A step-by-step guide to combination feeding

The pressure to feed your baby in the so-called right way is real. So many mamas and mamas-to-be feel overwhelmed when considering breastfeeding versus formula—but here’s the truth: the best option is the one that works for you and your new little one, and it doesn’t have to be all or nothing.

Combination feeding (also called mixed feeding or combo feeding) is an option for parents who want the benefits of both options. With combination feeding, your baby breastfeeds and bottle feeds with either pumped milk or formula (or both). The beauty of combination feeding is that it’s 100% customizable.

There are so many reasons you might choose combination feeding. A demanding work schedule may mean pumping isn’t possible or providing enough. Maybe your milk supply is lower than you’d hoped, so adding formula removes some of the pressure. Combination feeding also gives space for others to help so you can have a moment to yourself.

Whatever the reason, it’s your choice. If you’re considering combination feeding, make sure you chat with your pediatrician or a lactation consultant to ensure you’re doing it safely, but you can use our step-by-step guide to help you get started on the right path.

Step 1: Get baby comfortable using a bottle

Lactation consultants usually recommend introducing the bottle between the ages of 4 and 6 weeks to allow time for your milk supply to establish and for baby to get the hang of nursing. You can still start earlier if needed, but you may want to consider slow-flow bottle nipples that match the flow of the breast.

Dr. Brown’s Natural Flow® Anti-colic Options+™ Wide Neck bottles are perfect for starting combination feeding. The shape and flow of the nipple mimic mama to help baby easily transition between breastfeeding and bottles. The internal vent system is clinically proven to reduce colic-decrease spit-up, burping, and gas. 

If it’s your baby’s first time using a bottle, let someone else feed if possible (this is a great time to pump if you plan to include breast milk in the bottles). And don’t be surprised if your little one initially rejects the bottle. Some babies move from breastfeeding to bottle feeding with no complaints, while others need extra encouragement (welcome to parenthood; where no two babies are alike). Don’t force it, especially if they seem frustrated. Just follow their lead and try again the next day.

Step 2: Introduce formula

Next up: choosing your formula. There are so many options—organic, plant-based, sensitive stomachs, and more. Once again, the choice really depends on what works for your family and baby (and you can always discuss this in detail with your pediatrician).

Aim for introducing formula when you know your baby is hungry, ideally a few hours after your last breastfeeding session. Try to start with one or two formula feedings in the first week, a few days apart, to help baby get used to formula. Gradually and gently reducing nursing sessions also helps limit clogged ducts or mastitis (although you may need to express a bit initially as your milk supply adjusts).

Similar to offering a bottle, it may take trial and error and time to find what works for your baby. Expect slight digestive changes as the baby adjusts to the new food source. Formula-fed baby poop will look different from that of breastfed babies’, and sometimes you’ll notice a little more gas as your baby’s digestive system adjusts (although Dr. Brown’s internal vent system can help). You can also combine formula with breast milk to ease the transition.

Step 3: Experiment with a schedule that works for you

As you ease into a bottle and formula-feeding routine, experiment to see what works for you and your baby. Like parenting, there’s no one right way to combo feed.

Start by thinking about when you want to replace breastfeeding with bottles. If you plan to provide formula while away from your baby at work or out of the house, you’ll need to estimate how much your baby will eat based on how many hours you’re away.

If you plan to nurse during the day but offer formula or pumped milk overnight (big bonus here if your partner takes a feed or two and you get a stretch of sleep!), your schedule should mimic baby’s night waking schedules.

Writing down a rough schedule can help you feel confident your baby is getting enough. For example, a 4-month-old baby needs approximately 4 to 6 ounces of breastmilk every three to four hours, or 4 to 6 ounces of formula every four hours. (Note that formula takes a little longer to digest than breast milk.) You don’t have to stick to the schedule perfectly, but it can help you visualize how to make combination feeding work for you. When in doubt, a lactation consultant can help you determine exactly how much your baby needs. 

A note from Motherly on using combination feeding

With a bit of trial and error, you’ll soon find a combo feeding routine that works for both of you—and you’ll be able to rest easy knowing that your baby is getting the nutrition they need with flexibility that works for your lifestyle.