Is it OK to breastfeed during the day and give formula at night?

If you’re breastfeeding your newborn, there may be times when nights are hard. Maybe you have multiples, work nights or you want to start letting someone else in the house be responsible for those late, night-time feedings (YES!). The decision to breastfeed during the day but give infant formula at night is a common choice for many moms. This decision to combo feed— any sort of mix of breast milk and baby formula- allows for both formula feeding and breastfeeding interchangeably. Combo feeding with a night bottle is a great solution.

How to formula feed a breastfed baby

• When introducing your baby to formula after breastfeeding, it may be best to do so gradually, if possible.
• Try to switch one feeding at a time and give formula for only that feed for a few days. Then you can repeat with another one if needed, and so on.⁸
• Have someone else feed your baby with formula. Sometimes when babies smell mom, all they want is breast milk. If you’re having this problem getting your baby to take a formula bottle, see if having someone else give the bottle does the trick.⁹
• Ensure that you still use your breast pump to pump out breastmilk and avoid engorgement of the breast, which occurs when your breast is full of milk, but it’s not being used up at the same rate it’s being produced.¹⁰

Night-time pumping routine

Lactation consultant and Bobbie medical advisor, Jadah Parks Chatterjee, shares her insight for moms who are making the switch to combo feeding. It’s important to note that you will still need to express milk during the usual night-time feeding times, at least to start. “If you are combination feeding, providing human milk by utilizing the pump, it is recommended to pump 8-12 times in a 24 hour period, for 15-20 minutes to mimic your baby’s eating pattern. Pumping every 3-4 hours to support your body to continue to make milk and to prevent engorgement,” says Chatterjee. “Skipping night time pumping sessions can increase the amount of plugged ducts and the risk of mastitis.  Neither are fun, all are generally preventable with consistently expressing milk.”

Will combo feeding lower milk production?

“If our body doesn’t receive the message via stimulation from baby nursing, hand expression or pumping, the hormones needed to make milk will begin to decrease. This will affect your milk supply. Skipping night time pump sessions is common, and ok if it happens, we just don’t want to make it a habit if the goal is to have 25-35ml of human milk expressed daily for your baby,” says Chatterjee. “This is where getting to know and trust your body and body sensations come in. Are you feeling engorged when you skip a night time pumping session? If so, your body is communicating a back up of milk volume, increasing your risk for chronic engorgement, plugged ducts and mastitis. To prevent this from occurring, continue to engage your pump every 3-4 hours to prevent the discomforts of engorgement. “

Pumping at night

Additional night time pumping sessions are (usually) recommended for a short period of time to increase your milk supply. “If you are consistently finding you need to add additional pumping sessions at night, add a session during the waking hours to eliminate an additional feeding,” recommends Chatterjee. “However, if you and your baby have decided that it’s the early quiet hours after midnight when you like to feed, then wake up and feed your baby. Only if you are pumping to increase your milk supply or your milk storage supply do you need to pump following the feeding session. Otherwise, after the baby has enjoyed their 3 am snack, everyone should go back to sleep.”

Chatterjee notes that this information is very general and needs to be based on what’s going on with the lactating parent, their goals and how the baby is thriving. Moms can always connect with their OBGYN or infant feeding specialist for a more personalized plan. 

Night-time tips for formula feeding and pumping

Chatterjee shares her advice for planning for the night time if combo feeding and using a pump:

• Identify the support person and schedule for formula feeding at night.  
• Keep all of your feeding supplies nearby. 
• Have bottles of formula prepared for the night time feeding. The temperature of the formula is your baby’s preference. Cold milk or milk warmed with a bottle warmer are both acceptable options. 
• Although some experts recommend preparing each formula bottle right before you give it to your baby, there are times when this just isn’t practical. And one of those times may be the middle of the night. Since formula is safe in the fridge for 24 hours after it’s prepared, you can make that middle of the night bottle before going to sleep so it’s all set to go when you need it.¹¹ You can also have a formula pitcher on hand.
• Pumping to increase your milk supply to be stored and enjoyed for later? Pump for 15-20 minutes. 
• If you were dancing in your dreams while your pump alarm was going off, no problem. When you wake up, take a breath, hop into a warm shower then pump 15-20 minutes to decrease engorgement if present. If you don’t have time for a shower, try a warm compress for 10 minutes on your breast / chest to increase circulation and support milk flow when you are pumping. 
• Store the expressed/pumped milk. It is considered safe for expressed milk to be room temperature for 4 hours. After that, it should be refrigerated (up to 7 days) or placed in the freezer (6 months – 1 year). 
• Your body is communicating it is comfortable skipping night time pumping and you are reaching your daily goal in volume of milk?  Enjoy your dreams. 
• Have a support plan. The night-time feeding may not always have to be done by you. If you have a partner, family member or friend at home who can also feed your baby in the middle of the night, try to set up a schedule with them so you can get a little rest. Chatterjee shared that she and her partner alternated, one would get up to feed the baby and the other would do the dishes. 
• Don’t forget to burp your baby every 10 minutes or so.

What is baby formula, anyway?

If you’re new to baby formula, you may be wondering what it is and if it’s safe for your baby? Infant formula is an alternative to breastmilk that is used for feeding infants. Baby formula production is heavily regulated, so all formulas that are legally marketed and sold in the US have to have certain amounts of nutrients in them.¹ 

All baby formula ingredients should include the basics of water, a carbohydrate, protein, fat, vitamins, and minerals. The protein base of formula can come from many commonly used milk types like cow, goat, or soy. The most commonly used base is cow’s milk, but sometimes babies need another type of protein for a medical reason, or parents may choose a different kind of formula. 

It is recommended that parents practice exclusive breastfeeding for the first year of a baby’s life.² This, however, isn’t possible or practical for many parents, so formula can play an important role in providing babies the nutrition they need. 

What are the types of baby formula⁷

• You will find infant formulas are made from 3 common bases: cow’s milk, soy, or protein hydrolysate, which contains more broken down proteins. Most babies who breastfeed are fine to start cow’s milk formula, and the other two forms are mostly used for babies with medical issues. However, you should always talk to your baby’s healthcare provider before choosing a formula so you can make sure you are picking the best one for them.  
• You will also find that these bases come in 3 forms: powdered, liquid concentrate and ready to use. The main differences between these are the price and what’s involved in preparing them.

Reasons why some moms combo formula feed, especially at night:

1- Combo feeding allows someone else to assist with feedings 

Being a parent is hard (gulp). It’s exhausting to wake up at night (again and again) to breastfeed an infant, leaving all parents to newborns exhausted. Without rest, it’s really hard for parents to give their all to their babies during the day. Letting someone else formula feed the baby means getting some help and much needed rest, which leads to a more-rested and happier mom. 

With formula feeding, you get a chance to take a breather and perhaps get a full night’s rest since another family member can take care of feedings in the middle of the night. This also gives someone else a chance to bond and build a relationship with your baby. 

2- Combo feeding is a great way to feed multiple babies

Breastfeeding one infant can be tough, and breastfeeding multiples can be super tough. Some moms don’t have enough supply (especially in the beginning) to fully breastfeed two or more babies. Not to mention the time and logistics involved, which can be stressful. Multiples are also more likely to be premature and need more calories than babies born on time, so these infants are sometimes recommended to have formula by their healthcare provider for extra calories, vitamins and minerals.

Choosing to supplement with formula during the day or the night is a great way for moms to step back and allow some time for rest, which is definitely needed when you have two or more babies.

3- Combo feeding is thought to get your baby to sleep through the night

Although without any scientific support, many parents believe formula feeding will help their little one sleep through the night.³ Due to the way formula is made, it’s harder for babies to digest than breast milk, so some folks believe it may play a role in helping your baby sleep for longer before hunger sends them (and you) a wake up call.⁴  

However, it’s important to remember that babies wake at night for a number of reasons that do not relate to being hungry:⁵

Babies can be waking up at night because of these reasons other than hunger:

• They naturally have different sleep cycles than older children and adults 
• They are in the teething phase, which can be painful
• Some babies are just “better sleepers” than others

It’s important to remember that parents play a key role in helping their babies learn to self-soothe and go back to sleep on their own as they get older, so start to take note of why your baby may be awake? Are they crying or screaming because they are hungry or in pain? Or are they babbling up a storm with their new sounds? The crying probably requires your attention, but the babbling probably doesn’t.⁵

4- Combo feeding is used to help parents with night-time work schedules

Let’s face it, many moms are working moms, and this often means your schedule is not your own. Some moms work at night and others have very long days. Lots of moms try to make time to pump breast milk and leave a supply for their baby, but this may not be an option for everyone. 

Unfortunately, in the end many employers are not as supportive of breastfeeding moms as they should be. That’s why unsupportive work policies and lack of parental leave are one of the top reasons mothers stop breastfeeding early.⁶  

Is it OK to breastfeed during the day and formula feed at night?

Yes!  Combo feeding is a great way to extend your breastfeeding journey.

Feeding your baby can happen many different ways. That can mean formula during the day or at night or breast milk during the day or at night. How you feed your baby is up to you! If combo feeding is what makes feeding easier all around, then try it as a method to help in your baby’s first year. You can add in formula as much or as little as you feel good about.

Verified by Morgan Leafe, MD, MHA

Sources: 

1- Questions and answers for consumers concerning infant formula | Food and Drug Administration

2- Breastfeeding and use of human milk | Pediatrics

3- Infant feeding methods and maternal sleep and daytime functioning | Pediatrics

4- Breastfeeding your baby: breastfeeding- simply the best | New York State Department of Health

5- Why do babies wake up at night? | Seattle Children’s

6- Breastfeeding facts | Centers for Disease Control and Prevention

7- Infant formula: your questions answered | Mayo Clinic

8- Weaning | Centers for Disease Control and Prevention

9- Weaning your child | Nemours Kids Health

10- Breast engorgement | University of Michigan Health

11- Feeding your infant: how to prepare and store baby formula | Cleveland Clinic