Combination feeding is breastfeeding AND bottle feeding your baby. The bottle feeding component can include breastmilk and formula.
This can be a great option for moms that want to breastfeed but cannot transfer enough breastmilk to their baby for one reason or another by solely breastfeeding.
It is also a wonderful option when exclusively breastfeeding is taking a toll on your physical, mental, and/or emotional wellbeing.
Before you read on, please know the intent of this post is to provide support and tips to those interested in combination feeding. I am in no way trying to pressure moms to breastfeed or not breastfeed, as it is a very personal choice.
This post may contain affiliate links, which means I/we may receive a commission, at no extra cost to you, if you make a purchase through a link. Please see my full disclosure for more information.
Some women exclusively breastfeed and maintain a good milk supply without too much difficulty.
That was NOT me.
I had a lot of challenges along the way and had a love-hate relationship with breastfeeding.
I gave birth to "S" via cesarean section. After my daughter was born, she wanted to nurse almost continuously. My breasts were sore, but I expected that, and things seemed to be going well overall.
I remember thinking to myself, that breastfeeding wasn’t so hard after all. I also believed that I was destined to be one of those women that would "breastfeed effortlessly".
A few days after S’s birth, we went in for her first follow up pediatric appointment. She had lost a few ounces, but this was to be expected.
After another week, we went in for a pediatric appointment, and she had lost another few ounces, which was not normal or desired.
When the pediatrician recommended we go to a lactation consult and speech therapist, my heart sank and I remember feeling like a total failure.
At the first appointment, the lactation consultant weighed my daughter before and after a feed. She also observed my daughter’s latch during breastfeeding, and viewed the anatomy of her mouth.
The lactation consult noticed right away that my daughter had a lip tie. My daughter also only transferred half an ounce of milk during 20 minutes of nursing, which is not nearly enough.
The lactation appointment left me worried and overwhelmed, but it also felt good to have some answers.
So after a couple of weeks, "S" had a lip tie revision. She also went to a couple of speech therapy appointments to improve her sucking ability for milk transfer.
Meanwhile, I was breastfeeding and pumping around the clock, trying to get my daughter enough calories. I was weighing her obsessively, multiple times a day.
I was also using a supplemental nursing system so that my daughter could get pumped supplemental breast milk via a tube while also nursing at the same time.
My daughter was transferring milk better at this point, but still not enough. My milk supply had also dropped, to make matters worse.
At this point, I was still feeling like a failure and I was exhausted. I was HATING breastfeeding but in my mind there was no choice but to breastfeed.
"Breast is Best" was running through my mind like a guilt-ridden mantra.
After weeks of feeling inadequate and endless tears, I reached my breaking point. I knew I could not continue with my current breastfeeding regiment.
I am so glad I finally reached this breaking point because it helped me realize 4 things:
1. Breast is NOT best if...
Your baby isn’t getting enough calories, if mom is miserable, or if it just doesn’t work for the family.
2. Breast feeding does not have to be all or nothing
It is an option to breastfeed without exclusively breastfeeding. Your baby will still receive those beneficial nutrients and antibodies from breast milk even if it is not her only source of calories.
3. Fed really is best
If you are feeding your baby in the best way that you can, that really is enough. Breast milk and quality formula are both good options to nourish your baby.
4. How you feed your baby does not define you
You are not a bad mom or a bad person if you do not exclusively breastfeed your baby. You are not a bad mom or a bad person if you do not exclusively breastfeed your baby.
Yes, I wanted you to read that twice!
HOW I USED COMBINATION FEEDING
So at this point, I decided that I still wanted to breastfeed but I also wanted to find a way to make breastfeeding sustainable for me AND my daughter.
1. Breastmilk and Formula
I figured out that my daughter wanted to breastfeed around the clock because she wasn’t getting enough calories from me. This was true even after we improved her milk transfer issues with breastfeeding.
She would always breastfeed until she was exhausted but then would wake right back up to nurse again because she was still hungry.
I love Earth's Best brand because it is organic, there are no high fructose corn syrups, and it is still relatively affordable. They also have iron enriched and dairy free options for those with specific needs.
2. Manual Breast Pump
I started a routine where I would nurse my daughter on one side while using a a manual pump to collect milk on the other side. This was mainly to save any letdown milk otherwise lost, given my low milk supply.
This Hakaa Manual Breast Pump was a godsend for me and I ended up buying a few of them to decrease my washing frequency.
I know I cringe at the words manual breast pump, but let me assure you that this one is super easy to use! This manual pump is silicone and suctions onto your breast for easy application, removal and transfer to bottle.
3. Breastfeeding and Bottle Feeding
With every feed, I would first breastfeed my daughter, and then I'd top her off with a bottle if she was still hungry. I would bottle feed my daughter whatever stored breast milk I had first, then I would switch to formula as needed.
I used to Doctor Brown's Bottles for my daughter. They were recommended by our speech therapist for combination feeding.
4. Pumping 1-2x/day
I'll be honest, I really did not enjoy using an electric breast pump. I could have pumped around the clock to try and boost my milk supply, but that was not an option that was good for my mental health or my relationship with breastfeeding.
Instead, I decided pumping once or twice a day was a routine I could happily sustain.
If my daughter went to bed early, I would often do my pumping session right before I went to bed. That way engorged breasts would not wake me up before baby did for a night feed.
Although I did not love using my electric pump, I tried a few different versions to figure out what worked best for me.
The Medela Pump in Style Advanced was hands down my favorite. It gave me the most milk in the least amount of time compared to other pumps and was easy to assemble and clean.
The benefits of letting go of my all or nothing thinking around breastfeeding:
1. My daughter started gaining weight at a normal and healthy rate.
2. She started taking longer naps and was sleeping for longer stretches of time at night since she wasn't hungry all the time.
3. My daughter no longer wanted to breastfeed all of the time because she got enough calories in a single feeding.
4. I started to really enjoy breastfeeding my daughter. It became a true bonding experience for us.
5. My husband was able to help with the feeding, and he really cherished this special one-on-one time with our daughter.
6. My daughter got breastmilk during her entire first year of life.
I know I would have stopped much sooner if I continued to run myself ragged trying to exclusively breastfeeding, when it just wasn't working. I truly believe that the only reason I was able to continue to breastfeed my daughter was because I found a system that was sustainable for me/us.
COMBINATION FEEDING IS A GREAT OPTION
My combination feeding routine may not be conventional, but I am putting in out there to share some of the ideas that worked for me and my family.
For any other struggling breastfeeding mommas out there, I hope my story on combination feeding was helpful. Please stop being so hard on yourself and realize that one size does not fit all with feeding your baby.
I have so much respect for moms that work really hard to exclusively breastfeed, but you also don't have to do it. Some women physically can't, and for others it is too physically, mentally and/or emotionally taxing.
If you are feeding your baby in the best way that you can, then you are doing enough.