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Nursing and bottle feeding baby


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: 22 March 2020
Media review due: 22 March 2023

Community content from HealthUnlocked

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

Breastfeeding vs. Formula Feeding (for Parents)

Choosing whether to breastfeed or formula feed their baby is one of the biggest decisions expectant and new parents will make.

Healt experts believe breast milk is the best nutritional choice for infants. But breastfeeding may not be possible for all women. For many, the decision to breastfeed or formula feed is based on their comfort level, lifestyle, and specific medical situations.

For moms who can't breastfeed or who decide not to, infant formula is a healthy alternative. Formula provides babies with the nutrients they need to grow and thrive.

Some mothers worry that if they don't breastfeed, they won't bond with their baby. But the truth is, loving mothers will always create a special bond with their children. And feeding — no matter how — is a great time to strengthen that bond.

The decision to breastfeed or formula feed your baby is a personal one. Weighing the pros and cons of each method can help you decide what is best for you and your baby.

All About Breastfeeding

Nursing can be a wonderful experience for both mother and baby. It provides ideal nourishment and a special bonding experience that many mothers cherish.

A number of health organizations — including the American Academy of Pediatrics (AAP), the American Medical Association (AMA), and the World Health Organization (WHO) — recommend breastfeeding as the best choice for babies. Breastfeeding helps defend against infections, prevent allergies, and protect against a number of chronic conditions.

The AAP recommends that babies be breastfed exclusively for the first 6 months. Beyond that, breastfeeding is encouraged until at least 12 months, and longer if both the mother and baby are willing.

Here are some of the many benefits of breastfeeding:

Fighting infections and other conditions. Breastfed babies have fewer infections and hospitalizations than formula-fed infants. During breastfeeding, antibodies and other germ-fighting factors pass from a mother to her baby and strengthen the immune system. This helps lower a baby's chances of getting many infections, including:

  • ear infections
  • diarrhea
  • respiratory infections
  • meningitis

Breastfeeding also may protect babies against:

  • allergies
  • asthma
  • diabetes
  • obesity
  • sudden infant death syndrome (SIDS)

Breastfeeding is particularly beneficial for premature babies.

Nutrition and ease of digestion. Often called the "perfect food" for a human baby's digestive system, breast milk's components — lactose, protein (whey and casein), and fat — are easily digested by a newborn.

As a group, breastfed infants have less difficulty with digestion than do formula-fed infants. Breast milk tends to be more easily digested so that breastfed babies have fewer bouts of diarrhea or constipation.

Breast milk also naturally contains many of the vitamins and minerals that a newborn requires. One exception is vitamin D — the AAP recommends that all breastfed babies begin receiving vitamin D supplements during the first 2 months and continuing until a baby consumes enough vitamin D-fortified formula or milk (after 1 year of age).

The U.S. Food and Drug Administration (FDA) regulates formula companies to ensure they provide all the necessary nutrients (including vitamin D) in their formulas. Still, commercial formulas can't completely match breast milk's exact composition. Why? Because milk is a living substance made by each mother for her individual infant, a process that can't be duplicated in a factory.

Free. Breast milk doesn't cost a cent, while the cost of formula quickly adds up. And unless you're pumping breast milk and giving it to your baby, there's no need for bottles, nipples, and other supplies that can be costly. Since breastfed babies are less likely to be sick, that may mean they make fewer trips to the doctor's office, so fewer co-pays and less money are paid for prescriptions and over-the-counter medicines.

Different tastes. Nursing mothers usually need 300 to 500 extra calories per day, which should come from a wide variety of well-balanced foods. This introduces breastfed babies to different tastes through their mothers' breast milk, which has different flavors depending on what their mothers have eaten. By tasting the foods of their "culture," breastfed infants more easily accept solid foods.

Convenience. With no last-minute runs to the store for more formula, breast milk is always fresh and available whether you're home or out and about. And when women breastfeed, there's no need to wash bottles and nipples or warm up bottles in the middle of the night.

Smarter babies. Some studies suggest that children who were exclusively breastfed have slightly higher IQs than children who were formula fed.

"Skin-to-skin" contact. Many nursing mothers really enjoy the experience of bonding so closely with their babies. And the skin-to-skin contact can enhance the emotional connection between mother and infant.

Beneficial for mom, too. The ability to totally nourish a baby can help a new mother feel confident in her ability to care for her baby. Breastfeeding also burns calories and helps shrink the uterus, so nursing moms may be able to return to their pre-pregnancy shape and weight quicker. Also, studies show that breastfeeding helps lower the risk of breast cancer, high blood pressure, diabetes, and cardiovascular disease, and also may help decrease the risk of uterine and ovarian cancer.

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Breastfeeding Challenges

Breastfeeding can be easy from the get-go for some mothers, but take a while to get used to for others. Moms and babies need plenty of patience to get used to the routine of breastfeeding.

Common concerns of new moms, especially during the first few weeks and months, may include:

Personal comfort. Initially, many moms feel uncomfortable with breastfeeding. But with proper education, support, and practice, most moms overcome this.

Latch-on pain is normal for the first week to 10 days, and should last less than a minute with each feeding. But if breastfeeding hurts throughout feedings, or if their nipples and/or breasts are sore, it's a good idea for breastfeeding mothers to get help from a lactation consultant or their doctor. Many times, it's just a matter of using the proper technique, but sometimes pain can mean that something else is going on, like an infection.

Time and frequency of feedings. Breastfeeding requires a big time commitment from mothers, especially in the beginning, when babies feed often. A breastfeeding schedule or the need to pump breast milk during the day can make it harder for some moms to work, run errands, or travel.

And breastfed babies do need to eat more often than babies who take formula, because breast milk digests faster than formula. This means mom may find herself in demand every 2 or 3 hours (maybe more, maybe less) in the first few weeks.

Diet. Women who are breastfeeding need to be aware of what they eat and drink, since these can be passed to the baby through the breast milk. Just like during pregnancy, breastfeeding women should not eat fish that are high in mercury and should limit consumption of lower mercury fish.

If a mom drinks alcohol, a small amount can pass to the baby through breast milk. She should wait at least 2 hours after a single alcoholic drink to breastfeed to avoid passing any alcohol to the baby. Caffeine intake should be kept to no more than 300 milligrams (about one to three cups of regular coffee) or less per day because it can cause problems like restlessness and irritability in some babies.

Maternal medical conditions, medicines, and breast surgery. Medical conditions such as HIV or AIDS or those that involve chemotherapy or treatment with certain medicines can make breastfeeding unsafe. A woman should check with her doctor or a lactation consultant if she's unsure if she should breastfeed with a specific condition. Women should always check with the doctor about the safety of taking medicines while breastfeeding, including over-the-counter and herbal medicines.

Mothers who've had breast surgery, such as a reduction, may have difficulty with their milk supply if their milk ducts have been severed. In this situation, a woman should to talk to her doctor about her concerns and work with a lactation specialist.

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All About Formula Feeding

Commercially prepared infant formulas are a nutritious alternative to breast milk, and even contain some vitamins and nutrients that breastfed babies need to get from supplements.

Manufactured under sterile conditions, commercial formulas attempt to duplicate mother's milk using a complex combination of proteins, sugars, fats, and vitamins that aren't possible to create at home. So if you don't breastfeed your baby, it's important to use only commercially prepared formula and not try to make your own.

Besides medical concerns that may prevent breastfeeding, for some women, breastfeeding may be too difficult or stressful. Here are other reasons women may choose to formula feed:

Convenience. Either parent (or another caregiver) can feed the baby a bottle at any time (although this is also true for women who pump their breast milk). This allows mom to share the feeding duties and helps her partner to feel more involved in the crucial feeding process and the bonding that often comes with it.

Flexibility. Once the bottles are made, a formula-feeding mother can leave her baby with a partner or caregiver and know that her little one's feedings are taken care of. There's no need to pump or to schedule work or other obligations and activities around the baby's feeding schedule. And formula-feeding moms don't need to find a private place to nurse in public.

Time and frequency of feedings. Because formula is less digestible than breast milk, formula-fed babies usually need to eat less often than breastfed babies.

Diet. Women who opt to formula feed don't have to worry about the things they eat or drink that could affect their babies.

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Formula Feeding Challenges

As with breastfeeding, there are some challenges to consider when deciding whether to formula feed.

Lack of antibodies. None of the antibodies found in breast milk are in manufactured formula. So formula can't provide a baby with the added protection against infection and illness that breast milk does.

Can't match the complexity of breast milk. Manufactured formulas have yet to duplicate the complexity of breast milk, which changes as the baby's needs change.

Planning and organization. Unlike breast milk — which is always available, unlimited, and served at the right temperature — formula feeding your baby requires planning and organization to make sure that you have what you need when you need it. Parents must buy formula and make sure it's always on hand to avoid late-night runs to the store.

And it's important to always have the necessary supplies (like bottles and nipples) clean, easily accessible, and ready to go — otherwise, you will have a very hungry, very fussy baby to answer to. With 8-10 feedings in a 24-hour period, parents can quickly get overwhelmed if they're not prepared and organized.

Expense. Formula can be costly. Powdered formula is the least expensive, followed by concentrated, with ready-to-feed being the most expensive. And specialty formulas (such as soy and hypoallergenic) cost more — sometimes far more — than the basic formulas. During the first year of life, the cost of basic formula can run about $1,500.

Possibility of producing gas and constipation. Formula-fed babies may have more gas and firmer bowel movements than breastfed babies.

Making a Choice

Deciding how you will feed your baby can be a hard decision. You'll really only know the right choice for your family when your baby comes.

Many women decide on one method before the birth and then change their minds after their baby is born. And many women decide to breastfeed and supplement with formula because they find that is the best choice for their family and their lifestyle.

While you're weighing the pros and cons, talk to your doctor or lactation consultant. These health care providers can give you more information about your options and help you make the best decision for your family.

Baby won't take a bottle | Philips Avent

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any problems. If your breastfed baby refuses a bottle, don't worry. This is a common occurrence in many babies who are used to breastfeeding. Obviously, this can create certain difficulties for moms, especially if you need to return to work in the near future.

3 Philips Avent products to help you bottle feed:

So why is your baby refusing to bottle and crying? There are many ways to quickly and easily teach a breastfed baby to a bottle. Here are important tips on what to do when your baby refuses a bottle.

Is the baby refusing the bottle? Take a step back


If your baby cries while bottle feeding, the first thing to do is to start over and rethink your feeding approach and technique. Try the following steps when bottle feeding your baby: [1]

  1. Lift and tilt your baby's head forward. Before inserting the pacifier into the baby's mouth, make sure that the baby's head is raised and tilted over his body to avoid choking: so that the baby does not choke and have the opportunity to burp during bottle feeding.
  2. Insert the pacifier. Bring the pacifier to the baby's lips and gently guide it into the baby's mouth. In no case do not try to press the nipple on the baby's lips and try to push it into his mouth. After touching the pacifier to the baby's lips, wait for the baby to open his mouth and take the pacifier.
  3. Hold the bottle at an angle. Tilt the bottle at an angle so that the nipple is only half full. So the child can eat at his own pace.
  4. Let the baby burp during and after feeding. It can be useful for a child to burp not only after feeding, but also approximately in the middle of the process. This will help reduce gas or tummy discomfort that your baby may experience from swallowing too much air.
  5. Stop in time, do not overfeed the baby. If the baby begins to turn his head away from the bottle or closes his mouth, then he is full and you need to stop feeding.
  6. Perhaps the flow of milk from the nipple to the baby is weak or, on the contrary, too fast, so he is naughty and refuses the bottle. Try changing the nipple to a nipple with a different flow.​

Other tips if your baby refuses the bottle


If you've followed the steps above and your baby still refuses the bottle, don't worry. There are other ways to help bottle feed your baby. Here are some simple tricks you can add to your bottle feeding process. [2]

1. Remind your child about mom.

Sometimes a child can be fed by someone other than his mother - dad, grandmother or, for example, a nanny. If your baby fusses while bottle feeding, try wrapping the bottle in something that smells like mommy, like a piece of clothing or some fabric. This will make it easier to feed the baby when the mother is not around.

2. Try to maintain skin contact while bottle feeding.

Some babies need contact with their mother, so try bottle feeding while leaning against you. However, some babies are better at bottle feeding when they are in the exact opposite position than when they are breastfed. For example, there is a position with bent legs. Lay the child on your bent knees, facing you, pointing the child's legs towards your stomach. During feeding, the baby will be able to look at you and contact you in this way. If your baby refuses a bottle, experiment to see which works best.

3. Move while feeding.

Sometimes all it takes to get your baby to take the bottle is a little wiggle or walk. The next time your baby starts crying while bottle feeding, try moving around a little rhythmically to calm him down.

4. Try changing the milk temperature.

If the baby still does not want to take the bottle, check if the milk in the bottle is too hot or too cold. Before feeding, put some warm breast milk on the inside of your wrist to check the temperature. Milk should be warm, but if it seemed hot to you, just place the bottle for a short while under a stream of cold water.

Choosing the right bottle for your baby If you plan to combine bottle feeding with breastfeeding, it is advisable to choose bottles with a nipple that will have a wide base as the bottle will grip closer to the breast.

Also pay attention to the fact that the nipple is firm and flexible, the child must make an effort to drink from the bottle, as well as from the breast. Give preference to nipples with an anti-colic valve that vents air out of the bottle.

​Natural bottle allows you to combine breast and bottle feeding. 83.3% of babies switch from a Natural bottle to breastfeeding and back.*

If you choose a bottle for artificial feeding, traditional bottles are fine, but it is desirable that the nipple is made of a hypoallergenic material, such as silicone, has an anti-colic valve and did not stick together when bottle fed. In case your baby spit up often, then use special bottles with anti-colic and anti-reflux valve, which reduces the risk of spitting up and colic.​​

Bottle with unique AirFree valve reduces the risk of colic, gas and spitting up. With this bottle, you can feed your baby in an upright or semi-upright position to reduce spitting up. Due to the fact that the nipple is filled with milk and not air during feeding, the baby does not swallow air, which means that feeding will be more comfortable.

Both bottles are indispensable if you want to breastfeed, bottle feed or just bottle feed your baby.

“My baby refuses to breastfeed but bottle feeds – help!”

Sometimes a baby gets used to bottle feeding and refuses to breastfeed. Therefore, it is important to use bottles that are suitable for combining breastfeeding with bottle feeding. If, nevertheless, you are faced with the fact that the child refuses to take the breast, try using silicone nipple covers to make the transition from the bottle to the breast and back more imperceptible.

Remember that if you want to combine breastfeeding and bottle feeding, it is worth waiting at least a month before offering a bottle, so that you are lactating and have time to get used to each other and develop a breastfeeding regimen.​

Breastfeed and bottle feed your baby with pleasure


Remember that it takes a while for your baby to get used to bottle feeding. This is completely normal. If you have to go to work, be sure to set aside enough time to bottle train your baby beforehand.

Remember that every child is different, so what works for one may not work for another. With a little time and patience, you will find out what works best for your baby when he refuses a bottle.

You will identify your child's unique needs. However, if your baby still refuses the bottle after all the steps above, check with your pediatrician.

Articles and tips from Philips Avent

References:


*O.L. Lukoyanova, T.E. Borovik, I.A. Belyaeva, G.V. Yatsyk; NTsZD RAMS; 1st Moscow State Medical University THEM. Sechenova, "The use of modern technological methods to maintain successful breastfeeding", RF, 10/02/2012 3 llli.org - The Baby Who Doesn't Nurse

llli.org - Introducing a Bottle to a Breastfed Baby

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Bottle feeding | Canpolbabies.com

Find out how to bottle feed your baby safely, how to help your baby feel safe while feeding, and how to set feeding times based on your baby's needs.

The most important thing is to choose the right position when feeding

When bottle feeding, avoid lying down as the milk flows out of the bottle under the force of gravity (at a constant rate controlled by alternating pressure on the nipple).

An infant may choke on milk if fed in a horizontal position. Therefore, it is very important to choose the right - more upright - position for feeding (the baby's head should always be slightly higher than the rest of the body).

Your baby's head should be in the crook of your arm, in line with his spine. The bottle feeding position should resemble the natural feeding position - especially when you feed him with two different feeding methods.

Remember:

  • Never leave a baby alone with a bottle as they may choke
  • Never let your baby sleep with a bottle in their mouth

How to give your baby a bottle

Place the bottle in the child's mouth so that it forms a right angle with his face. Your baby should not encircle the entire nipple with his lips, but only its oblong part, while the lips should rest against the rounded part. The oblong part should always be full of milk. Otherwise, the baby will swallow a lot of air during feeding, which can cause colic. Air bubbles in the bottle mean your baby is suckling properly.

Emotional connection

Little children need parental love and affection. Your closeness helps him feel safe. Therefore, it is very important to talk affectionately with the baby as often as possible, hug and stroke him. Feeding is the best time to build an emotional relationship with your baby.

This is very easy to do when you are breastfeeding because you are already in physical contact with each other. However, bottle feeding also allows you to be closer to your baby as he feels the warmth of your body. Bottle feeding also allows other family members - the father, brothers and sisters to get closer to the child, since not only the mother can feed the baby in this way.

Calm emotional background

Never feed your baby when you are irritated or tense. Take some time for yourself first, take a deep breath and try to relax. When you have calmed down, sit in a comfortable chair, place a pillow under your arm, place your baby on the pillow, and start feeding while speaking gently to your baby. Your child feels your emotions. If you are tense, he will also feel restless. Also, never feed your baby when he is excited, crying or screaming. When he is in this state, his airways are not protected and food can enter his larynx instead of his esophagus.

Feeding by the hour

Formula milk is not as easily digested by the baby's stomach as breast milk, so according to generally accepted rules, it should be given every 3 hours.

Some pediatricians say it's best to give your baby formula on demand, that is, when the baby is hungry. In their opinion, it is better to feed the child than to wait another hour and keep him in suspense because he wants to eat. However, you still need to control the number of feedings and your baby's weight gain.

During the first month of life, the baby should eat > 7-8 times a day, 90-100 ml for each feeding, in the second month of life: 6-7 times a day, 100-120 ml for each feeding. During the first six months, the baby should gain approximately 150-200 g per week.

Feeding breaks

When your baby sucks milk from a bottle, he also swallows air. Therefore, he may feel full even before he drinks half the bottle. When feeding a child, breaks should be taken every few minutes to allow the baby to take in air - after such a break, he should ask for food again. During feeding, hold the baby in an upright or semi-recumbent position for a while (sometimes even for several minutes) to give him the opportunity to release air accumulated during feeding from the digestive tract. Help the child by holding him on your shoulder, putting his hands on your back. Bend and spread his legs a little. You can also massage his back or pat him gently from the bottom up. Remember to protect your clothes with a diaper or towel. You can also help your baby burp out excess air when he is in your lap. The child should lie on his tummy, leaning on your hip, and his arms should hang freely on the other side.

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