Can You Mix Breast Milk and Formula?

Curated by Claudia Shannon / Research Scientist / ishonest

The breast laid plans of moms and babes oft go awry — so if you set out to exclusively breastfeed, don’t feel guilty if you wake up one morning (or at 3 a.m.), and decide you need to reset your standards.

Breastfeeding can be immensely rewarding and incredibly challenging. It can be a source of great joy and a cause of literal pain.

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We all want the best for our babies, and while we’ve been reminded time and time again that breast is best, formula can be a blessing and a game changer.

The good news for weary parents is that you can have it both ways. It’s possible to successfully feed your baby breast milk and formula.

You can find compromise, provide your baby with the nutrition they need, and maybe even catch a break. Here’s what you need to know.

Can you mix breastfeeding and formula feeding?

There’s no denying that the benefits of breast milk are plentiful. A mother’s milk evolves to meet baby’s changing nutritional needs, offers antibodies that protect from infection, and may even reduce the risk of sudden infant death syndrome.

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What’s more, breastfeeding is good for a new parent, too. It can speed up the recovery process, help fight postpartum depression, and reduce the risk of certain cancers.

While the American Academy of Pediatrics and World Health Organization both recommend exclusively breastfeeding for the first 6 months of a child’s life, parents know that this isn’t always possible or practical.

This uncompromising expectation can eventually lead to breastfeeding burnout and cause moms to prematurely quit.

In fact, one small study has shown that using early limited formula in combination with breastfeeding for newborns who were losing weight while still in the hospital had no negative impacts on breastfeeding and actually reduced rates of hospital readmission.

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So yes, exclusive breastfeeding is the ideal — but if your reality suggests that it isn’t possible, formula boasts the vitamins, minerals, carbohydrates, fats, and protein an infant requires to survive and thrive.

Formula can offer an option that meets nutritional needs while also allowing for breastfeeding parents to address and adapt to their own needs.

When it comes to breastfeeding, it doesn’t have to be an all-or-nothing experience.

If you’re feeling overwhelmed, over-tapped, or just plain over it, consider supplementing with formula in order to continue your breastfeeding journey.

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While breastfeeding is definitely encouraged as much as possible, remember that some breastfeeding is better than none, and you can find a middle ground that works for you and your family.

Combination feeding is using breast milk for some feeds and formula for others. It still affords you and your baby the amazing health benefits of breastfeeding, but offers an alternative when medical or life circumstances make exclusive breastfeeding not possible.

It’s a good idea to research or work with a medical provider or lactation consultant before beginning to add formula to your baby’s diet. They can help you determine how much formula to provide at each feeding, or in a 24-hour period.

Formula takes more work and time for little tummies to digest, so they often need less than you’d expect.

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Gradually adjusting your breastfeeding sessions as you begin adding formula to your feeding plans will help you and your little one more readily make the transition from exclusively breastfeeding to combo feeding.

It might make sense to try combination feeding if:

You aren’t producing enough milk

If you’re struggling to produce enough milk to satisfy your adorable, but insatiably hungry infant, you may be able to naturally boost your supply by hydrating, eating well, and pumping regularly.

However, sometimes — despite a mom’s best efforts — her production can’t match her baby’s demands. Hormonal changes, previous breast surgery, some medications, and even age can contribute to supply issues.

You’re a mom of multiples

A milk supply shortage can also impact moms of twins or multiples. Keeping up with the demands of two or more babies can leave you feeling depleted and sucked dry — even if your little ones remain ravenous.

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Combination feeding might be the solution you’re looking for. Whatever routine you establish, give it time — you and your twins will adjust.

You need more sleep (and a break)

New parents are heroes. But you know what else is heroic? Asking for help.

Having a partner feed your wee one a bottle of formula can give you the solid chunk of Zzz’s you so desperately need.

If you’re unable to get help during the nighttime hours, consider giving your baby a small amount of formula before bed — it might keep their tummy satisfied for longer.

You’re going back to work

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If you can’t or don’t want to juggle your job and your pump parts, consider combination feeding. For example, you can breastfeed in the morning and in the evenings, and have a caregiver provide formula in the hours in between.

It will take time for your supply to adjust to this change, so don’t go cold turkey on your breast pump during the day. Also, be mindful that your baby might experience a reverse cycle and want to nurse more often when you are at home.

Can you mix breast milk and formula in the same bottle?

If you’re wondering if you can mix breast milk and formula in the same bottle, the answer is yes!

It’s important to adhere to some safety guidelines when doing this though.

First, prepare your formula

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If you’re using powdered or concentrated formula, you will first need to prepare it per the instructions, making sure to add the correct amount of distilled or safe drinking water.

Once you’ve properly mixed the formula and water, you can add your breast milk.

Note that you should never use breast milk in place of water during formula prep. Maintaining the right ratio of water-to-formula and then adding breast milk separately ensures you won’t change the nutritional content of the formula.

Adding excessive water to formula can dilute nutrients, while adding insufficient water can put strain on a baby’s kidneys and digestive tract, causing dehydration. In extreme cases, this can also lead to neurological problems.

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If you’re using ready-to-drink liquid formula, no extra steps need to be taken before combining it with your breast milk.

Ensure safe storage and disposal of breast milk and formula

There are different rules for the storage, use, and disposal of breast milk and formula.

Breast milk can be frozen in a food-grade plastic container for 6 months. Once thawed, it can stay in the refrigerator for 24 hours.

Freshly pumped breast milk can be kept in the back of the refrigerator for up to 5 days or in an insulated cooler for up to 24 hours.

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An opened container of liquid formula should be refrigerated and used within 48 hours. If you have premade formula bottles, however, they should be used within 1 day. Likewise, a refrigerated bottle of formula mixed with breast milk should be used or discarded within 24 hours.

While a bottle of room temperature breast milk is good for up to 5 hours, a bottle of formula or breast milk mixed with formula should be discarded after 1 hour from the start of use.

Bacteria reproduce quickly in anything cow-milk-based, so don’t try to save a partially used formula or formula-and-breast milk bottle in the refrigerator beyond that 60-minute mark.

Benefits & risks

What are the benefits?

Mixing breast milk and formula in the same bottle can make feeding time more convenient.

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There are other advantages to this method of combination feeding, too:

  • Baby may adjust to the taste quicker. If your finicky little love is used to your breast milk, they might initially turn their teeny nose up at the taste of formula. Mixing the two together may get them used to this unfamiliar flavor more readily.
  • Baby may sleep for longer stretches. It takes more time for a baby’s body to process formula, so they might be able to go longer stretches of time in between feeds if you’re using both breast milk and formula together.

What are the risks?

There are some potential downsides — and even a few risks — to mixing breast milk and formula together in one bottle. Be aware of the consequences so you can make an informed decision.

You could be wasting breast milk

Many might cringe at the idea of mixing breast milk and formula in the same bottle, worried that some of that hard-earned precious “liquid gold” could go to waste.

No mama wants to see the fruits of her pumping labor go down the drain — so if your baby generally doesn’t finish their bottle, consider giving them breast milk first, and then offering a separate bottle of formula afterward if they still seem hungry.

Your supply may diminish

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Adding formula to your routine — whether you’re supplementing with straight formula or mixing formula and breast milk together in a bottle — can cause a reduction in your milk supply.

Supplementing gradually can help ensure you maintain an adequate supply.

Potential health risks

As previously mentioned, it’s important to properly prepare your formula, per the instructions.

Breast milk shouldn’t be used as a substitute for water when making bottles with powdered or concentrated formula. Neglecting to use the right amount of water could be hazardous to your baby’s health.

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Furthermore, breast milk mixed with formula has a significantly shorter shelf life than breast milk alone. A bottle containing both together must be discarded within an hour of initial use.

Takeaway

Breast milk and formula don’t have to be mutually exclusive. Babies can thrive on breast milk, formula, or a combination of both.

Keep them separate, mix them together, nurse, pump, and find what works for you and your baby.

Just keep some key safety precautions top of mind when preparing bottles and you’ll figure it out in no time. You’ve got this!

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