Mixed feeding: how to start and combine breast and bottle

There are as many ways of feeding as there are mothers, so the important thing is to be able to offer every mum and her baby the best solution for their situation. That's why, if your decision is to go for mixed feeding, we, the midwives at Happymami, have prepared the following post for you. Mixed feeding: how do you start the transition from breast to bottle? , to clear up all the questions you may have. The best food for your baby is breastfeeding, but there are many occasions when a mum needs or wants to give her baby breastfeeding combined with a bottle. That's why we want to give you the best information so that you get it just right. Find out more about our bottle for mixed feeding.

What happens if I do mixed feeding with formula?

Mixed feeding can be done with breast milk (expressing and feeding it later) or with formula. The important thing is to follow suitable guidelines to protect your breastfeeding, based mainly on avoiding generic bottles and using a Happymami mixed-feeding bottle. That way, on the one hand you'll prevent your body from stopping producing breast milk, and with the tailor-made Happymami bottle you protect your baby from nipple confusion, safeguarding your breastfeeding.

Take a look at our Breastfeeding Guide to answer all your questions about mixed feeding.

Mixed feeding from the start: how does it work?

From pregnancy onwards, your body prepares to breastfeed your baby. And after birth, when you put your baby to the breast, a whole process is set off in your body that will provide your baby with all the milk they need during the breastfeeding stage. So that we understand each other, let's call this process the engine of breastfeeding, and its main stimulus will be your baby's sucking, among others. That gives us the famous rule: “the more your baby sucks at the breast, the more milk you produce”. Whether it's the baby's own sucking or a breast pump, this information matters in cases where babies have needed time in an incubator and have been separated from their mother.

🍼 Our personalised bottles are designed to combine with breastfeeding from day one. 🍼

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Factors in mixed feeding

Your breastfeeding rests on two fundamental pillars, your body and your baby, and making sure that neither of them gets confused will be of the greatest importance if you want to do mixed feeding without losing your breastfeeding.

What is teat and nipple confusion in a newborn during mixed feeding?

It's the confusion we create in your baby by using a teat that is different from your breast when we do mixed feeding, after which your baby will get confused and refuse your breastfeeding. That's why we need to avoid generic bottles and use a tailor-made Happymami bottle, to prevent confusion in your baby and protect your breastfeeding when you combine breastfeeding and bottle.

What should you do to avoid confusion during mixed feeding?

To avoid confusion when mixed feeding, you can use alternative feeding methods such as finger feeding with a syringe, a spoon or a supplemental nursing system. If you use a bottle, choose one that resembles your breast as closely as possible. A custom-designed Happymami bottle is the closest match.

👶🏻 Use bottles adapted to your baby's needs to avoid confusion when combining breast and formula 👶🏻

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Why is it important to use a bottle similar to your breast for mixed feeding?

When they are born, your baby has a set of reflexes, called primitive reflexes. These reflexes are normal and will disappear over time, and they help them “survive” during this first stage. Of all the primitive reflexes of the newborn, we focus on two: the rooting reflex and the sucking reflex. The rooting reflex happens when the area around your baby's mouth (peri-oral) is stimulated: they will turn their mouth in search of that stimulus. And the second, super-important reflex is sucking, a reflex that means that when something touches your baby's palate, they suck. But your baby doesn't know what a nipple is, or a dummy, or what mum's breast is like, and they must learn how much stimulation mum is going to give their palate. Because, for example, if mum has a large breast with a short nipple. In this case, over the following days the baby will learn that mum's breast is very large, so when it is brought close during feeds and it touches the corner of their lips, the baby will already have learned that it is a large breast and will open their mouth wide. They will also have learned how much stimulation they will get from mum's nipple on their palate, which is perfect for the baby, who feels very comfortable with that stimulation and breastfeeds perfectly. That's why every breast, with its own nipples, is perfect for breastfeeding; all we need is for the baby to learn what mum's breast is like, and it will take a few days or weeks to establish.

Advantages of using personalised Happymami bottles in mixed feeding

Happymami bottles are an excellent tool to support babies while they are learning to feed, especially when they are developing and perfecting the sucking reflex. Designed to imitate the texture and shape of the mother's breast, these bottles allow a natural transition between breast and bottle without confusing the baby.

Teats adapted to your baby's learning

Happymami teats stimulate your baby's palate in a similar way to the maternal nipple, helping to reinforce the sucking reflex. They make it easier for your baby to associate similar feeding patterns between mum's breast and the bottle. Start designing your bottle

Mixed feeding with formula

To do mixed feeding with formula, the most important thing is to make sure you don't confuse your breast. Just as we mentioned before that you shouldn't confuse your baby by using a bottle designed for mixed feeding, now it's time to think about not confusing your body if you do mixed feeding. That's why, if you combine breastfeeding and bottle, bear in mind that each time, your baby will need a larger amount of food. So we must make sure that the breast also produces more, keeping the breast properly stimulated, either with your baby or with a breast pump. And that way you can do mixed feeding without losing your breastfeeding.

Mixed feeding without reducing your milk production

After birth or a caesarean, and above all after skin-to-skin contact with your baby and putting them to the breast, your body understands that there is a baby, and it will start up all the machinery to offer your baby the food they need. In the first days your body says: “Right, there's a baby, let's start breastfeeding”. As we stimulate it with feeds, or with a breast pump if the baby is in an incubator, after a few days your body will have a rise in breast milk. Every mum is unique and it may happen sooner or later, but with the right stimulation we will get that rise in breast milk. This rise in milk shows that your body understands “OK, OK, there's a baby or babies, I'm going to give it everything to be sure” and it produces maybe 3 litres, for example, your breast will be really engorged and what you have to do is put your baby to the breast. The days pass and, of those 3 litres your body had produced, your baby perhaps takes half a litre, just as an example. Then your body says “Perfect, it's not 4 babies, it's 1 baby” and adjusts its production to your baby's needs. Because it is perfectly prepared to do so.

How do you do mixed feeding?

To do mixed feeding without affecting your breastfeeding we should follow a few guidelines. The first is to avoid using generic bottles, using a tailor-made Happymami bottle, so you prevent confusion in your baby and protect your breastfeeding.

Resources for mums who choose mixed feeding

In this section you will find practical information and key resources for mums who opt for mixed feeding, a detailed breastfeeding guide, and basic tips for newborn care. Everything you need to know for this important stage.

• Breastfeeding guide 🍼
• Newborn care guide 👶

How do you do mixed feeding with a newborn?

In the first ten days we need to focus on establishing breastfeeding, so the most advisable thing is to do exclusive breastfeeding only. These days are crucial for your breastfeeding, and we need both your baby and your body to understand that we are going to start the engine of breastfeeding, so for the first 10 days, breast only. From day ten of breastfeeding, we can start to do mixed feeding by introducing one bottle a day. Our advice is to give one bottle a day, if possible with your own breast milk (and it is highly recommended), so your breast will keep producing everything your baby takes. It can be interesting to do this feed at night, because there are babies who sleep a little longer after a bottle feed, and those 2 or 3 hours can be very beneficial for your rest. Continue this pattern until the newborn is twenty days old.

Mixed feeding for a 1-month-old baby

From day twenty of the newborn, continuing with our mixed feeding, we can already introduce a second bottle feed a day, the night one we were doing, and if you want another one during the afternoon or evening too. When isn't so relevant; the important thing is that we keep the breast properly stimulated to keep maintaining and increasing the production machinery. And obviously without forgetting to use a tailor-made Happymami bottle so as not to confuse your baby. From one month of life onwards, we can give the bottles more freely, always prioritising the feeds you can do at the breast, and use the bottle for those feeds that you need or want. Also, if you do mixed feeding because your baby needs a supplement. First give the breast until it is empty and then supplement with the amount prescribed by the paediatrician. If you carry on giving the bottles with your milk it will be perfect. If you decide to introduce formula feeding as well, it will also be fine.

Mixed feeding for a 2-month-old baby

It's very important to bear in mind that as your baby grows, they will need a larger amount of milk per feed. This means that if we offer your baby the breast and then they take 30 ml of formula, it would be advisable, at least until 2 months, to express the same amount of breast milk. That way your body will produce everything your baby needs even if we do mixed feeding. Keeping this regularity of expressing until 3 months would be essential for ideal mixed feeding. But obviously we must adapt this information to your situation. The amount of milk per feed will be determined by your paediatrician if it's a supplement. Or by your baby's needs; as a guide, the amounts of each bottle a newborn should take depending on the stage of mixed feeding are:

• A two-day-old baby, 19 to 20 ml per bottle
• A three-day-old baby, 30 to 40 ml per bottle
• A four to five-day-old baby, 50 ml per bottle
• A six to seven-day-old baby, 60 to 70 ml per bottle
• An 8-day-old baby, 70 ml per bottle
• A nine to fifteen-day-old baby, 80 to 90 ml per bottle
• A fifteen-day-old to one-month-old baby, 110 to 120 ml per bottle
• A two-month-old baby, 120 ml to 150 ml per bottle
• A three-month-old baby, 150 to 180 ml per bottle
• A four-month-old baby, 180 to 210 ml per bottle
• A five-month-old baby, 210 ml per bottle
• A baby of more than six months, 210 to 250 ml per bottle

Mixed feeding schedules

It's important to bear in mind that these schedules are only a general approximation. Every baby is different and may need more or fewer feeds throughout the day, depending on their age, growth and appetite.

• Morning (7:00 – 8:00 AM): Breastfeed to start the day.
• Mid-morning (10:00 – 11:00 AM): Bottle to complement the feeding.
• Midday (1:00 – 2:00 PM): Breastfeed to keep stimulating production.
• Afternoon (4:00 – 5:00 PM): Another bottle feed to make sure the baby is well fed.
• Evening (7:00 – 8:00 PM): Breastfeed before sleeping.
• Early hours (2:00 – 3:00 AM): If the baby needs it, a breast or bottle feed to soothe hunger.

How should mixed feeding be given?

To offer mixed feeding to your baby, you can do it as a supplement. Offering the breast first until it is empty and, after it is empty, giving the supplement with your Happymami bottle. Another option is to do complete bottle feeds, for example if mum has to go back to work and dad needs to give the baby the bottle at home.

Risks of mixed feeding

If you do mixed feeding, the main risk that can happen is that you lose your breastfeeding, which is why it's important not to confuse your body or your baby. We need to keep your body stimulated so that it produces everything your baby takes, and use a tailor-made Happymami bottle to prevent confusion in your baby, protecting your breastfeeding.

🍼Reduce the risks by choosing personalised bottles that respect your baby's natural sucking. 👶🏻

Start designing your bottle

Frequently asked questions about mixed feeding

How do I give my baby mixed feeding?

• Offer the breast first: Start with a breastfeed to stimulate milk production.
• Introduce the bottle: After the breastfeed, offer the bottle to complement the feeding.
• Set a schedule: Keep a regular schedule for both feeds, adapting to your baby's hunger cues.

How do I combine breastfeeding and bottle feeding?

• Alternate the feeds: Offer the breast first and then the bottle, or vice versa, depending on the need.
• Use breast milk: If possible, use breast milk in the bottle to make the transition easier.
• Choose a suitable bottle: Use a bottle that imitates the flow of the nipple to make it easier for the baby.

How do I start mixed feeding?

• Start gradually: Introduce the bottle once breastfeeding is established, usually after the first few weeks.
• Offer the bottle at specific times: Choose times of day when you can offer the bottle, such as in the afternoon or at night.
• Watch your baby's reactions: Pay attention to how your baby accepts the bottle and adjust your approach as needed.

Conclusion: mixed feeding, how do you start? Happymami bottle

The key to mixed feeding is to avoid disrupting your milk supply or confusing your baby. That is why the early stages of breastfeeding are especially important. These guidelines are a good starting point, but they should be adapted to your situation.

Always use a custom-designed Happymami bottle to help prevent nipple confusion, and keep stimulating your breasts to maintain your milk supply. Be patient: it takes time to learn, but it will get much easier.

Bibliography: mixed feeding, how do you start? Happymami bottle

Materna L, Guillen AM, Dalmau Serra J, De Neonatología S, De Nutrición S, Fe L, et al. Alimentación del recien nacido sano . Aeped.es. .

Fabm AKMI. Initiation of breastfeeding . Uptodate.com. 2022 . Available at: https://www.uptodate.com/contents/initiation-of-breastfeeding