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

Ask Allison

Q My sister-in-law and I both work three-day weeks and we help each
other out with child minding on our working days, which up until recently has worked out really well. Between us, our kids are aged between five and nine years – the problem is that it’s now become quite apparent that we have very different parenting styles. I prefer my two daughters (seven and nine) to have a structured day. For example, in my house, we have allocated times for television and iPads, etc. My sister-in-law, however, lets the kids run loose after school – homework is ignored and my kids end up wired after eating sugary treats all afternoon. I am considering looking at after-school childcare for the kids, but I’m worried that this is going to cause a family argument. Is there a diplomatic way that I can ask my sister-in-law to introduce some discipline into her child-minding days? It certainly doesn’t do her two kids any harm when I am minding them in my own house!

In a word, no, there is no diplomatic way to do this as it may very likely seem like your saying that your parenting style is better than
hers. As L’Óreal says, ‘now here comes the science bit.’ Dr. Kaylene
Henderson, a child psychiatrist, wrote a very interesting blog about ‘the
science behind the Mummy Wars’. She explains that before she had
children of her own she hadn’t been aware of how parents have a
very specific sense of the right parenting style. She also found that parents could be very definite in defending their chosen parenting style. Dr. Henderson, who describes herself as a curious, scientific, open-minded person, was surprised at how defensive parents could be and, at times, of their judgemental attitude towards each other. She explained the neurology of the Mummy Wars; okay, I’ll need you to bear with me for a second. Warning; I’m about to use some neuro-techie language.

Why do we judge each other?
As we have all had different experiences, this means that we all have very different memories stored in our brains. Most of our memories are ‘explicit’ memories – these are ones that we can recall easily such as important dates that mean something to us; important birthdays, special events or stories of and about our lives.
There is another type of memory called ‘implicit’ memory that plays a
key role in our parenting. This type of memory is the stuff that you do on autopilot. Psychologists call these heuristics or rules of thumb –
such as tying your shoelace, or driving your car (once you have learnt
to do both first!). Otherwise we’d really waste a huge amount of time
pondering over tasks that we have readily available to us. This seems to be where the science bit of our parenting style kicks in. This implicit memory goes all the way back to when you were an infant being parented by your parents. This is when you started the process of storing up how they did it into your memories.
Unless you make a conscious choice and effort to parent differently, what you saw and unconsciously learnt will be your automatic go-to parenting style.

We learn habits
This can really kick into gear when we feel our parenting style is
being mirrored or highlighted by disapproval from another parent. I know the cold sweat you feel when your child decides to make their outstanding bad behaviour performance at, of course, the most public and worst time. The implicit autopilot of how your parents dealt with these outbursts will flow unconsciously from you if you haven’t worked super hard to be aware and consciously change the old habits.
What’s happening for the on-looking parent is that they see you doing something they are used to doing, but you are doing it all wrong. Simply, because that is not how they know how to do it.

Find a way that works
You both have different parenting styles – who is to say which type is correct? You just need to know what works best for your family and that’s the bottom line. The irksome feelings won’t go away. You can talk to your sister-in-law, but I’m adding a caveat that it would be hard not to hurt her feelings. What we’re possibly looking at is that you prefer a more structured form of parenting, whereas your sister-in-law has a more permissive style. I’m not sure the two styles can mix, the mixture is a bit like oil and water.
If a collaborative shared form of parenting style can be agreed upon, then that is great, but our learnt hardwiring may prove difficult to change despite the intent to do so.
Perhaps, your own instinct of changing childcare might work best for you. In terms of making childcare work; the fit is ultimately the most
important aspect as you want a cohesive congruent feeling of the other caregiver to just ‘getting it’, like in any good partnership. Best of luck
with this and I wish you both well.


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.