Combination feeding: A lot of moms do it, but for some reason there isn’t much advice out there for the mothers who feed their babies both breastmilk and formula (aka combo feeding, supplementation, and partial weaning).
We’ve talked a lot about nursing and pumping, including nursing clothes for working moms and tips for pumping at the office, and when we recently asked what other kinds of feeding topics readers would like to see, the reader/commenter known as CPA Lady offered to write a post on combination feeding. We’re so glad we can share her experiences and advice!
In this guest post, she explains her initial plans for breastfeeding and formula feeding, her decision to try combo feeding, details about her daughter’s feedings from birth to six months, and more. Thank you, CPA Lady! — Kate
Picture credit: CPA Lady. AWWWWW.
Background Info: When I First Considered Formula Feeding
I began maternity leave with my first (and only) child with the idea that I would give nursing a try, but I planned to wean entirely to formula by the time I returned to work at 12 weeks. I did not even consider combo feeding as a possibility, since all the literature I read had warnings that if you began supplementing, your supply would dry up.
So I actually went into using formula expecting to exclusively formula feed. I found the website Fearless Formula Feeder helpful in figuring out how to navigate the world of formula.
Once I decided to try to combo feed, I flew by the seat of my pants, guided by absolutely nothing, because there was no real guidance that I could find. There were two sort-of-relevant pages in the 700-page What to Expect: The First Year (affiliate link) that I read over and over, desperate for any nugget of useful information.
Most of what I found on the internet had the tone of “you should just try harder to breastfeed.” How helpful. So I ended up making it up as I went along.
Psst: these are some of our latest favorite bras for nursing and pumping!
How Combination Feeding Worked for My Family: Time Frame, Logistics, Etc.
My baby “E” was breech and born via planned C-section. Her blood sugar was low enough that it was considered an emergency, so she was taken to the nursery, where they fed her formula as her first food. Her blood sugar came back up, they brought her to me, and I tried nursing for the first time.
One of the surprise benefits of having a C-section was that I was in the hospital for 3.5 days, with access to the lactation consultants 24/7. With plenty of help from them, E and I got the hang of things, and nursing was off to a great start.
3 weeks old
We introduced the first bottle of formula, using a Dr. Brown bottle and Enfamil newborn formula, which I picked based on the extremely scientific method of reading Amazon reviews. My husband gave E a bottle with one ounce of formula. I watched from the other room with a twinge of self-doubt. She guzzled down the entire bottle happily.
From this point forward, E typically got one bottle of formula per day around 2 a.m. on the three nights when my husband was not working. This really improved my quality of life because I was able to sleep for 5 or 6 hours straight while my husband took care of the baby.
Cluster feeding kicked in at some point in the blurry early weeks, and an occasional bottle helped me get a break during that delightful experience. This was especially helpful on nights when I was home alone and about to go crazy.
6 weeks old
We increased to two bottles of formula per day, the night bottle and one around midday. We were really into the swing of things with nursing at this point and I shocked myself by starting to love it.
8 weeks old
We were up to 50/50 formula. At this point I started feeling really resistant about quitting nursing entirely. I began wondering if I could combo feed by choice. I knew I was going back to work during a slow time, but we were headed into tax season. I’d be hitting the peak of that and working 70+ hours a week around the time my daughter turned six months old. I set a new optimistic deadline of making it to 6 months before switching entirely to formula.
12 weeks old
I went back to work. E had a pretty regular schedule: Wake up and nurse, 8+ hours at daycare, rush home and nurse right away, small bottle of formula + nurse again right before bed. At this point she started sleeping through the night.
If I had a normal 40-hour-a-week job I think I could have kept up this schedule of combo feeding for a long time. E only drank formula at daycare since I was not pumping at all. I brought in a big container of formula powder that stayed at daycare, and empty bottles each day. The daycare teachers used the water there, so I never had to do any pre-mixing. E typically got three bottles of formula during the day.
4 months old
I was still nursing two or three times per day depending on how late I got home. Tax season started in earnest, so I started missing the early evening nursing session more and more frequently.
5 months old
I would nurse either once or twice a day. As I got farther into tax season, it was much more likely that I only nursed E in the morning since I usually got home after she had gone to bed (ugh).
I started becoming more emotionally ready to stop. I didn’t think she was getting that much milk when she was nursing.
Up until this point, my supply had been strong, but once we got down to once a day it started noticeably dropping off.
On the day E turned 6 months old, I nursed her for the last time. I made a little speech about how I was so happy that I did it and told her we were done. That afternoon she hatched her first tooth, which was funny because I had always joked I’d stop nursing as soon as she got teeth. If she missed nursing, she didn’t act like it.
I was a little bit sad to quit, but happy I made it for so much longer than I originally had planned. Overall it was a great experience and I would definitely do the same thing again. With an eager baby and a good supply, combo feeding was really the best of both worlds for me — the benefits of breast milk paired with the flexibility of formula. Formula allowed nursing to be a joy rather than a chore for me.
This post contains affiliate links and CorporetteMoms may earn commissions for purchases made through links in this post. For more details see here. Thank you so much for your support! – Kat
Why I Chose To Combination Feed My Child
Our combined work schedule
My husband was working nights and weekends and I was working a ton of overtime. We saw him for a few hours on two weeknights, and during Saturday afternoon and evening. I was doing 90% of the parenting by myself.
I could not handle the pressure to be the sole source of sustenance for our daughter on top of keeping everything else in our life afloat. It also allowed my husband to take over completely and let me get some rest during the time he could spend with us.
Those darned billable hours
This is the reason I never pumped at work and why I didn’t push through tax season to keep on combo feeding for longer than six months. I don’t want to use the word “regret” here, but the insane pressure I put on myself to bill, bill, bill when my daughter was a baby makes me sad in retrospect.
Based on the nature of my work, and the design of my work space, any time I spent pumping would be non-billable time that I would need to make up. Pumping = seeing my daughter less. I prioritized spending time with her over feeding her breastmilk. That part I do not regret.
Honestly, I was incredibly burned out by the time I had my kid. I had spent my 20s throwing myself into school and work. From always having to do the best and go to the best school and get the best grades, then get the best job at the best firm and work the most hours.
The phrase “breast is best” was more than I could handle.
I freaked out at being told that I was supposed to attach myself to a breast pump multiple times a day for a year, and reorganize my entire life around making that happen at any cost, just to make sure my kid was smarter and healthier than other people’s kids by a small margin. And for what? So she could go to the best school and get the best job and work the most hours? I was not in the right place to add another “best” to my plate.
Combination Feeding and Mommy Guilt
How did I do it without guilt?
First, I was confident in my decision that this was the right thing for me and my family for all those reasons stated above. And second, I had ongoing, vocal support from women in my life, including from my sister and my best friend, both of whom exclusively breastfed (EBF) till their kids were 2.
My work mentor had used formula entirely once she came back from maternity leave. So did some of the other women I worked with. I also had friends who had kids at the same time who supplemented. To have thoughtful, educated women tell me “It’s okay if you don’t EBF” was a huge relief. And I totally scoped out the formula cabinet at daycare, and at least half the babies in this yuppie, organic-kale-eating daycare were drinking formula.
I secretly enjoyed feeling like a rebel too, which is hilarious because I’m a pretty uptight rules-follower generally.
No one ever shamed me, even when I mixed bottles of formula in public (REBEL!!!!). I was shocked. I had a whole dramatic speech worked up but never had to use it.
Products For Formula Feeding That I Loved:
Some of our guest poster’s favorite items for formula feeding — see all her combination feeding tips:
basket / drying rack / travel packs of formula / nursery water
- Dr. Brown dishwasher basket: I had three of these, two regular & one wide-mouth. I cannot see using those bottles without having a dishwasher. There are just too many parts.
- Munchkin High Capacity Bottle Drying Rack: This worked perfectly with all the fiddly little parts to the Dr. Brown bottles. I still use it for sippy cups.
- An astronomical number of bottles: 12? It was not unusual to have the entire top rack of our dishwasher filled with bottles and bottle pieces.
- Enfamil Single-Serve Formula Travel Packs: Great for on-the-go use. I would stuff a handful of these in the diaper bag in case I needed to make a bottle when we were out and about. My friend called these “Crystal Light for babies” because of the packaging.
- I did buy nursery water to make formula with for the first six months or so, but by the time she was closer to one I just used tap water. (Editor’s note: Here are some tips on using water in infant formula.)
Other Random Tips on Combination Feeding:
1. My kid never showed a bottle or breast preference.
I remember being new-mom irrationally worried about nipple confusion. In retrospect, I wonder, is that even real, or is it just something made up to scare people into not giving their kid a bottle? I think we introduced formula early enough that my kid thought it was just another kind of food served in a different kind of container. She never had a problem switching back and forth. She didn’t have breastmilk in a bottle since I didn’t pump, so I’m not sure if that would have confused her or not.
2. I never used a bottle warmer.
I went rogue and warmed water up in the microwave like you’re not supposed to. Then I had the genius idea to see if she’d drink room temperature formula, which she did happily.
3. How to Get Deals on Formula
I used Amazon Subscribe & Save to get diapers, wipes, formula, baby food pouches, and other stuff. If you have five things on your order each month you get 20% off everything. Toothbrushes are a good thing to add to an order for a low dollar item if you need something to round out an order.
If you sign up with the formula companies ahead of time they will send you a ton of free formula samples. That way you can try different kinds to see what your baby likes or does well with. I know some people who had family members sign up for samples too to get extra.
If your kid doesn’t end up liking one kind of formula, you can donate the unopened samples to your local food bank. The formula companies also regularly sent books of coupons that I would use at Target, and once I bought formula at Target, they would print out more formula coupons at the register nearly every time I shopped there.
I rarely bought formula without a coupon or some kind of discount.
Thank you SO MUCH to CPA Lady for sharing her combination feeding tips and tricks with us! Readers, did you try combo feeding your child? Where did you fall in the formula vs. breastmilk continuum?
Social media picture credit: Shutterstock / Rob Hainer.
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Mrs. Jones says
Good for you CPA Lady! I also did combo feeding but not exactly by choice, since son wouldn’t BF at first.
I never used a bottle warmer either (or a wipe warmer, sheesh)–I didn’t want son to get hooked on warm drinks and not be able to make that happen all the time.
We didn’t use a warmer either. We started combo feeding from day one and figured it would be much easier if we didn’t offer the choice. He would go from warm b*ob to formula bottle from the fridge without complaint.
This is such a great resource – thanks for taking the time to share your tips, CPA Lady. I stumbled into combination feeding with my first son around 8 months, and it was such a relief after months of stressing about how many ounces I was pumping. It was so freeing to be able to send extra food to daycare and not worry about growth spurts, big eating days, etc.
Same here. I’ve switched to combo feeding between 6 and 9 months with each kid and weaned completely around a year. The first kid, I had guilty twinges, but like CPA Lady says, it is so freeing not to think of yourself as the baby’s sole source of food! Current baby is 10 months and I’ve dropped pumping at work but I usually nurse him around his bedtime and pump right before i go to bed. I nurse him (while I’m still dozing) in my bed in the am. Usually I have 2 breast milk bottles to send to daycare, but if I end up with none for a day, I don’t sweat that either.
Thanks for the real talk and for sharing your experience, CPA Lady!
This is great! I agree with you that it’s nice to hear thoughtful, educated women say it’s okay not to EBF. You hit the nail on the head with the “always needing to be the best.” There’s a book called “Lactivism” by Courtney Jung that I’ve been meaning to read because it suggests the benefits of exclusively breastfeeding might have been exaggerated.
FWIW, just found out that my mother gave up BFing me at 2 weeks because I wouldn’t latch at all. My memories are hazy, but I think she supplemented a little with formula for my sisters but primarily BFed. She got a lawyer, an accountant and architect – I turned out top 10% at a top 10 undergrad and top 10% at a top 10 law school and reasonably mentally stable (IMO), so we formula babies apparently turn out OK too!
I’m also combo feeding my now 5mo baby girl, due to a low supply. Initially I wanted to breastfeed 100% but it was clear in the hospital that my plan wasn’t going to work, as we relied on donor milk in the hospital while my milk came in. My daughter started on formula (Gerber Good Start Gentle) from the day we brought her home and she’s still on it. At 3wks old we learned she had both tongue & lip ties, which was limiting her to only transferring 1oz of milk at at time from the breast, before she tired out. We got her ties revised, and her nursing improved, but my supply did not grow substantially. So she’s remained on formula, and I still pump at the office and nurse her before/after work and on weekends.
We use the Playtex Vent-aire bottles, Gerber Good Start Gentle formula, Dr Brown’s bottle warmer & Munchkin bottle sterilizer (I use it both for the bottles and my pump parts). She gets 1 bottle of breast milk and 2 bottles of formula at daycare. So far no issues with nipple confusion – she happily goes between breast and bottles. And the best part is that my husband can take her 2AM feedings so I can get some sleep! I still feel a tiny bit of guilt about not being able to exclusive breastfeed my little girl, but she’s a happy baby that’s gaining weight, which is my main goal.
This is great. I’m pregnant with #2 and contemplating a very different experience than with #1. (I EBF’d for 6 months with only the occasional formula bottle for giggles after that, pumped until 14 mos or so, and didn’t wean until after 2. V. disappointed to learn that I don’t get a medal or some sort of certificate for this.) I’ll have a short (8-12 week) mat leave this time around and I shudder to think about possible pumping accommodations (open office space). Also somehow I managed to get Lyme disease in my 2nd tri and the jury’s still out on whether BFing at all will be advisable! Anyway, thanks muchly for the extremely detailed rundown.
Your line about not wanting to make breastfeeding another thing you’re “the best” at is so on point.
I’m exclusively breastfeeding my 5 month old, but had a couple weeks of formula supplementation. SO much pressure on moms. It’s hard enough already.
I was discussing combo feeding with a friend of mine who has stopped pumping at work (she was pumping and dumping to maintain supply because she is on a fast-acting drug that is not recommended for nursing), and she is really stuck on knowing how much formula to offer on the weekend. I assumed you needed to do about as much as the kid gets during the week at daycare, but she thought he was probably still getting something from her breast during the day. Has anyone else been in that situation?
Great resource and much needed! There is definitely an “all or nothing” approach to using formula.
We started combo feeding because my daughter had a tongue tie that prevented her from getting enough milk from EBF. Once her tie was resolved, we re-introduced formula to supplement pumped milk when I was back at work. Now she’s on formula during the day and we still nurse in the AM and PM. I’ll go ahead and plug the Kirkland formula from Costco – so affordable and just as high quality as the name brands.
This is great! We combo feed my DH who is 3 months old. She gets one bottle of formula every day or every other day. We mostly do it for the flexibility – I can be gone 5hrs without being worried there’s enough pumped milk for her. Formula was also a sanity-saver during cluster feeding, which is why we introduced it in the first place. Her pediatrician was on board since it was clear that the cluster feeding was tough on me (emotionally and physically). We introduced bottles/pacifier within the first week and we never had issues going between breast/bottle. I think if you have a good latch and a good supply combo feeding is totally possible without reducing supply. Like the author here, I think it can actually extend the breastfeeding relationship.
Omg…combo feed my DD not my DH!!! Hahah
Thank you so much for sharing this!
This is useful. I started combo feeding when I stopped rrgularly pumping at 9 months postpartum. I still nurse twice a day now that she is 11 months. It’s the best of both worlds!
Now I only pump when I travel or when I get home after bedtime.
Maddie Ross says
I never really thought of what I did as “combo feeding,” but we did exactly this with my first. I stopped pumping unless I was traveling or missed an evening feed altogether around 8 months. We did use up the rest of the frozen stash first, but then went to formula and eventually did all formula at daycare until she started whole milk. I continued morning and evening feedings through 14-ish months.
Thanks for sharing- you are right on that there are really no good resources on combo feeding. We had to supplement my now-8 month old son from week three because he wasn’t gaining weight quickly enough (likely due to low supply). My son’s pediatrician suggested offering a bottle of formula for his last meal before we went to bed and he suggested that my husband give the bottle (he called it the ‘sports center bottle’ with the idea that my husband could catch up on his sports while hanging with the baby). This ended up being great for a number of reasons. It allowed me to get some sleep (since I was breast feeding at all other times) and have a little bit of a break. More importantly, it allowed my husband to participate in feeding our son and I know he loved that they got to spend that time together. Per my lactation consultant, we initially also offered an ounce of formula to supplement after every other nursing session until we were able to get his weight up. That lasted a month or so and then we tapered down and offered a supplemental bottle maybe once or twice throughout the day.
After I went back to work at 4 months we did about 50-50 breast milk v. formula (I was pumping three times / day initially) and eventually switched over to all formula at the 7 1/2 month mark. We never had any issue with nipple confusion. We also never warmed up any of the bottles which I think probably helped.
Excellent info on a great topic! I’m out of the baby phase, but I’ll add my experience. I started combo feeding my first around 7 months. My milk supply had started dropping. Turns out it was because of a medical issue, but I didn’t know that at the time. She was already taking bottles at daycare, so it wasn’t hard to get her to drink from a bottle. The hard part was that she would not drink the first few formulas I tried. I actually did a taste test of formulas and breastmilk (I know) and Gerber Good Start Gentle was the winner. She took right to it. At first, I sent one bottle of formula as a daycare backup. Then, I started mixing it in with breastmilk. First 25% formula, then 50%, etc. until it was 100% formula. She seemed fine with it. I continued nursing at home and pumping as possible until about 10 months. At that time, I was diagnosed with thyroid disease and put on some meds that weren’t breastfeeding-friendly. I weaned then. I was kind of sad at the time, but it worked out just fine.
I’ve supplemented from the beginning due to low supply/weight gain issues. I’ve done weighted feedings and he gets 2-3 oz from me and usually takes 4-5 oz to be full. So when I’m home, I bf and then supplement with 2-3 oz in a bottle. The nanny gives him 5 oz bottles (a mix of formula and whatever I’ve pumped at work/after he’s gone to sleep). It was such a disappointment at the beginning but now I feel mostly fine about it. and I feel like I have a better idea about how much he takes in. He likes boobs, he likes bottles, he likes everything. We try to pacefeed bottles to mimic the flow of breastmilk, but I don’t know if that’s a real thing or a lactivist recommendation.
My biggest remaining question is if the amount of formula he takes needs to increase since formula doesn’t change but breast milk changes with the baby. Plus he’s started to sleep through the night (5 months) and is missing the two night feeds he used to get. So is 25-30 oz enough a day or should that be increasing? The breastfeeding groups all scare you about stretching the baby’s stomach, but also not sure if that’s a real thing.
We use Plum Organics formula, which seemed like the crunchiest option if you don’t want to import from Europe.
I do think the stomach size is a real concern, at least according to my pediatrician.
From what I understand, babies don’t need to continue increasing the size of feedings beyond five months. I guess growth starts to slow down a bit. so it seems like you might be okay with the 25-30 that he’s already getting. My IBCLC and pediatrician always said to go by whether he’s peeing/pooping/thriving, which can drive you insane, but I am more okay with now that my baby is five months old and a little more sturdy seeming.
I also had (very) low supply and nursed as much as I could until I went back to work. Then, morning and night only until around 4 months. My son has a dairy protein sensitivity so we give him Alimentum. He’s now 10 months and doing amazingly – big, healthy, skilled.
I was heartbroken I couldn’t exclusively nurse, especially since the LCs and internet made it seem like I just wasn’t trying hard enough. Ultimately, though, it worked out great. My husband could feed him! I could eat dairy after 4 months! Both big wins!
This is great! I started combo feeding when I went back to work at six months. She gets a bottle of formula in the afternoon whether I’m with her or not (i.e. I just dropped the afternoon pumping/feeding).
I have combo fed from the beginning, although my plan was to EPF. We had a short hospital stay and LO’s latch wasn’t great, and when I went back to the hospital 2 days after discharge to see a lactation consultant, she had lost more than 10% of her weight, so I was advised to supplement with formula and pumped milk. I didn’t pump around the clock as advised, and because of that and her bad latch, I didn’t establish a full milk supply. During the end of my 12-week leave, I was pumping around 7x per day, and she was getting at least half her nutrition from me, but now that I am back at work and only pumping around 3x per day my supply has dropped quite a bit. She gets about 1-2 bottles of BM/day and the rest formula. I still have a lot of guilt around not trying too hard, but she is thriving and healthy so the guilt has lessened as time goes on. I agree that there is a real dearth of guidance around combo feeding and that the pressure to EBF is a bit much- although when #2 comes I will try again!
This is SO helpful! I’m one of those “I hope to EBF but whatever happens, happens” people and I definitely won’t feel bad if I have to combo feed.
When I was younger and nannyed for two working moms, both combo-fed their babies (I took care of them starting at 3 months). They never gave me special instructions on the formula – I mixed with with tap water, served it room temp, and neither of those kiddos ever minded/had issues (well, one kid had reflux but once he got on meds for that he was a much happier little guy – definitely wasn’t the formula making him spit up so much).
I think in retrospect this was such a great model for me because it made it seem like formula was no big deal – as soon as mom got home, baby would go right back to nursing and it just made sense to me.
It’s not exaggerating much to say combo feeding saved my sanity. I didn’t respond well to the pump at all, so it would take 3+ pumping sessions to get enough for a bottle. I was a SAHM at the time, so it wasn’t a huge deal, but after a while I got really darned tired of never being able to leave my son. Formula let me have a few hours off — that and switching him to his own crib instead of co-sleeping were game-changers. You read so much about how even a drop of formula ruins the gut bacteria and then your baby will be doooooooomed — but having a healthy mom is important too. We nursed for a very long time, so combo feeding didn’t hurt our nursing relationship. I still think EBF is great if you can swing it, but I don’t regret introducing formula.
Wonderful article! I’m about to transition from EBF to Combination feeding and my daughter is approaching 10 months old. This is extremely helpful information.
However, I would like more specifics about what she did on weekends when baby wasn’t at daycare. Did she give bottles of formula just like daycare, or was she able to nurse?
I so agree with this approach! Thank you for putting it out there. I was able to EBF with both kids until 6 months, and I stopped pumping that day with both – it was so hard to manage with biglaw and definitely had a big impact on my hours. I was blessed with a great supply and able to freeze a nice supply so at 6 months they alternated between frozen breastmilk and formula, gradually getting more and more formula until it ran out. Just like everything else being a working mom, everyone has to do what works for them.
I’m about to go back to work and my LO has EBF from the start she has taken formula and had No problem going from bottle to breast. My concern is while I’m at work for 8 hours if I don’t pump will it cause me to dry up? It is frustrating trying to find info on combo feeding.This has been very helpful.
Oh my goodness I needed to read these comments!! I am pregnant with my thrid and was very unsuccessful at nursing my first two. I asked many times about doing both and I always thought it to be so strange how people just goes nuts at the thought of doing both. My husbands work schedule is crazy and I will be doing much of the day to day with all three alone. I have always felt if I didn’t feel so overwhelmed to do one or the other exclusively I would have lasted much longer nursing if I could have just done both. So if anything ladies thanks for making me feel like I am not crazy ?