Tips for Successful Combination Feeding (Bottle & Breast)

Combination feeding—a feeding approach in which baby is fed using both the breast and the bottle—is an adaptable and accessible option for many families. Despite its commonality, there's a noticeable lack of readily available information on mastering successful combo feeding. Online, you'll encounter warnings about nipple confusion and bottle interference with breastfeeding, but as a feeding therapist and lactation counselor, I'm here to debunk these myths. Contrary to these misconceptions, abundant research affirms that babies can adapt between breastfeeding and bottle feeding, and with the appropriate guidance and support, this adaptability becomes even more feasible. In this guide, we'll explore practical tips for achieving successful combination feeding, ensuring a fulfilling experience for both you and your little one.

Tip 1: Establish a Comfortable Nursing Relationship

Creating a successful foundation for combination feeding starts by ensuring a positive experience with direct breastfeeding for both you and your baby. Focus on essentials like achieving a good latch, finding comfortable feeding positions, and seeking professional support when needed. It's important to stress that the harmony between breastfeeding and bottle-feeding flourishes when breastfeeding itself is in good shape. Negative effects on direct breastfeeding from introducing a bottle are usually seen when existing breastfeeding issues have not been addressed.

Tip 2: Choose a Slow Flow Bottle

Selecting the right bottle is crucial for successful combination feeding. While research shows nipple confusion is not real, babies can form a preference for the often faster, more passive flow of the bottle—what we often call “flow preference.” The best way to help ensure baby does not develop a preference for the bottle is to use a slower flow bottle, regardless of baby’s age. In most bottle brands, selecting a slow flow, level 1, or even slower options like “preemie” flows for newborn are a good choice. As long as baby is doing well on this slow flow bottle nipple, there is no need to level up as they age. Babies will naturally become more efficient as they get older.

Tip 3: Ensure a Deep Latch on the Bottle

Contrary to what many believe, the best bottles for going between the bottle and the breast are typically not the ones that resemble breasts. Most babies latch deeper onto bottles with more tapered nipples. Of course, every baby is different, so experiment with different bottle styles to find the one that best suits your baby's preferences. A deeper latch—one where baby’s lips extend down towards the collar of the bottle nipple where the bottle meets the nipple—ensures a more efficient sucking technique.

Tip 4: Pace Feed

Practice pace feeding to ensure your baby stays actively engaged during bottle feeds. Hold the bottle in a more horizontal position, allowing the baby to naturally pace themselves. Effective positions for pace feeding include an upright position where baby is fed on just a slight incline or side lying, where baby is lying on their side. Pace feeding gives baby more control over feeding and helps keep bottle feeding a more active feeding experience.

Tip 5: Plan Ahead as Needed

If you plan to combo feed later or foresee the need for your baby to eventually take a bottle, start offering a bottle early, around 2-3 weeks of age or as soon as breastfeeding feels well-established. Early introduction ensures your baby learns and retains the bottle-feeding skill. Babies are born with a suck reflex, but this reflex gets weaker and eventually goes away between 4 and 6 months of age. This suck reflex helps baby learn the skill of feeding, so introducing the bottle early helps baby use their suck reflex to help them learn and refine their bottle-feeding skill.

Tip 6: Customize Your Feeding Schedule

There is no one-size-fits-all approach to combination feeding. Customize your feeding schedule based on your baby's needs and your lifestyle. Be flexible and open to adjustments, finding a rhythm that works best for both you and your little one. Pay attention to your baby's cues, ensuring that their unique feeding preferences and patterns are accommodated. A personalized feeding schedule contributes to a stress-free combination feeding experience.

Additionally, depending on your chosen feeding combination, consider the following:

• Breastmilk-Only Combination: If combining breast and bottle feeding but providing only breastmilk, pump to replace those bottle feedings. For example, if your baby nurses six times a day and takes two bottles of pumped breastmilk, you should pump twice. Breastmilk follows the supply-and-demand principle, and maintaining a full milk supply requires signaling to your body the amount needed.
• Formula Combination: If directly breastfeeding and providing formula through bottles, there is no need to pump in place of those bottles. Your body will naturally adjust production based on demand. For instance, if you nurse four times a day and give a bottle of formula four times a day, your body should adapt to produce the necessary amount for those four nursing sessions.

Successful combination feeding is entirely achievable! By establishing a positive breastfeeding routine, introducing the bottle thoughtfully, and choosing the right techniques, you can create a harmonious feeding experience for your baby. Remember, each baby is unique, so embrace flexibility and seek guidance from professionals to tailor the combination feeding journey to your family's specific needs. Whether at the breast or the bottle, every feeding moment is an opportunity to strengthen your bond with your little one while ensuring their nutritional needs are met.