Combination feeding without losing track
A breastfeed at 6am. A bottle of formula at 10 because you had to be somewhere. Expressed milk in the afternoon, given by someone else. Another breastfeed at 7pm that went on for most of an episode of something you did not follow.
By the evening, the day is a blur of three different kinds of feed, and the question of how much your baby actually had does not have a tidy answer.
Combination feeding, sometimes called mixed feeding, is common, and it can work really well. It also creates a particular kind of admin, and that admin is what this post is about.
What the NHS says about combining breast and bottle
This is the part that should come from the NHS rather than from us, so here it is in their terms.
On its combining breast and bottle feeding page, the NHS says it can take several weeks for you and your baby to feel happy and confident with breastfeeding, and that introducing formula feeds can affect the amount of breast milk you produce.
The NHS also says that if you are planning to mix feed, it is usually best to wait until around 6 to 8 weeks after the birth so you have time to get the hang of breastfeeding, and that expressing between bottle feeds can help maintain your supply.
None of that is a rule you have failed if your situation is different. Lots of families combination feed from early on for all sorts of good reasons. It is simply worth knowing, so you can make the choice with the full picture.
For help with your own situation, speak to your midwife, health visitor or a breastfeeding supporter. The National Breastfeeding Helpline is open 9.30am to 9.30pm every day on 0300 100 0212.
Why combination feeding is harder to keep track of
With one type of feed, a day has a single thread. With two or three, you are holding several at once.
The questions that come up most:
How much did they have today, all in? Breast gives you minutes, bottles give you ml. They do not add up neatly, and they are not meant to.
Which side was last? Still matters, even with bottles in the mix.
Who gave the last bottle, and when? Especially when more than one person is feeding.
Is the expressed milk keeping pace? If you are pumping to replace feeds, it helps to see sessions and output over a few days, not guess at them.
The hardest part is often simply that different people are doing different feeds and nobody has the whole day in their head.
What is worth writing down
You do not need to record everything. A few details, logged as they happen, cover almost every question you will ask later.
Breastfeeds. Time, side and roughly how long.
Bottles. Time, amount, and whether it was formula or expressed milk.
Expressing. Time and how much.
Anything that stood out. A feed that went badly, a sleepy baby, a day out that threw the timings.
That is it. The goal is not a perfect record. It is a record good enough that you are not reconstructing the day from memory at 10pm.
What a combination-fed day looks like written down
When families look back at a week of mixed feeding, a few things tend to show up:
A rhythm you did not know you had. Breastfeeds cluster at certain times, bottles at others, often in a pattern that is steady across the week.
The bottle that has crept earlier. Useful to spot if you are trying to protect particular breastfeeds.
How expressing is going across days, not hours. One small pumping session means little. A week of them shows you the trend.
That picture is also exactly what is useful to bring to a health visitor or breastfeeding supporter if you want help. A real week beats trying to remember it.
Keeping it in one place
The simplest thing that helps with combination feeding is having breast, bottle and pumping in the same timeline rather than in three different notes apps and a scrap of paper on the fridge.
In Littles, each breastfeed records the side and duration, bottles are logged in ml or oz, whichever the bottle in your hand is marked in, and pumping sessions sit alongside them. Both parents can log into the same account, so the person doing the 10am bottle and the person doing the 7pm breastfeed are adding to the same day.
There is nothing predicting when the next feed should be, and nothing telling you your baby should have had more. It shows what happened.
When to speak to someone
Please contact your midwife, health visitor or GP if:
you are worried about your baby's weight gain or how much they are taking
wet or dirty nappies have dropped off noticeably
your baby seems more sleepy than usual, or unwell
feeding has become painful, or you are finding it hard going in any way
The NHS says to call 999 or go to A&E if your baby is difficult to wake or cannot be woken, or has not had a wee in the past 12 hours.
Mixed feeding is a legitimate way to feed a baby, not a halfway house. If you want support to keep breastfeeding alongside bottles, or to change the balance, that support exists and you are entitled to ask for it.
Littles is free to download, and logging feeds, sleep and nappies stays free for as long as you want it.
Your baby's patterns, and the rest of the analysis screens, are part of premium. Two weeks free to try, then £6.99 a month or £50 a year.
Sources: NHS guidance on combining breast and bottle feeding and on mixed feeding; National Breastfeeding Helpline; NHS guidance on when to call 999 or go to A&E.
Related reading: How much milk does a baby need? A plain guide in ml and oz
