When you're preparing to welcome a baby, one of the many decisions you'll face is how you plan to feed them. Breastfeeding, formula feeding, expressing or a combination of these. There's no shortage of information and opinions, but what if you don't fit neatly into one category? What if you want to breastfeed but also have the flexibility to offer a bottle, or breastfeeding hasn't gone quite as you'd hoped?
I've experienced combination feeding with both of my children, although for different reasons. With my first, it wasn't something I'd planned, whereas with my second, it was a conscious decision. Looking back, I wish I'd approached feeding my first baby with fewer preconceived ideas about what breastfeeding should look like and less judgement around introducing formula. I think I would have been much kinder to myself, and it would have made a real difference to my emotional wellbeing during those early months.
Despite how common combination feeding is, it doesn't always receive much attention during pregnancy or in conversations about preparing to feed your baby. And I think that's a shame, because feeding isn't always as straightforward as we'd hope. I also remember encountering healthcare professionals who held quite strong views about particular feeding approaches, when what I really needed was balanced information and support to make decisions that worked for me and my baby.
That's part of why I wanted to write this article. I'm sharing my experiences and what I've learned from feeding my children and supporting families during pregnancy and postpartum. This isn't intended as individualised feeding or medical advice, and I'd always encourage women to seek guidance from a qualified lactation consultant, particularly when navigating feeding difficulties or wanting to maintain their breastmilk supply.
More than anything, I hope this article helps women feel informed, supported and confident in exploring their options. Feeding your baby can be challenging enough without the added pressure of judgement, guilt or feeling there's only one right way to do things.
What Does Combination Feeding Actually Look Like?
One thing I appreciate about combination feeding is that there isn't one particular way to do it. It can look completely different from one family to another, and it can change considerably as your baby grows.
For some women, combination feeding means breastfeeding most of the time while their partner offers an occasional bottle of expressed breast milk. For others, it might involve breastfeeding in the morning and evening while their baby receives formula during the day. Some families introduce supplementary feeds because of concerns about their baby's growth or milk intake, while others find that sharing feeding responsibilities supports their wellbeing.
There are also women who never intended to combination feed but find themselves doing so because of breastfeeding challenges, separation from their baby or other circumstances that make exclusive breastfeeding difficult. When breastmilk and formula are both part of a baby's feeding, this is often referred to as mixed feeding.
I think it's particularly important for women to know that introducing formula doesn't necessarily mean they have to stop breastfeeding altogether. For some families, combination feeding is temporary, while for others it becomes a sustainable and enjoyable part of their feeding relationship.
Understanding How Combination Feeding Can Affect Breastfeeding
Although combination feeding can offer greater flexibility, one consideration is how introducing formula might affect breastmilk production, particularly in the early weeks.
Breastmilk production largely works on a supply-and-demand basis. Generally speaking, the more frequently milk is removed from the breasts, whether through breastfeeding or expressing, the more signals the body receives to continue producing milk. When breastfeeds are regularly replaced with formula, breastmilk production may gradually decrease. For some women, this is part of their intention, particularly if they're hoping to reduce the number of breastfeeds. For others, maintaining their existing supply is important, and introducing supplementary feeds can require more thought and planning.
I would really encourage women considering combination feeding to seek professional support rather than trying to navigate these decisions on their own. An International Board Certified Lactation Consultant (IBCLC) can provide invaluable, individualised guidance to help you explore how combination feeding might work for your circumstances, including ways to maintain your breastmilk supply and continue working towards your feeding goals.
There are also situations where additional milk may be medically indicated, such as concerns about a baby's weight gain, hydration or ability to transfer milk effectively. These circumstances require timely assessment by an appropriately qualified healthcare professional, who can help determine what the baby needs while considering the mother's breastfeeding goals.
It's also worth remembering that breastfeeding difficulties aren't always simply a matter of insufficient milk production. Sometimes there are other contributing factors that warrant further investigation, such as challenges with attachment, milk transfer or underlying health conditions. For women who want to continue breastfeeding, access to skilled, individualised support can make an enormous difference. Introducing supplementary feeds doesn't automatically mean breastfeeding has failed, nor does it necessarily mean exclusive breastfeeding will never be possible.
Choosing Bottles and Formula Without the Overwhelm
If you've ever wandered through the baby aisle at your local department store, you'll know how overwhelming feeding products can be. Bottles are marketed as being closest to the breast, teats are designed to reduce colic, and there are specialist feeding systems, electric sterilisers, bottle warmers and seemingly endless varieties of infant formula. And, of course, prices often vary considerably between products.
It's easy to assume the most expensive option must be the best, especially when marketing suggests a product is more advanced, more natural or somehow better suited to your baby's development. But I think it's worth looking beyond the advertising.
In Australia, infant formula products must meet established nutritional and safety standards. Queensland Health explains that standard cow's milk-based infant formula is suitable for most healthy babies, while certain medical circumstances may require a specialised formula and professional guidance.
You might also notice formulas marketed for different developmental stages. Interestingly, many parents don't realise that babies don't need to switch from Stage 1 (starter) formula to Stage 2 (follow-on) formula at six months. According to Queensland Health, there's no evidence that switching to follow-on formula provides additional health or nutritional benefits, and a suitable starter formula can continue to be used until 12 months. I think this is a great example of how a product marketed for an older baby isn't necessarily a better choice.
Bottles can be similarly confusing. Teats come in various shapes, materials and flow rates, and different babies have different preferences and feeding needs. I recently completed some lactation training with Vijaya Hunt, a Brisbane-based registered midwife and International Board Certified Lactation Consultant (IBCLC), whom I highly recommend. During the training, she discussed bottle and teat selection and suggested the Dr Brown's Options+ Anti-Colic Bottle (narrow neck, Level 1 teat, 250ml) as an option worth considering, particularly for breastfed babies. This wasn't something I'd known much about when feeding my own children, but having learned more, it's certainly a bottle I'd consider if I were to have another baby.
Rather than feeling pressured to buy an entire collection of expensive feeding equipment, I think it's helpful for families to understand that there are different options available. A qualified lactation consultant can also provide individualised guidance, particularly if bottle feeding is proving difficult or you're hoping to combine breast and bottle feeding. Sometimes finding an approach that works involves a little trial and error, and that's perfectly understandable.
Understanding Responsive Bottle Feeding
Something else I think deserves more attention is responsive bottle feeding. Whether a baby receives expressed breastmilk or formula, feeding isn't just about the amount of milk they consume. It's also an opportunity to respond to their cues, provide comfort, and enjoy the lovely sense of closeness that comes with feeding a newborn.
You may have heard of paced bottle feeding, an approach that aims to give babies greater control over the flow of milk and opportunities to pause during a feed. Rather than encouraging babies to finish a set volume, responsive feeding focuses on recognising their hunger and fullness cues. Babies communicate these cues in different ways, including turning towards milk when hungry or slowing down, turning away, or becoming less interested when they've had enough.
Families may want to learn more about paced feeding, particularly when combining breastfeeding with bottles. A lactation consultant or child health nurse can help explain the approach.
It's also worth highlighting that bottle feeding can be an incredibly connected experience. Holding your baby close, maintaining eye contact, talking gently and responding to their needs all create opportunities for bonding. That connection certainly doesn't belong exclusively to breastfeeding.
What About Expressed Breastmilk, Formula and Donor Milk?
Another consideration for families exploring combination feeding is what they'll offer their baby when breastfeeding directly isn't possible or practical.
For some women, expressing breastmilk feels like the most natural option because it lets another caregiver help feed while the baby keeps receiving breastmilk. However, expressing isn't always as straightforward as it may seem at first. Maintaining a pumping schedule, washing equipment, safely storing milk and then feeding your baby can become a considerable workload, particularly if you're also breastfeeding directly. What initially seemed like a way to make life easier can sometimes involve three separate responsibilities: breastfeeding, pumping and bottle feeding.
For other families, formula offers a more manageable way to provide supplementary feeds. Neither arrangement is necessarily easier or more appropriate for everyone, and individual circumstances can make a significant difference.
There's also the option of donor breastmilk, although this is another area where reliable information is important. Milk supplied through established hospital milk banks undergoes screening and pasteurisation, while breastmilk shared privately between families doesn't necessarily undergo the same processes and can carry additional safety risks.
Whether a family uses expressed breastmilk, formula, or donor milk, appropriate preparation, handling, and storage are essential. Resources such as the Australian Breastfeeding Association provide detailed information about these considerations. My intention isn't to explain every aspect of preparing or storing milk, but to highlight that different options have practical considerations worth understanding.
When Feeding Doesn't Go to Plan
While there are plenty of practical things to consider when combination feeding, I think one of the most important conversations is about the emotional experience of feeding our babies. We spend so much time talking about birth preferences, expectations and the possibility of birth trauma, but I don't think we always give the same attention to the emotional impact of feeding experiences.
For some women, breastfeeding is something they've imagined doing for years. It might represent closeness, connection, a particular vision of motherhood or simply something they've really wanted to experience. When breastfeeding becomes difficult or doesn't work out in the way they'd hoped, the disappointment can be profound. There can be grief, frustration, anger, guilt and an overwhelming sense of having somehow fallen short, even when a woman has done everything she reasonably could to make breastfeeding work.
Unfortunately, these feelings aren't always well understood. Well-meaning friends, family members and healthcare professionals might reassure a mother that her baby is healthy, that formula is a perfectly acceptable alternative or that she shouldn't be so hard on herself. While those reassurances often come from a place of kindness, they can sometimes unintentionally dismiss what she's experiencing.
A woman can be incredibly grateful that her baby is healthy and receiving adequate nutrition while also grieving the breastfeeding experience she wanted. Those feelings aren't mutually exclusive. Similarly, a woman might feel enormous relief when she introduces formula or decides to stop breastfeeding. Perhaps she's been experiencing significant pain, struggling with repeated feeding difficulties or feeling completely overwhelmed by the demands of feeding. For her, making that change might mean finally getting some rest, enjoying time with her baby or feeling more like herself again. That relief is just as valid as the grief another woman might experience.
I can certainly relate to the emotional complexity of feeding. Looking back on my experience with my first baby, I realise how much of the pressure I felt came from my own expectations about what I thought feeding should look like. By the time I had my second baby, I approached combination feeding quite differently, and that shift in perspective was incredibly valuable.
I think we do women a disservice when we suggest there's a correct way to feel about these experiences. Sometimes what a woman needs most isn't reassurance that everything is fine, but simply someone willing to listen and acknowledge that things haven't gone the way she'd hoped.
Why Individualised Feeding Support Matters
One challenge with infant feeding is that women often receive an enormous amount of information without the individualised support they need. A mother might hear different recommendations from different professionals, read conflicting advice online and receive countless well-meaning suggestions from family and friends. Meanwhile, she's recovering from birth, learning to care for her newborn and possibly functioning on very little sleep. It's hardly surprising that feeding can become overwhelming.
In my view, good support starts with understanding what the woman actually wants. Does she hope to exclusively breastfeed? Is she interested in combination feeding? Is her priority to continue some breastfeeding while reducing the pressure she's experiencing? Or has she decided that formula feeding is the most appropriate option for her family? These distinctions matter because the information, professional guidance, and practical support she needs will depend on her circumstances and goals.
A woman who desperately wants to continue breastfeeding deserves the opportunity to explore what might be contributing to her difficulties and whether there are options that could help. Equally, a woman who has decided to formula feed deserves respectful, practical information without being made to feel that she needs to justify her decision.
As a birth and postpartum doula, I believe there's enormous value in having people around you who can listen without judgement, help you identify questions you'd like answered, and connect you with appropriately qualified professionals when you need additional support.
You Don't Have to Choose Between Your Baby's Needs and Your Own
Remember that feeding your baby is only one part of the much bigger experience of becoming a mother. Of course, ensuring your baby receives adequate nutrition is essential. Breastfeeding also offers well-established health benefits for both mothers and babies, and women who want to breastfeed deserve meaningful support. But I don't believe that recognising the benefits of breastfeeding means we should ignore the realities of women's lives.
Women are recovering from birth, managing interrupted sleep, navigating relationships, returning to work, caring for other children and adjusting to an enormous amount of physical and emotional change.
For some families, combination feeding creates opportunities for partners to participate in feeding. For others, it allows breastfeeding to continue when exclusive breastfeeding isn't achievable or desirable. Sometimes it provides flexibility that makes everyday life feel more manageable.
Remember that breastfeeding doesn't have to be exclusive to remain beneficial. Breastmilk still provides nutritional and immunological benefits when it makes up only part of a baby's milk intake. Introducing formula doesn't erase the benefits of the breastmilk your baby has already received or continues to receive.
And if breastfeeding isn't part of your feeding journey at all, there are still countless opportunities to nurture a secure, loving and responsive relationship with your baby. Babies build connections through being held, comforted, spoken to, responded to and cared for consistently over time. Feeding is one opportunity for that connection, but it certainly isn't the only one.
Finding What Works for Your Family
If there's one thing I'd love women to take away from this article, it's that feeding your baby doesn't have to be an all-or-nothing decision.
The approach you imagined during pregnancy may feel completely different once your baby arrives. You may find breastfeeding easier than you expected, or much more challenging. Perhaps your baby will have their own ideas about how they prefer to feed.
Whatever happens, I hope you feel able to seek reliable information, ask questions and access support that respects both your individual circumstances and your feeding goals. While there's a great deal of conversation about the best way to feed a baby, I think we sometimes lose sight of the woman doing the feeding. Her experience matters, too.
And ultimately, that's why I wanted to share this article. Not to suggest combination feeding is the right approach for everyone, but to encourage more understanding, compassion, and openness around the different ways families feed their babies.
At Redland Doula Co, I provide personalised birth and postpartum support to families across Redland City, Brisbane and surrounding areas. Whether you're preparing for your first baby or navigating the early weeks of motherhood, I believe every woman deserves compassionate, non-judgemental support and the confidence to make informed decisions about her care and her baby. If you'd like to learn more about how I can support you, I'd love to hear from you.
