Alternating between breastmilk and formula, known as combination feeding, allows parents to provide their baby with both. This flexible strategy enables babies to receive beneficial nutrients from breastmilk while fulfilling caloric needs through formula.
Reasons for Combination Feeding
Parents choose combination feeding for various reasons, such as addressing a low breastmilk supply when a baby isn’t gaining enough weight. Supplementing with formula ensures adequate nutrition for growth. This method also allows other caregivers to feed the baby when a parent returns to work or school, helping maintain the breastfeeding relationship even with a busy schedule.
Combination feeding accommodates shared feeding responsibilities, allowing partners or other family members to participate. Babies with specific health needs, like very low birth weight or prematurity, may also benefit from formula supplementation to support their growth. Additionally, this approach facilitates a gradual transition for babies eventually switching entirely from breastmilk to formula.
Methods for Alternating Feeds
One common method involves supplementing with formula after breastfeeding, particularly if the baby needs additional intake. Alternatively, parents can alternate full feeds, where some consist solely of breastmilk and others are entirely formula. When introducing formula, it is often advised to wait until breastfeeding is well-established, typically around three to six weeks postpartum, to help secure a steady milk supply.
Mixing breastmilk and formula in the same bottle is generally considered safe if done correctly. However, some experts recommend keeping them separate to avoid wasting breastmilk if the baby does not finish the bottle. If mixing, formula should always be prepared according to manufacturer instructions first, using the correct amount of water, before adding breastmilk. Pumping breastmilk can greatly facilitate combination feeding by allowing other caregivers to give expressed milk via a bottle, or to maintain milk supply when formula feeds are given.
Paced bottle feeding is a technique that can help breastfed babies transition to bottles by mimicking the slower flow of breastfeeding. This method involves holding the baby in a more upright position and pausing during feeds, which gives the baby more control over the milk flow and helps prevent overfeeding. Introducing a bottle when the baby is calm and not overly hungry, and having another caregiver offer the first few bottles, can also ease the transition.
Impact on Infant Health
Introducing formula alongside breastmilk can lead to adjustments in a baby’s digestive system, such as changes in stool consistency or frequency. While some fussiness or gassiness is normal, persistent symptoms like diarrhea, vomiting, or blood in the stool could indicate a formula intolerance or allergy.
Nipple confusion is a concern where babies might develop a preference for the faster flow of a bottle nipple over the breast. Using paced bottle feeding with a slow-flow nipple can help minimize this by making bottle feeding more similar to the effort required at the breast. Even with combination feeding, babies continue to receive immunological and nutritional benefits from breastmilk. Research suggests that even partial breastfeeding is associated with reduced risks of certain health issues, such as eczema and milk sensitization, compared to no breastfeeding.
Managing Your Milk Supply
Combination feeding affects the lactating parent’s milk supply. When formula feeds replace breastfeeds, the breasts receive less stimulation, signaling the body to produce less milk. To counteract this, pumping strategies can help maintain milk supply if formula feeds are introduced. Pumping regularly, especially when a breastfeed is replaced by formula, helps to empty the breasts and encourage continued milk production.
Monitoring milk supply involves observing signs such as the baby’s weight gain and the number of wet and dirty diapers. A gradual introduction of formula is recommended to allow the parent’s body to adjust and prevent discomfort like engorgement or mastitis. Consulting with a lactation consultant can provide personalized guidance on maintaining supply and navigating the complexities of combination feeding.