Wanting to add formula in but not sure how? This post is perfect for you! Combo feeding is definitely attainable and does not have to be complicated! 

Did you know that Dr. Young from @BabyFormulaExpert has a “How to Choose Confidently Choose a Formula for Your Unique Angel” course? It goes over everything – ingredients and how to choose the right formula (think gassiness, milk intolerance, digestive issues – maybe you need to make a change!). Click here and use code BUMBLE for discount.

Have you seen my “all of your formula questions answered” post? Much of this is included there too.

How can I supplement with formula?

There are many ways to supplement with formula!

Here are some examples:

• Breast/chest-feed and then offer a formula bottle
  • If you’re worried about your supply, you have a history of low supply, or baby still acts hungry after feeding at the breast/chest, you can offer a bottle of formula after the feeding.
  • It’s best to keep the TOTAL feed around 30-35 minutes. This will prevent snacking and make feeds more efficient (as long as your baby is healthy and gaining weight).
• Feed a bottle with a combination of formula and breastmilk 
  • You can mix formula and breastmilk together in ANY quantity you would like!
  • Make sure to follow the formula guidelines (once breastmilk of any kind [thawed, fresh] is mixed with formula, it is good for 24 hours from the thawed milk OR when you made the mixture, whichever expires first.
• Feed one bottle of breastmilk and another bottle of formula
  • If you’re pumping but not quite enough to supply for the whole day OR you’re storing some milk and replacing with formula, you can feed alternating breastmilk and formula bottles. I always did this because I pumped directly into bottles, so it was easier for me – less transfer and mess.
  • This could be in any combination – 1 bottle of formula and the rest breastmilk, or visa versa!
• Only breastfeed when baby is near and offer only formula when you are away from the baby 
  • I have many friends who did this! Some friends developed a literal aversion to their breastpump – it caused them to feel SICK! NOT WORTH IT! I suggested to this friend to ONLY feed from the breast, cut down breastfeedings, and supplement other feedings with straight formula. It worked so well for her that she went on another 6 months of breastfeeding! (You know I always say that formula EXTENDS breastfeeding!)
  • To keep up your supply, you will need to pump in replacement of breast/chest-feedings if you are going to be gone more than a day.
• Breast/chest-feed every other feeding and offer formula or a combination of formula and breastmilk in a bottle for the other feedings
  • See above!
• Replace feedings with formula and store breastmilk that you pumped during this replacement
  • I am a BIG proponent of storing breastmilk and replacing with formula to EXTEND the total time baby will get breastmilk. For example, if you stored 1 feeding of breastmilk per day and replaced with formula for 1 month, you could offer 1 bottle a day for 1 month of breastmilk when you WEAN! Thus extending the total amount of time that baby gets breastmilk.

*See formula guidelines for timing of when to use combination bottles*

Common questions about combo feeding with formula:

Can I mix breastmilk and formula? Or do I have to offer one or the other/one after the other? You can absolutely mix any amount of formula with any amount of breastmilk. See above “How can I supplement with formula” and “formula guidelines” for more information.

How will supplementing with formula affect my supply? This depends on a lot of factors:

• If you are supplementing after a feeding
  • This will only affect your breastmilk supply if you are cutting feedings short to supplement.
  • If you have low supply, this will most likely not affect your supply negatively. Keep offering the breast first and supplement after.
• If you are replacing breastfeedings/pumping sessions with formula 
  • If you are replacing breastfeedings/pumping sessions with formula, your supply will decrease in most cases.

If you’re curious about a plan to keep breast/chest-feeding and start supplementing or cutting back on some feeds, book a text or video chat consult with Kate, Lauren or Natalie (NICU RNs) to hash it out. If we think it’s best, we will recommend a breastfeeding consultation.

If you want to wean, check out our weaning blog post.

REMEMBER: BREASTFEEDING DOESN’T HAVE TO BE ALL OR NOTHING!

How do I know if my baby isn’t tolerating a certain formula?

If you are transitioning to formula from breastmilk or are starting to supplement with formula, you may notice that your baby’s bowel habits change.

It’s common for formula-fed babies or babies who are being introduced to formula to have a change in bowel habits such as new onset of constipation or diarrhea. Remember that true constipation is the difficult passage of hard, pebble-like stool.

It is also normal to notice a change in the consistency of baby’s poop with formula. Babies who are mostly breastfed will have stool that is yellow to green, soft and seedy, and the contents absorb mostly into the diaper. Formula fed babies tend to have stools that are thicker in consistency (similar to soft serve ice cream) that can range in color from yellow to brown to black. When transitioning, you will see this change over a few days.

When to call your doctor:

• If your baby has gone more than 3-4 days without pooping.
• If there is a noticeable change in baby’s behavior or baby is inconsolable.
• There is blood in your baby’s stool or baby’s stool looks like grape jelly
• Your baby has persistent, new onset vomiting.
• There is blood or a coffee ground look to your baby’s vomit
• Your baby’s stool is white or grey
• Your baby’s abdomen is hard and distended
• You baby has persistent constipation with a new formula
• You have a feeling that something is going on with your baby. ALWAYS trust your gut!

Do formula fed babies sleep better at night? Should I be supplementing before bed?
THIS IS A MYTH!!! Well, to some extent.

Breastmilk and formula have the same calories per oz (19-20 cal/oz). If your baby is not being fed enough due to low supply or something anatomically rela

ted such as a tongue or lip tie, then they WILL sleep better when you supplement (combo, BM or formula) because they will be getting the calories they need. Formula itself does not make babies sleep deeper or longer.

How do I prevent waste of formula and breastmilk?

If your baby is consistently finishing bottles, increase by 0.5-1oz for 1-2 days. Keep increasing as baby is finishing. You can ALWAYS add more!

It is normal for babies to take different amounts of formula at different times of the day, especially if your baby is sleeping through the night. If your baby is on solids, you can always add excess formula to purees as long as it is finished within 1 hour of the bottle.

Guilt associated with formula – how can I overcome it?

Ugh, I know the feeling. Society makes us feel guilty about using/supplementing with formula. We are so hard on ourselves as moms.

You are allowed to have those feelings, however what we need to focus on is the TRUTHS!

• Our baby is being fed
• Our baby is healthy because of formula
• Formula gives me a mental and physical break that is healthy for me and my baby
• Partners/family can be more involved and take more responsibility
• I am NOT a failure for using formula because my baby is healthy and being fed
• It’s no one’s business if I choose to formula feed, supplement, or breastfeed.

If we focus on these truths, we can create a positive association around formula!

Is fed really best?
YES YES YES YES YES. ALWAYS.

I am a FIRM BELIEVER in this. Underfed babies can have lifelong complications such as seizures and brain damage from low blood sugar, brain damage from high bilirubin levels due to malnourishment, stunted physical growth and brain growth due to malnutrition and failure to thrive.

Equally as important is your mental health as a parent.

Mamas who struggle with low supply – IT IS NOT YOUR FAULT. IT IS OK TO SUPPLEMENT/STRICTLY FORMULA FEED.

MAMAS WHO STRUGGLE WITH MENTAL HEALTH AND TAKE MEDICATION, IT IS OK TO STOP BREAST/CHEST-FEEDING OR NEVER BREAST/CHEST-FEED AT ALL.

Formula is NOT a marketing scam. It saves the lives of babies every single year (and moms too).

Formula is NOT the F word.

Fed is best – and feed in a way that works for your entire family. THAT’S what makes a happy baby and parent.

PRO TIP: I fed my daughter, Roey, formula and this is where I got it from (use code BUMBLEBABY for discount).

One of my favorite formulas that has a protein ratio closest to breastmilk is Bobbie Formula (use code BUMBLEBABY10 for discount). Read my post on why I love Bobbie Formula! 

Have more questions? Schedule a text or video chat consult with Kate, Lauren or Natalie (NICU RNs) and they can help answer any questions that you have!

Other helpful webinars and e-guides:

• Helpful formula posts Instagram Guide
• Baby formula expert course – Dr. Bridget Young’s step-by-step method to finding the right baby formula with confidence! Use code BUMBLE for discount
• Understanding baby formula webinar – Dr. Bridget young, a formula specialist, explains the differences and components in formula to help you choose the best one for your baby.

Watch our bottle refusal workshop! Watch our recorded workshop, “Bottle Refusal and Tips.” Join Lauren, NICU RN and mother of 2, discuss tips for bottle refusal in infants. She discusses different strategies for avoiding bottle refusal along with tips and tricks for reversing bottle aversions. She also goes over alternative methods for giving breast milk/formula to babies who have ongoing issues with bottle refusal. 

Other helpful blog posts:

• How to strictly formula feed
• 5 ways to skin to skin without breastfeeding
• How to correctly bottle feed
• Transitioning from formula to milk
• My journey to formula
• Why Kate loves Bobbie formula 
• Everything you need to know about formula

**This post is educational and not meant to take the place of your provider. Bumblebaby makes a small commission on some of the items listed above.