Should I breastfeed or bottle-feed? That is the big question many mamas struggle with during pregnancy and after the baby is born. But there's a third option: combination feeding.
Many moms end up choosing combination feeding, meaning that they feed their baby by both breastfeeding and bottle-feeding either pumped milk or formula, or a combination of both in the same bottle.
Combination feeding usually involves a period of experimenting and learning—mostly about your baby. After some trial and error, you will determine exactly how much milk your baby needs every day, their favorite bottle and nipple type, and what feeding schedule works best for your family. I know it sounds daunting now, but you will get it—we promise.
All three feeding options (breast, bottle and combination feeding) are good choices. It's all about finding what works best for you and your baby, mama.
Here are the answers to some of your commonly asked questions about combination feeding.
How do I find the right balance between breastfeeding and bottle-feeding?
According to the Centers for Disease Control and Prevention (CDC), one out of three breastfeeding mamas in the United States supplements her breast milk with formula by the time her baby reaches 6 months of age.
Combination feeding is all about finding the right balance between breastfeeding and bottle feeding using pumped milk or formula. This is going to vary by baby and by family, based on your specific variables. Here are a few example scenarios:
A mother works outside of the home full-time. When she is away, her baby gets formula from a bottle and when she is home, the baby breastfeeds; it works out to be a 50-50 split between breast and bottle-feeding.
A mother mostly breastfeeds, but when she runs errands or takes care of her elderly relative, her partner gives the baby a bottle of formula.
A mother mostly bottle-feeds but still nurses her baby to sleep every night.
There are so many ways to do combination feeding! The beauty is that you get to decide what works best for you.
As you start experimenting and getting more experience feeding your baby, it will get easier to figure out what balance of bottle-feeding and breastfeeding you and your baby need.
How much milk does my baby need?
Figuring out how much bottled milk to give your baby requires a bit of math. The average 1 to 3-month-old baby consumes 25 ounces of milk per day over eight to 12 feedings, so start with that and adjust as you get to know your baby.
So, say your baby eats 10 times per day: Dividing 25 ounces by 10 feedings is 2.5 ounces per feeding, so each of the bottles would be about 2.5 ounces.
When you nurse, there's no need to track how much they get. Here's how your baby will let you know that they are done breastfeeding:
Falling asleep at the breast and staying asleep when you take the nipple out of their mouth
Declining to re-latch
Showing open, relaxed hands. Look at your baby's hands when they are done nursing. If they are clenched into fists they are likely still hungry, but if they are relaxed and open, they are likely full.
Every baby is different, though. For specific recommendations for your baby, check with your pediatrician.
How do I start bottle-feeding?
When introducing a bottle to your baby, there seems to be a golden window between four and six weeks. Earlier than four weeks can cause nipple confusion, which may make them prefer a bottle over the breast because drinking from a bottle is easier.
It's worth noting that for cases when bottle feeding needs to be introduced earlier, some lactation consultants recommend using special newborn slow-flow nipples anytime you bottle-feed—even beyond the newborn phase—to restrict the flow of milk so that babies need to exert a similar level of effort for both bottle and breast.
In The Motherly Guide to Becoming Mama, Sharen Medrano, IBCLC, writes, "If the baby does need to be fed pumped milk or formula, know that there are other ways to feed a baby besides a bottle! Medicine cups, shot glasses, syringes and even spoons can be used to give milk to a baby. Just put the spoon (for example) right up to the baby's lips, offer slowly, and they'll start to eat. This will lead to a better transition to the breast when you move to breastfeeding. Be sure to feed them slowly, though, giving small amounts at a time and allowing them to swallow completely before offering the next sip."
(See? There are just so many ways to do combination feeding!)
But you don't want to wait too long before giving that first bottle. Introducing a bottle later than six weeks risks having the baby refuse the bottle because they have grown fond of breastfeeding.
When you do give the first bottle, if possible, ask your partner or a friend to feed your baby their first bottle. They are more likely to take it if they don't think mama is around to feed them.
How do I get started with pumping?
If you're choosing to supplement bottle feeding but still want to use your own milk, pumping is a good option.
When you pump, you have the option to do both breasts at the same time or one breast at a time. What you choose will likely depend on why you are pumping and when you last fed your baby.
For example, if you will be away from the baby for a period of time and are pumping to maintain your supply and bring milk home, you will probably choose to pump both breasts. If you are home with the baby and they have just nursed on the left side only, you may choose to then pump the right side to increase your supply or to add some milk to your freezer stash.
Be sure to consult your pump's instruction materials to confirm that you're operating the pump correctly and that the flanges are optimally positioned for you.
When you're done pumping, follow the manufacturer's instructions for cleaning the pump and accessories. If your baby is younger than 3 months old or has specific health concerns, your baby's provider may advise sterilizing the equipment between uses, so be sure to ask.
How often you pump will depend on why you are pumping, so there will be a lot of variation here. The most important thing to know, though, if you want to maintain your milk supply, is to try to pump as frequently as your baby eats.
Breast milk is made on a supply-and-demand system, so the more you pump, the more milk you will make.
If you will be exclusively pumping, or away from your baby for a period of time, pump as frequently as the baby eats—about every two to three hours. This will maintain your supply and help prevent clogs and engorgement.
If you are pumping once per day to increase your freezer stash, you might try to pump in the morning, as many moms find that they have the most milk early in the day.
Mamas who exclusively pump will generate anywhere from 19 to 30 ounces of milk per day (though this can vary a lot). If you pump eight times per day, you can expect anywhere from 2.5 to 3.75 ounces per pumping session (and again, your own amounts may be different).
How do I store breast milk?
If you are going to give your pumped milk to your baby within the next three to eight days, you can simply keep it in the fridge. If you plan to store it longer, you can freeze it. In cases where you plan to store the breast milk for later, it's recommended that you refrigerate or freeze the milk immediately after pumping to ensure maximum freshness down the road.
Here's how long pumped milk can be stored:
Room temperature: 4 hours. Keep covered.
Cooler bag: 24 hours. Keep ice packs in contact with milk, and avoid opening the cooler.
Refrigerator: Three to eight days. Store in the back of the fridge. Clean hands, pump and pumping surface will increase shelf life.
Freezer inside refrigerator: 2 weeks. Store in back, away from sides.
Separate freezer: 3 to 6 months. Store in back, away from sides.
Deep freezer: 6 to 12 months. Store in back, away from sides.
How do I start feeding with formula?
If you need to go the formula route, do so with confidence. Formulas are getting better all the time and are highly regulated, so they are perfectly safe and healthy for your baby.
There are tons of options out there. Some moms choose organic formulas, as they want to be extra careful about pesticides. Some mamas are even sourcing formulas from European countries since they don't include synthetic ingredients like those found in the United States (note that this option can be quite expensive). Your pediatrician can give you guidance on what the best formula for your baby is.
Once a bottle of formula has been prepared, it should be stored in the refrigerator and used within 24 hours. Once the baby has eaten from the bottle, though, it should be discarded within an hour.
Can I combine breast milk with formula in the same bottle?
It's okay to combine breast milk and formula in the same bottle—it doesn't have to be one or the other).
There are a few reasons a mother might choose to do this: to increase the milk volume of a feed or to stretch out her supply of pumped milk over a few feedings.
When you combine pumped milk and formula in a bottle, don't worry about the ratio—just combine as much of each as you have, up to the total number of ounces you're going to feed your baby (see ounce guidelines above). There's no magic formula for how much of each.
When preparing the bottle, make the formula first and then add in the breast milk. Breast milk should not be used instead of the water used to make formula—this can cause dangerous health problems for the baby.
One last note: Once pumped milk has been mixed with formula, it must be used within 24 hours, or within an hour after the baby has started drinking from the bottle—bacteria enters the bottle as the baby eats and can make the milk start to turn if left for too long.
You're doing great mama
It may take a period of experimenting to figure out exactly what's right for you and your baby, and that's okay. As with all areas of parenting, feeding your baby can be highly complex. Ultimately, you must trust yourself and your decisions. Your baby will be fine because they have you. That is what matters most.
A portion of the article has been excerpted from The Motherly Guide to Becoming Mama.
For mamas who are using combination feeding, these are our favorite products to make nourishing your baby a breeze:
Portable bottle warmer
For warming up pumped milk or formula, we love the Baby's Brew Warmer. It runs on batteries and attached directly to the bottle—it even has a formula dispenser. Feeding your baby on the go has never been easier.
Double electric breast pump
Adjusting to pumping your milk is so much easier with the right gear. The Luna is super quiet (no waking the baby) without compromising on power. It has both expression and massage modes so you can adjust the flow as needed, all while staying comfortable (and proud of the work you are doing!).
Bottle holder
You know those products that make you want to scream, "Where was this when I first had my baby?" This is one of them. It secures to your counter to hold the bottle or sippy cup while you prepare with one hand and hold your baby with the other.
Nursing sweater
Breastfeeding and pumping are so much easier when you don't have to struggle with clothing that gets in the way. And mama, you deserve to love your outfit, too. Oriane makes both possible with their stunning line of women-centered, easy-access nursing clothing. (Psst: This also works as a maternity sweater.)
We independently select and share the products we love—and may receive a commission if you choose to buy. You've got this.
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