combining breast and bottle feeding

Combining breast and bottle-feeding

Combining breast and bottle-feeding can be very useful if you’re returning to work or if you want your partner to take over some of your baby’s feeds. Your baby will still get the nutritional goodness from your breast milk, but can still feed when it isn’t convenient to offer a breast.

Combining breast and bottle feeding: Timing is everything

You can use infant formula or expressed breast milk for one or more feeds by bottle. If possible, midwives recommend that you wait until your baby is at least six to eight weeks old, as combining breast and bottle any earlier than this may affect your milk supply. Bottlefeeding a breastfed baby too early could also affect their ability to suck at the breast properly, as milk flows faster out of a bottle than from a breast.

Supply and demand

Your supply of breast milk is driven by frequent breastfeeds, where you follow your baby’s feeding cues. Feeding your baby formula can affect the frequent feeds that are required to make the right amount of milk, particularly in the early days of breastfeeding. The less you feed, the less milk you produce. However, if your baby is older and breastfeeding is established, it is possible to maintain your breast milk supply combined with formula feeds, as long as you continue to breastfeed every day.

Do it gradually

If you substitute a breastfeed with a formula feed, it will take around three to seven days for your breasts to adjust to missing that one feed. Your body needs time to reduce the amount of milk it makes. Gradually reducing breast feeds can prevent your breasts from becoming uncomfortably engorged and/or developing mastitis. Let your baby have a few days (or weeks, if possible) between each time you substitute a breastfeeding session with a bottle. It’s a good idea to express a little milk from your breasts, to your own comfort, if you become engorged. But don’t express a whole feeding’s worth of milk; just take enough to make you feel comfortable. Your body will get the signal to produce less milk over time.

combining breast and bottle feeding

Getting baby used to bottles

If you’ve breastfed your baby from the beginning, do not be too surprised if the bottle is rejected at first. A good time to introduce those first few bottles is during the second feed of the day, when your baby is hungry but not starving, and likely to be in good spirits. It can also help to have your partner or a grandparent feed your baby the first bottle.

Take your time

According to, it’s important to be patient and allow baby plenty of time to learn how to drink from a bottle. Sometimes it can help for someone else to try the baby with a bottle. If baby reacts against it, stop and try again when the baby is calm. Trying to force the baby to feed from a bottle is not recommended.

Paced bottle-feeding is a great way for the baby and carer to get used to bottle-feeding. Here’s how it works:

  • Baby sits up on the carer’s lap.
  • Hold the bottle almost level and teat is offered in the same way you would the breast, tickling the top lip and allowing baby to take the teat into the mouth and suck.
  • Tilt the bottle slightly towards baby, and when baby pauses you can tilt the bottle down to allow baby to rest for a moment.
  • Repeat until baby has taken the full feed.

If your baby is over six months and doesn’t like a bottle you can use an ordinary or sippy cup with handles on it. Babies at this age are usually able to manage a cup. Only put a small amount of liquid into the cup so that any spills are easy to clean. This works well because your baby can control the milk flow. See more at

How to treat breast engorgement

Breast engorgement can make your breasts feel swollen and painful. Warm flannels applied to the breasts will help the milk to start flowing before you feed or pump. Cold compresses applied to the breast after a feed or pumping session can be very soothing. Before feeding or pumping, massage the area, starting behind the sore spot. Use your fingers in a circular motion and massage toward the nipple.

Combination feeding essentials

  • bottles of your choice
  • different sized teats with different flows. Your baby’s feeding speed will change as they grow
  • a breast pump – if you plan to express
  • formula milk – if you are not expressing
  • a sterilising system

Combining breast and bottle feeding

Mum’s story – Combining breast and bottle-feeding

“I exclusively breastfed my daughter for six months before attempting to introduce some formula feeds. She was due to start with ther child minder at six and a half months, so I planned to breastfeed in the mornings and nights and give bottles of formula during the day. She had happily taken a few bottles of expressed milk at around at three months, but I didn’t persevere with the bottle feeds. This was a mistake, as she simply refused to take a bottle later on. I began to panic, as I was due to start back at work in a matter of weeks. It took a lot of experimenting with three different types of bottles and also the discovery that I should have been using a faster flowing teat until she finally took the bottle a few days before I was due to return to work!” Lucy Smith.

Making the transition

It is now recommended to fully breast feed your baby for six months, but if a mother decides she cannot continue to fully breastfeed, rather than stop all together, she can mix or combine feed. Some mothers find it difficult to wean the baby off the breast and when the baby refuses to take an artificial feed, she may think it’s the feed that the baby doesn’t like. You will find it easier to make the transition if you recruit someone else to feed the baby for you. It’s better that you are not present.

combining breast and bottle feeding

If you bottle or cup feed the baby, he is clever enough to know that you will not refuse him the breast if he refuses the bottle! It is not recommended to mix breast and artificial feed into the same bottle. Take your time to make the transition from breast to artificial feeds. It will not happen overnight and so you could need two weeks preparation before the big day.

If you want to continue to breastfeed, you can give a morning and night feed for example, and offer the baby three feeds during the day. These can be expressed breast milk or artificial feed. The amount of artificial feed required at six months varies from baby to baby, but the average would be 180-220ml in each. The rule of thumb is to offer approx 25ml per pound of baby weight.

Midwife and antenatal educator Margaret Hanahoe set up the Domino and Home Birth schemes at the National Maternity Hospital. She is the co-author of two ebooks, “From Bump to Birth” and “After Birth”, both available to download on Amazon.

More like this:

Expressing breast milk
Tips to get baby to drink from a bottle
Tips for switching from breast to bottle


Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….

burping your baby

Burping your baby

Always burp your baby after feeding time is over. If she doesn’t burp after a few minutes, try changing the baby’s position and burp for another few minutes before feeding again.


Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.