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.

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.

• 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.

Breastfeeding more and giving fewer bottles

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 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