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23.03.2023

Mixed feeding

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The WHO recommendation for exclusive breastfeeding for the first six months of a baby’s life

Biologically and nutritionally speaking, Mother’s Milk is unique and the World Health Organization (WHO) advocates for exclusive breastfeeding for the first six months of a baby's life. From the age of six months, the WHO recommends the gradual introduction of complementary foods that suit the baby's needs and metabolic capacities, in addition to the milk that should remain the basis of his diet.

In practice, several reasons can lead the mother to choose mixed feeding.

 

What is mixed feeding ?

Mixed feeding consists in combining breast milk and bottle-feeding of infant milk. Depending on the child’s age, the infant milk can be either infant formula, follow-on formula, or growing-up milk formula.

Each mother determines the appropriate feeding pattern for her baby and for her situation (number of feeds of breast milk, number of feeding bottles of infant milk, etc.).

There are many reasons for a mother to choose mixed feeding:

  1. The baby needs to be supplemented with infant milk due to insufficient weight gain,
  2. Returning to work without completely giving up breastfeeding,
  3. Regaining some independence,
  4. Need or wish to have more time for oneself,
  5. etc.

While breast milk is indeed the best for your baby’s health, it’s up to you to choose what best suits your situation.

 

Mixed feeding for Parents and for Baby

For the parents

As you reduce the number of feedings, your lactation gradually decreases.

If you wish to breastfeed for as long as possible while combining it with infant milk, it is strongly advised to exclusively breastfeed for at least the first six weeks of your child's life so that the lactation develops well.

It is generally recommended to start mixed feeding a few weeks before getting back to work. This is when the father/co-parent or the grand parent can take over by bottle-feeding the baby.

 

For the baby

When switching to a feeding bottle, your baby's sucking action is different (extrusion reflex of the tongue when breastfeeding). It can take about three weeks for the baby to fully adopt bottle-feeding without any difficulty.

More stretchable or breast-like teats may be more suitable during this transition. It may be necessary to try several teats before finding the most adapted for your baby.

As with breastfeeding, make sure that you are comfortable before giving your baby a feeding bottle (see the FAQ on "How should I bottle-feed my baby").

 

Mixed feeding in practice

The transition from breast milk to infant milk must be progressive. You should reduce the number of breastfeeds every 2 to 3 days (or even every 5 to 6 days if necessary) gradually and replace it with a bottle of infant milk adapted to the age. It is advised to start by replacing the afternoon feeds which are often less abundant.

At the same time, do not hesitate to keep on expressing your milk regularly even if your baby is not around. This will ensure good lactation and avoid breast engorgement.

At your workplace, you can express your milk with a breast pump (manual or electric) and store it according to the appropriate storage rules (see the golden rules below). In Belgium, as in France, the regulations stipulate that every employer should offer a breastfeeding area either to allow you to breastfeed your baby or to express your milk once or twice a day for half an hour and, if necessary, to be able to store your milk in the refrigerator.

To get your baby used to bottle-feeding, you can start with a bottle of breast milk mixed with infant milk, for example, in proportions of 2/3 and 1/3 respectively. When your baby is used to this proportion, you can then reduce it to half of breast milk and half of infant milk, then to 1/3 and 2/3 until you can give him a full baby bottle of infant milk.

It may then be the father's/co-parent's/grandparent’s turn to give the bottle, with the advantage that your baby will be less sulky because when you give it yourself the first few times, your baby associates your smell with breastfeeding. When baby is not with his parents, it is then up to the nursery nurse, the nanny or another family member to take over.

 

The golden rules for storing breast milk properly

 

 

Family, friends, and the healthcare professional in this new stage

Although breast milk is of course the best thing for your child's health, each situation is unique, and your family, your friends and the medical profession play an essential role in listening to you and supporting you and your choice of feeding method for your baby.

Your doctor will usually also inform you that, if you wish, you can give up mixed feeding and go back to exclusive breastfeeding if you can increase the feeding frequency and express your milk more regularly.

In the case of mixed feeding, the paediatrician remains the privileged interlocutor and the only health professional authorised to give guidance to you in the choice of an infant milk that suits your baby. He can also answer any other questions about infant nutrition (e.g. what new foods to introduce and when during the complementary feeding stage), and he will accompany you and reassure you at each new important stage of your baby’s life.

 

Important notice

Breast milk is the best food for infants. Ask your paediatrician for the choice and use of infant formula. A lactation consultant or a midwife can assist you to start breastfeeding or mixed feeding.

This article cannot be a substitute for a medical consultation or advice from a healthcare professional.

 

References

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