About mixed feeding or supplementing breastmilk with formula
Breastfeeding has many benefits for babies and breastfeeding mothers.
But sometimes breastfeeding is difficult, or your baby might not be able to feed directly from your breast. In these situations, you can usually give your baby expressed breastmilk.
In some cases, a health professional might suggest that your baby needs extra nutrition from small amounts of infant formula, as well as your breastmilk. This is called mixed feeding or supplementing with formula.
A baby might benefit from mixed feeding if they:
- have a very low birth weight (under 1500 gm)
- are born very premature (at less than 32 weeks of gestational age)
- are very ill
- aren’t gaining weight well.
Mixed feeding is usually needed for only a short period of time.
If you’re having breastfeeding challenges, start by talking with your midwife, child and family health nurse or GP. These professionals will be able to advise you and refer you to a lactation consultant if you need extra support. You can also call the National Breastfeeding Helpline on 1800 686 268 or use the ABA LiveChat.
Worried about milk supply?
Many new breastfeeding mothers worry about their milk supply, especially if their babies cry after feeds or their breasts feel empty. But most breastfeeding mothers can breastfeed and produce enough milk for their babies if they have the right information, support and care.
The best way to know if your baby is getting enough milk is to check their nappies and body language after feeds. Your baby is getting enough milk if they:
- have at least 6-8 wet cloth nappies or 5 very wet disposables in 24 hours
- have soft poos 3-4 times a day if they’re younger than 6-8 weeks
- are alert and mostly happy after and between feeds.
Your child and family health nurse will measure and chart your baby’s weight, length and head circumference at your regular check-ups. Your baby is getting enough milk if they’re gaining weight at about the right rate.
If you think you need to increase your milk supply or your baby needs extra feeds, or you’re concerned your baby is losing weight, talk to your midwife, child and family health nurse, lactation consultant or GP.
Before you try mixed feeding
There are several things to think about before you try mixed feeding.
Regular mixed feeding might make it more difficult to keep breastfeeding because it can interfere with keeping up a good supply of breastmilk. So if you’re thinking about supplementing with formula, it’s important to talk about it first with your midwife, child and family health nurse, lactation consultant or GP.
You might talk about:
- how to boost your milk supply
- how much formula to give your baby
- how many times a day to give formula
- how long to continue giving formula.
When you’re doing mixed feeding
There are some things to be aware of if you try mixed feeding.
When your baby has a feed from a bottle of formula and not from your breast, you might notice that your baby starts to prefer the bottle to the breast and then refuses the breast. Also, the colour, smell and consistency of your baby’s poos will change.
You might also notice your breasts getting overfull, which can be painful and can cause your body to stop producing milk. If you started mixed feeding because you were concerned about your milk supply, this might be a sign to increase breastfeeding again and reduce mixed feeding.
Increasing breastfeeding while doing mixed feeding
If you’re ready to increase breastfeeding again and reduce the amount of mixed feeding your baby has, talk with your midwife, child and family health nurse and/or lactation consultant.
How quickly you cut back on mixed feeding depends on why you’re supplementing with formula, how old your baby is and how much formula your baby is having.
To cut back on mixed feeding, you can try:
- gradually increasing your milk supply by expressing after breastfeeding
- increasing how often you breastfeed your baby
- gradually reducing the amount of formula you offer in each bottle
- cutting out some formula feeds.