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Mixed feeding: supplementing breastfeeding with formula

0-18 months

Breastfed babies are sometimes given extra feeds as well as breastmilk. This is called mixed feeding or supplementing with formula.

About mixed feeding or supplementing with formula

Breastfeeding has many benefits for babies and their mums.

But sometimes breastfeeding is hard or your baby might not be able to feed directly from your breast. In these situations, you can often give your baby expressed breastmilk.

In rare cases, a health professional might suggest that your baby needs extra nutrition from small amounts of infant formula, as well as your breastmilk. This is called mixed feeding or supplementing with formula.

A baby might benefit from mixed feeding if she:

  • has a very low birth weight (under 1500 gm)
  • is born very premature (at less than 32 weeks of gestational age)
  • is very ill
  • isn’t gaining weight well.
If breastfeeding is causing you any pain or discomfort, you might need to express your breastmilk. This will stop your breasts from becoming engorged and keep your milk supply up. Ask your midwife, child and family health nurse, lactation consultant or GP for advice.

Worried about milk supply?

Many new mums worry about their milk supply, especially if their babies cry after feeds or their breasts feel empty. But it’s very rare for mums to be unable to produce enough breastmilk.

The best way to know if your baby is getting enough milk is to check his nappies and weight gains. Your baby is getting enough milk if he:

  • has at least 6-8 wet cloth nappies or 5 very wet disposables in 24 hours
  • has bowel motions every day (if he’s younger than 6-8 weeks old)
  • is gaining weight at about the right rate (check with your child and family health nurse)
  • is alert and mostly happy after and between feeds.
If you think you need to increase your milk supply or your baby needs extra feeds, talk to your midwife, child and family health nurse, lactation consultant or GP. You can also call the National Breastfeeding Helpline on 1800 686 268.

Before you try mixed feeding

There are several things to think about before you try mixed feeding.

Regular mixed feeding might make it more difficult to keep breastfeeding because it can interfere with keeping up a good supply of breastmilk. So if you’re thinking about supplementing with formula, it’s important to talk about it first with your midwife, child and family health nurse, lactation consultant or GP.

You might talk about:

  • how to boost your milk supply
  • how much formula to give your baby
  • how many times a day to give formula
  • how many days to give formula.

When you’re doing mixed feeding

There are some things to be aware of when you’re doing mixed feeding.

When your baby has a feed from a bottle of formula and not from your breast, you might notice:

  • your breasts getting overfull, which can be painful and can cause your body to stop producing milk
  • a reduction in your milk supply
  • your baby preferring the bottle to the breast and then refusing the breast
  • a change in the colour, smell and consistency of your baby’s poos.

Increasing breastfeeding while doing mixed feeding

If you’re ready to increase breastfeeding again and reduce the amount of mixed feeding your baby has, talk with your midwife, child and family health nurse and/or lactation consultant.

How quickly you cut back on mixed feeding depends on why you’re supplementing with formula, how old your baby is and how much formula your baby is having.

To cut back on mixed feeding, you can try:

  • gradually increasing your milk supply by expressing after breastfeeding
  • increasing how often you breastfeed your baby
  • gradually reducing the amount of formula you offer in each bottle or cutting out some formula feeds.
Video

Common breastfeeding questions: enough milk, too much milk, expressing

4:58

This video answers common questions about breastfeeding and milk supply. A lactation consultant says most mums can make plenty of milk for their babies. She talks about typical weight gain, and how to know whether your baby is getting enough milk. She also talks about changes in the amount of milk you produce in the weeks after birth and whether you need to express milk.

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Last updated or reviewed
26-10-2017

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Raising Children Network is supported by the Australian Government. Member organisations are the Parenting Research Centre and the Murdoch Childrens Research Institute with The Royal Children’s Hospital Centre for Community Child Health.

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