Many moms end up supplementing breast milk with formula at some point. Trying to figure out the best way to do it can be confusing – should you mix breast mix and formula together? Or give breast milk first, and formula only as needed? Here are three ways to supplement breast milk with formula, and the pros and cons of each.
For the first month after my son was born, he wasn’t gaining enough weight, and I needed to supplement. I was also constantly pumping and trying to figure out when I should give him breast milk and when I should give him formula.
For example, I’d read somewhere online that I could mix it together in one bottle. I’d also read that giving formula might help my baby sleep longer at night. Or maybe I should just use all of the breast milk I had until I ran out and then give him formula?
3 Ways to Supplement with Breast Milk with Formula
Here are the different ways that I tried supplementing with formula, along with the pros and cons that I found.
Option #1: Mix breast milk and formula together in one bottle
PRO: If your baby is accustomed to breast milk, he is more likely to accept the bottle, as the flavor will be more like what he’s used to. Also, you only have to make one bottle.
CON: If your baby doesn’t finish the bottle, it will have to be thrown out an hour after he starts drinking it. (Breast milk-only bottles can be kept for the next feeding; formula bottles must be discarded an hour after the feeding begins.) Throwing away breast milk – especially when you are supplementing – is painful!
Option #2: Start baby with a breast milk bottle and follow with a formula “chaser”
With this option, you give your baby all the milk that you have available for the feeding, and then offer him formula after the breast milk bottle if he is still hungry.
PRO: No throwing away breast milk! Also – if it is important to you to minimize formula, with this option, you are only giving your baby the amount of formula that you absolutely have to.
CON: You have to prepare and wash two bottles. Also, if your baby doesn’t like the taste of formula, he might refuse the second bottle and still be slightly hungry and cranky.
Option #3: Pick one or several feeds of the day to be formula feeds and only offer formula at that feeding
PRO: It’s much simpler – only one bottle to deal with and one liquid to prepare. And again, no throwing away breast milk.
CON: If your baby doesn’t like the taste of formula, it might be difficult to get him to take this feeding. However, it’s more likely that he’ll take it since he’ll be pretty hungry (versus option #2, where he’ll already have had some pumped milk).
I generally chose option #2 until I was able to get my supply up with fenugreek.
Because I am a bit lazy, I bought some of the nursettes that they gave me in the hospital and would give him those after a feeding when I ran out of breast milk. This worked great; it was lucky for me that he didn’t mind the taste, and I still only had to prep and deal with one bottle since the nursettes were all ready to go. The only downside with these is that they are a little expensive.
Rules for Mixing with Breast Milk and Formula in the Same Bottle
If you decide to go with option #1, where you put everything in the same bottle, here are some guidelines for how to do it:
- If you’re using formula that needs to be prepared (like powdered infant formula), mix and prepare according to the directions first, before adding it to your breast milk. Do not add the powdered formula directly to your breast milk. (This doesn’t apply if you’re using ready-to-feed formula.)
- If you’re preparing a mixed milk bottle to feed later, chill the prepared formula before adding it to refrigerated breast milk to avoid raising the temperature of the breast milk – just like you should chill freshly pumped breast milk before combining it with milk already in the fridge. (If you’re feeding immediately, you’ll be warming the breast milk anyway, so this doesn’t apply.)
- When feeding from a mixed bottle, you should discard milk based on the earliest time that would apply to any milk in the bottle.
You also might like:
- How to Boost Your Milk Supply: Get More Letdowns
- Chocolate Malt Lactation Milkshake
- No-Bake M&M and Chocolate Chip Lactation Bites Recipe
- KidsHealth.com. “Formula Feeding FAQs: Preparation and Storage.” https://kidshealth.org/en/parents/formulafeed-storing.html
- Kellymom. “Human Milk Storage.” https://kellymom.com/store/freehandouts/milkstorage01.pdf
Christina says
April 25, 2018 at 6:28 pmMy LO is 6 weeks old and I want to try supplementing with formula as my milk supply is dwindling . In the first three weeks I had so much milk I was able to store at least 100 bags of 3 and 4 oz my freezer ! But I’ve gotten lazy I started pumping less not know it would slow my supply! I only planned to breast feed the first 6 months! Wondering how transitioning would be for my LO. What if he rejects the formula
Amanda Glenn says
April 25, 2018 at 6:52 pmHi! I would try mixing it with breast milk to start and see how that goes! Good luck!
stephanie says
January 30, 2018 at 5:38 amhi im pregnant with my second baby Im 28weeks.and I want to try ep
but I want to start pumping straight after I gave birth, but what does the baby have while im pumping
and if its forumla will she or he take my breast milk and the stuff comes before milk, how does this work, please im so confused, worried and really need to know more
Thank you
Stephanie
Amanda Glenn says
January 30, 2018 at 4:05 pmHi! Congrats on your pregnancy! I have an answer to this here (about halfway down the page). Good luck and let me know if you have any other questions!
https://exclusivepumping.com/exclusive-pumping-frequently-asked-questions/
Chelsea says
September 22, 2017 at 9:07 amI have just started EPing. With my first child I was making barely a half ounce despite mother’s tea, fenugreek and eating my weight in lactation cookies. My second child is now 2 months old and my supply is going down again. I’m pumping about 1-1.5 oz per session. We tried nursing and it was going great for a while but he soon became too aggressive at the breast and we spent more time re-latching than actually eating. Thankfully he will suck on anything that it put in his mouth. Is there anything I can do to establish a supply so that I’m not feeding my child something I JUST pumped? I want to stay ahead of him a day or two.
Amanda Glenn says
September 23, 2017 at 9:33 amHi! What dose of fenugreek are you taking and do you smell like maple syrup? What is your pumping schedule?
One option that is challenging to get but might help is domperidone. More info at the bottom here:
https://exclusivepumping.com/increasing-milk-supply/
Kelsi says
March 16, 2017 at 9:05 amTrisha,
Were you able to get your supply back up at all? I’m currently at 3-4 pumps per day and my supply is dropping. We tried supplementing with formula for the first time this morning and my 10 month old wouldn’t have it. I just bought some tea this morning…we found out our son has a diary allergy at one month. His doctor told us to give him Similac Alimentum if we needed to supplement. That stuff is NASTY. It smells like dog food – I can’t even imagine what it tastes like. Does anyone know of something similar that might taste/smell less awful? Or any other ideas on how to get him to take formula? Could we just decrease the number of bottles he drinks since he’s eating solids?
Amanda Glenn says
March 16, 2017 at 10:34 amHave you tried mixing formula and breast milk together? When I transition babies from breastmilk to other stuff I start with just a splash in the bottle and gradually increase it. Just an idea.
Kristin says
March 13, 2017 at 11:08 amFor Option #2. . .I’m curious why it is necessary to use two different bottles. In option #1, the breast milk and formula are being mixed together in the same bottle. Why can’t the “formula chaser” in option #2 be put into the same bottle that was just used for breast milk?
Amanda Glenn says
March 13, 2017 at 3:03 pmHi Kristin! You can do that too. You’d probably want to at least rinse it out in between but I guess you don’t have to completely wash it. Good idea!
Donna says
March 15, 2019 at 7:19 pmThat’s the same thing I wondered! I am an Rn and 2 of myb3 kids were not good nurses so I supplemented. I cried too as I wanted everything pure and natural. BUt thinking back I would have pumped what I could….we didn’t have Hospital grade pump then……and I would get an organic formula and use both. Even if your baby is getting 1 oz of your milk at a feeding which you pumped….it’s still wonderfully good and formula isn’t terrible either. Enjoy your baby . They grow up so fast! My Mom used to try to tell me this but I felt like a failure! If you live and take care of your baby and nurture them you are not a failure! And my cousin fully formula fed her baby and that baby is a DOCTOR now! Do your best and don’t stress over this!
Nicole says
December 5, 2016 at 12:16 amReading all these posts make me feel less alone. I started supplementing my little girl on day 2 and feel so bad about it. She didn’t seem full or happy. I was bf but couldn’t get latch and baby was unhappy. Started pumping and enjoyed it more. Having a 3 year old at home as well makes it almost impossible to pump enough so some feeds are completely formula. She also has acid reflux so it’s hard to know if formula makes it worse. I would like to exclusively pump but have enough for her. Right now I go about 5 to 7 hours between pumping because I was convinced I was going to stop giving breast milk, however I want to ep for as long as possible. Tips? What formula do you guys like? Anything I try makes her gassy.
Jennifer says
December 30, 2016 at 4:38 amNicole,
I recently had to start supplementing formula because my baby girl is not gaining weight. I have found that changing my diet has helped. I recently found out that she has been gassy because she has a milk protein allergy. My baby girl also has acid reflux. I would suggest seeing her pediatrician and inquiring about Pepcid. Taking Pepcid once a day has seemed to make a difference with the reflux. Also, if you change your diet I would recommend not eating foods that would normally cause heartburn, such as, pizza or anything spicy, this could be the cause of extra reflux issues with your little one. Also, you could always ask your pediatrician about having an allergy test done to see if your little one has any allergies to anything you might be eating. Good luck.
Trisha says
January 13, 2017 at 8:31 amThis makes me feel better… I went back to work and with that and a three year old I am only pumping twice per day at this point. My supply is dropping now even from what I was getting. I just bought the tea and am going to try that to get as much as I can. I may only be pumping twice a day but at least I know that she’s getting that little bit. I had an amazing supply before I went back to work, to the point where I had a small stockpile of frozen milk. That is dwindling now unfortunately. I am not sure what reflux looks like in babies, but if it means they spit up a lot, my daughter spits up a lot if I eat to much cabbage or broccoli or any other veggies like that.. and it gives her gas. My daughter did well on enfamil newborn but the regular is not agreeing with her. I am going to try something else next.
Helen says
September 15, 2016 at 10:23 amI’m also in a similar situation. I have started pumping regularly from a few days ago. My baby is 2 and a half weeks weighing around 3kg and I’m getting 80ml per 3-4 hourly pumping sessions but she is still fussy when this has finished so I top up with 30-40ml of formula at most feeds. It takes me 30minutes to pump 80ml. Just wondering if pumping 5 times a day at 30minutes each is ok? I’ve read on multiple sites to pump 2 hours altogether in 24 hours and to pump around 8 times but this would mean I’ve pumped 4 hours…. So I’m wondering whether pumping for longer would affect my supply?
Also I’m feeling bad for topping up with formula and making her full as she’s only 2.5 weeks but I just can’t get her to settle on the breast at all and have exclusively been pumping. I’m already feeling guilty about whether my milk supply will last and whether I’ll eventually have to switch completely to formula.
Jennifer says
December 30, 2016 at 4:49 amHelen,
Hello. I know what you mean when you state that you feel bad for topping up with formula. I have to supplement because my daughter is not gaining weight properly. The first bottle of formula that I gave her I cried. I have a son who is 10 1/2 years old. I breastfed exclusively with him, no formula at all. I don’t know if it is because I am older or my thyroid issues; however, I just cannot seem to produce enough even with taking Fenugreek and drinking plenty of water. I try to pump every 2 hours but this is not always possible with so many doctors appointments because of her medical issues. I noticed when I do pump I am lucky to get 2 ounces, most of the time it is only 1 ounce. Does anyone have any suggestions on how to get more per pumping session.
Thank you
Amelia says
September 7, 2016 at 1:49 pmHi, very informative and interesting article. My baby is 7 weeks and I have being pumping as baby won’t latch. I pump 6 to 7 times a day and for 20 minutes at each session. I get about 150mls in the morning and for rest of the day I get about 80 to 100mls. My baby takes 120mls every two to three hours so am able to get just enough to feed her. I really want to increase my supply and am hoping to try fenugreek. Can you please give me dosage on how to take fenugreek.
Amanda Glenn says
September 7, 2016 at 4:15 pmHi Amelia, I would start with 2 capsules 3 times a day and increase it after a few days if you don’t smell like maple syrup.
Heidi says
August 22, 2016 at 9:51 pmGreat article! Wish there were more out there like this. My baby is 4 weeks- he never did latch so I am exclusively pumping. He is getting formula for half of his feedings since this is what he started with in the hospital due to no latch. Plus we felt it was easier to continue partial formula feeds since he will be out to daycare in only a few more weeks and it would be easier for the provider. I pump every 2 hours for 20 min (for the first two weeks I also pumped every 2 hours through the evening). I have found this massively increased my supply and has maintained as long as I’m drinking lots of water. I have a huge freezer stash now especially since he eats every 3 hours. This past week I cut back the night pumping sessions to only when he wakes up- every 4 hours- but continue to pump every 2 during the day. Hope my tip helps somebody else. Best of luck ladies!!
Karen says
August 23, 2016 at 10:32 amWow! How much do you get at the 2 hourly pump? I only get 100ml when I pump 3 hourly and it’s only sufficiently feeding him for 1 feed and no more addition… I get lesser output if I pump 2 hourly. I just started my fenugreek pills, really wondering what am I missing. How come my supply just doesn’t seem to increase and we are in week 5 already.
Marielle says
August 21, 2016 at 10:01 pmWhat about exclusively pumping while traveling? Best storage methods? Formula supplementing times etc?
Amanda Glenn says
August 22, 2016 at 9:19 amHi Marielle, A lot depends on how you’ll be travelling (plane vs car, because you can take a cooler in the car) and where you’ll be staying (i.e., do you have access to a fridge). If you have more details I’d be happy to help. 🙂
Karen says
August 16, 2016 at 4:41 pmHi, your article is really informative.
My baby is 4 weeks plus and I am still trying to catch up his feed with my pumping session as my supply isn’t that much yet. There are times, when his feed is near yet my pumping schedule is not up yet. I am unable to pump as the output will be lesser if I pump before 3 hours. I will be able to sufficiently feed him ONLY if I pump minimally at 3 or more hrs apart. As the output will be sufficient to feed him. However, I end up having lesser pumping sessions. At night, I pump at least once and we feed him full formula for night feeds. Total sessions about 5-6 pumps in 24 hrs
During, the day as much as possible I give him full breastmilk. Unless, I do not have enough supply.
Now that my baby is 4 weeks already and my supply is still not there yet. Is this normal and is there anything wrong with me?
Will my supply still kick in naturally on its own? I am now drinking Nursing tea 3x a day.
I am Considering if i should start fenugreek supplements pills as i worry about over supply and engorgement etc as i do not know if i do not have enough supply or is it just that my supply hasn’t come in yet. Please advice.
Also, if i am out with baby alone i will not be able to pump. What should i do then? Any issues if i do not pump at all during such situations?
Amanda Glenn says
August 17, 2016 at 9:25 amHi Karen,
I would definitely try fenugreek – it can’t hurt and I wouldn’t wait to see if your supply increases on its own at the 4 week point. If you’re out with your baby I think it’s fine to push your pumping session back or make a later one longer – just make up the time later in the day. And I wouldn’t let it go too long – if you normally pump every 3 hours I wouldn’t wait 8 or 10. Hope that helps!
Stephanie B says
January 16, 2014 at 7:18 pmThanks! I really enjoy your articles! Any tips on how adding food to baby’s diet at six months affects EPing? Did your son still require as much breastmilk? Or were you able to drop a pump due to him needing less?
The Extreme Pumper says
January 16, 2014 at 9:09 pmThank you so much Stephanie!!
At six months, my son still needed about the same amount of breast milk. At the beginning, it’s so much work to get them to *actually* eat a little oatmeal or pureed food, and that food doesn’t have nearly as many calories as breast milk does. I think both kiddos started needing less breast milk around 8-9 months. That’s exciting that you’re starting solids soon! How fun!
Stephanie B says
January 16, 2014 at 9:47 pmThanks! Well in that case, I will just keep on pumping! 🙂
Stephanie says
January 12, 2014 at 5:16 amI supplemented with formula during week 3 of my baby’s life when she lost weight. I too used the nursettes. But I used them for finger feeding via a syringe and tubing taped to my finger (she would suck on my finger to eat which was apparently supposed to cause less nipple confusion). I also tried the SNS system (supplemental nusing system). My baby would suck at the breast. Meanwhile, she was sucking formula via tubing in the corner of her mouth. This was supposed to stimulate my milk production and keep her at the breast but also gain weight. Long story short…she failed to gain weight on both methods. Once my milk supply returned (after a bad experience with a nipple hield), we had success with EPing!
The Extreme Pumper says
January 12, 2014 at 8:01 pmThe third week was the really bad week for me, too. I never tried an SNS but was curious about it. I’m sorry it didn’t work, but I’m so glad to hear that your got your milk supply up and have had good luck with EPing!
Sreedevi says
August 1, 2016 at 8:19 amHi
I am exactly at 3rd week and asked to supplement as baby is losing weight.she has 3 bottles 2oz formula. While I.pump I get max 40ml.I am having fenugreek tablets, but dont see a visible increase in quantity of pumped milk. Is there a specific brand I need to use or is there something wrong with pumping? I pump for 15_20mts, in simulation phase, I het the max output. Once I use expression phase, nothing much comes. Should I shift between simulation and expression phase? Can my milk supply increase? I don’t smell of maple syrup inspite of having around 12 fenugreek capsules…
Amanda Glenn says
August 1, 2016 at 4:16 pmHi! Are the capsules 610mg each?
Sreedevi says
August 5, 2016 at 4:23 pmYes, I have it thrice. 4 tablets per dose.
I did try lactation plus. Mother’s tea too. Still getting 40ml/2hrs and 50ml on mornings.
Also today my baby refused to breastfeed..I had to pump and give her. I used to breastfeed her one time/day thinking she might go back to breast once my supply is back.
Any help is greatly appreciated, on how to increase quantity and right steps to make sure I can do this for the time I get any milk from my breast:(
How to make sure, without baby drinking from breast, that supply doesn’t lower.
While pumping, I get most of milk in simulation phase and 2mts after that. Rest of 15mts, iget very less, just trickle. It’s the initial 5mtz, which gets 95%of 40ml.
I don’t see any let down after that.. has someone faced this??