Combination Feeding: Mixing Breast and Bottle Without Losing Your Milk

Going back to work, a baby who is not gaining well, twins, the exhaustion of the early weeks, or simply wanting dad to give a feed: there are many reasons to move to combination feeding, and all of them are legitimate. The risk is that your milk supply fades without you meaning it to, as one feed after another is replaced.

The breast works on demand: the less it is used, the less it produces. So the whole point is to bring in another way of feeding at the right time, protect your milk, and give a bottle without getting in the way of breastfeeding.

Combination feeding: what are we talking about?

We speak of combination feeding when baby receives both breastfeeds and meals given another way: your expressed milk or another milk, by bottle, cup or spoon. The share of each varies, from one feed a day replaced to only a few breastfeeds kept.

“There is no better food than breast milk for your baby,” remind the mpedia paediatricians, who nonetheless leave the decision to each mother, according to her constraints and wishes. One nuance matters for the first days: in the maternity ward, the WHO asks that a breastfed newborn be given no food or drink other than breast milk, unless medically indicated. If a supplement is offered, ask why, and whether it can be your own milk. Our guide to getting off to a good start with breastfeeding helps you tell whether baby is drinking enough.

When to introduce a first bottle?

Ideally, once breastfeeding is well established. The guidelines vary by country:

• in France, the mpedia paediatricians advise waiting at least 6 weeks, long enough for lactation to be established and for baby to master sucking at the breast;
• in the United States, the Office on Women's Health says at least one month after birth.

Before that age, a supplement may be needed for a medical reason. It is then decided with the midwife or paediatrician, and you express milk to replace each missed feed. If you are going back to work, plan this step a few weeks ahead: our article on breastfeeding and returning to work offers a plan.

Protecting your milk supply: the golden rules

Production drops when the breasts are emptied less often, mpedia points out, and stress or tiredness can add to it. To make combination feeding last as long as you wish:

1. Replace the least productive feeds first, usually the afternoon ones.
2. Keep the morning, evening and night feeds at the breast, as mpedia advises.
3. Space out the changes: wait a few days, from 2 or 3 to 5 or 6 depending on the woman, before replacing a second feed, to avoid engorgement.
4. Express your milk when you are apart from baby, at the time he would have fed.
5. Breastfeed more on weekends and days off, without a bottle if possible.

A breast pump suited to your rhythm makes these sessions easier, and the milk collected can become the next day's supplement. Our advice on expressing your milk and our guide to storing breast milk detail the organisation.

Bottle-feeding a breastfed baby: the paced method

At the breast, baby has to suck to trigger the flow of milk. A bottle held vertically, on the other hand, flows under gravity: baby drinks fast, sometimes too fast. And because milk flows more easily from a bottle, he may then turn his nose up at the breast, warn the mpedia paediatricians. So-called “paced” or “responsive” bottle feeding limits this gap. The steps, according to the UK's NHS and La Leche League France:

1. Sit baby almost upright, with his head and upper back supported by your hand, rather than lying in the crook of your arm.
2. Brush his lips with the teat and wait for him to open wide and draw it in himself.
3. Hold the bottle almost horizontal, tilted just enough to keep the teat full of milk: it is baby who sucks to bring the milk.
4. Take breaks as soon as he slows down, tenses up or turns his head away. To slow things down without taking the teat out, simply lower the bottle.
5. Let him decide when it ends. The NHS insists: never force baby to finish, as you risk overfeeding him.

A feed then lasts about twenty minutes. If he finishes in 5 to 10 minutes, the flow is too fast, notes La Leche League, which advises the slowest-flow teat that suffices for baby. Explain this method to whoever looks after your child: a breastfed baby often drinks more frequently, and in smaller amounts.

From the shop

To keep your milk in the game

No bottles in this selection: the aim of combination feeding is to protect your milk supply. A breast pump, a way to store your milk and a pillow for comfortable feeds all help.

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• The whole aisle · Breast pumps2 products online, delivered anywhere in Morocco.Open the aisle

Products sold by La Maison du Bébé, publisher of this magazine. Prices as of 12 October 2026; please check the product page.

Cup, spoon or bottle: what are the options?

The bottle is not the only way to give a supplement. The Office on Women's Health says a baby can drink from a cup around 3 or 4 months, and the WHO asks maternity units to inform mothers about the use and risks of bottles, teats and dummies.

But there is no perfect solution. La Leche League France acknowledges that, while a breastfeeding problem is being sorted out, a bottle is often more effective than a cup, spoon or syringe, and better accepted by mothers. What matters most is how it is given.

Does “nipple confusion” really exist?

Studies do not settle it. A literature review published in 2015, summarised by La Leche League France in 2017, retained 14 studies: for supplementary bottles, four out of six found signs of confusion; for dummies, only four out of ten found an effect on breastfeeding. The data therefore lean towards a link with bottles, not with dummies, but none proves the cause. A difficulty at the breast can also come from insufficient production, a hard latch or prematurity.

In practical terms, if baby gets restless at the breast or feeds become uncomfortable after a bottle is introduced, have a midwife or lactation consultant watch a feed quickly, as La Leche League recommends.

Going back to more breast, or restarting your supply

Combination feeding is not a one-way street. To give the breast more room again, you increase the number of breastfeeds and reduce the supplement little by little. As baby drinks more at the breast, he takes less from the bottle, notes La Leche League, which advises watching the nappies throughout the transition. Pumping sessions after some feeds can add to the stimulation.

Even after a complete stop, relactation is possible. The WHO, which devoted a report to it, says that many women manage to produce enough milk again for exclusive breastfeeding. It is better to have support: Naître et grandir stresses that professional help, such as a lactation consultant's, will probably be needed. If you are thinking instead of stopping, our article on gentle weaning explains how to cut feeds without pain.