Mixed feeding: combining breastfeeding and bottle feeding

What is mixed or combination feeding?

When it comes to feeding their baby, some parents decide to exclusively breastfeed and some to exclusively formula feed.

Other families combine breastfeeding with using a bottle for breastmilk or infant formula. This is called combination feeding or mixed feeding (NHS, 2023).

Any amount of breastmilk will give babies many of the benefits of breastmilk without exclusively feeding from the breast. 

Why do some families combination feed?

Parents combination feed their baby for a variety of reasons (NHS, 2023; NICE, 2017):

• When they have been advised to supplement the baby’s milk for a period.
• To gain flexibility for the family, so the baby can be fed from a bottle with either expressed milk or infant formula milk.
• This could include the mother or breastfeeding/chestfeeding parent returning to paid work.
• To move from exclusive bottle feeding and start or resume breastfeeding.

It can be helpful to talk to a breastfeeding counsellor, a midwife or a health visitor about options. They can discuss how mixed feeding can affect the production of breastmilk and offer support to manage the supply (NICE, 2017). 

Our Infant Feeding Line is also open every day of the year, from 8am to midnight, on 0300 330 0700, where you can speak to our Breastfeeding Counsellors.

Emotional support with feeding a baby or babies

As well as practical support, Breastfeeding Counsellors can help with the emotional challenges of feeding a baby or babies. They provide a safe space to talk about the feelings being experienced. They can also support the parents’ decisions around carrying on or stopping any planned method of feeding (La Leche League GB, 2026 a).

Supplementing the baby’s feeds

Sometimes, the baby may need additional milk. This may be because (La Leche League GB, 2026 a; NHS, 2025; NICE, 2017):

• The baby has lost more than 10% of their birth weight in the early days.
• The baby was born early or is unwell, and they are not yet able strong enough to get all the energy they need from breastfeeding alone.
• A difficult birth for the birthing woman, parent or baby, or other health issues that mean that the milk supply is slow to increase.
• The woman or parent who is breastfeeding has had surgery which has removed milk-producing tissue or the connection to the nipple (although this is not true for everyone who has had surgery).

In these situations, it may be recommended that the baby has extra feeds (‘top ups’) until breastfeeding/chestfeeding becomes established. This is usually a short-term strategy, after which parents may move towards more breastfeeding or more bottle feeding. Top ups might be donated breast milk, milk expressed by the woman or parent who is breastfeeding (sometimes before the birth), or infant formula (La Leche League GB, 2026 a).

The milk can be given from a spoon, cup, bottle, a syringe, or a supplementer – a tiny tube taped next to the nipple which the baby can get milk from as well. This gets the baby familiar with attaching to the breast (NHS, 2023; La Leche League GB, 2026 a).

What is the parent’s goal while giving additional milk?

Parents who are supplementing may aim to (La Leche League GB, 2026 a):

• Continue with mixed feeding
• Move to exclusive bottle feeding
• Move to exclusive breastfeeding

Moving to exclusive breastfeeding is often possible. It will be necessary to build up the milk supply, and support from a skilled and knowledgeable breastfeeding helper who can meet individual needs will be invaluable (La Leche League GB, 2026 a). NCT Breastfeeding Counsellors, the healthcare team, or local lactation support can help.

How to introduce a bottle feed

Where possible, it is recommended to wait until breastfeeding is established before introducing a bottle. This is usually 4-6 weeks after birth, when it feels like things are starting to go well. Starting earlier than this can affect milk production (NHS, 2023; La Leche League GB, 2026 a).

There is usually no need to have a set time for breast and bottle feeds, and most families will find a pattern that works for them. Most babies will need to feed at least 8 times in 24 hours, although 10-12 times or more is ideal. In some cases it will be more than this. 

If feeding is painful or there are any concerns about how often the baby is feeding, speak to the health visitor, one of our NCT Breastfeeding Counsellors, or local lactation support.

If intending to continue breastfeeding, then expressed milk or infant formula can be offered after a breastfeed. This ensures that the baby is hungry when feeding from the breast, which will help maintain the supply (NICE, 2017). If planning to reduce breastfeeding, then the bottle can be offered before the breast.

When a bottle is introduced, the baby will adjust more easily if feeds from the breast are reduced gradually over a period of weeks. This also helps reduce the risk of developing swollen or uncomfortable breasts, or mastitis (NHS, 2023). 

If the baby is over 6 months and can drink from a cup then a bottle is not necessary (NHS, 2023).

What if my breastfed baby won’t take a bottle?

A baby that has been exclusively breastfed might take some time getting used to feeding from a bottle.

Some options to try (NHS, 2023):

• Offer the bottle when the baby is feeling content and not too hungry.
• Try bottle-feeding the baby in a different position to which they are breastfed.
• Someone else could give the baby the bottle, so the baby can’t smell the breastfeeding parent.
• Offer milk from a cup, spoon, or syringe instead.

See our article for more tips on how to bottle feed.

How can I tell if my baby is getting enough milk?

Some parents are worried about how much milk their baby is getting when they combination feed. If the baby is getting enough milk, they will have plenty of wet and dirty nappies. See our article Is my baby feeding well? for more information. 

Will my baby get nipple confusion if I combination feed?

Most babies switch between the breast and bottle without difficulty, and there’s no strong evidence for the concept of nipple confusion. If a baby gets frustrated with feeding from the breast, this may be due to the difficulties that made the bottle necessary in the first place (La Leche League GB, 2026 b).

You can get help to resolve any feeding issues from NCT breastfeeding support or your local health visitor.