feeding with formula.

Sometimes a lower baby weight is nothing to be concerned about and only lasts for a short period of time due to a temporary milk supply or feeding issue.

Your health professional may say that your baby will benefit from mixed feeding if they were: born very prematurely (earlier than 32 weeks), had a very low birth weight (less than 1,500g), is unwell or has a medical condition.

How do I move from mixed feeding to breastfeeding?

If you are planning to increase breastfeeding again after mixed feeding, it’s important to keep up your breastmilk supply. Your healthcare professionals or one of the organisations listed below can help support you to do this.

Where can I get more help?

It's important to know that many breastfeeding and baby weight gain issues can be solved with the help of someone skilled in breastfeeding support.

You can call Pregnancy, Birth and Baby on 1800 882 436 to speak to a maternal child health nurse. Alternatively, you can contact:

  • a registered lactation consultant
  • your maternal child health nurse
  • your midwife
  • your doctor
  • the Australian Breastfeeding Association Breastfeeding Helpline: 1800 686 268 (1800 mum 2 mum)

Depending on your circumstances and your baby's age, they can advise you on:

  • how much formula to give your baby
  • how many times a day to give formula
  • when to move back to exclusive breastfeeding, if relevant

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:
Council of Australian Governments (COAG) Health Council (Australian National Breastfeeding Strategy 2019 and beyond), Australian Breastfeeding Association (Mixed feeding), The Royal Women’s Hospital (Breastfeeding problems), Royal Women's Hospital (Low milk supply)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: September 2022


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Related pages

  • Breastfeeding your baby
  • Feeding your baby with formula
  • Paid and unpaid parental leave – things to consider

Need more information?

Mixed feeding | Australian Breastfeeding Association

If you decide to introduce formula, you can keep breastfeeding too. Find out how to balance the feeds.