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How do I use the time I spend bottle feeding to help me bond with my baby?

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Watch this film to find out how to use the time you spend bottle feeding to help bond with your baby.

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Research-based information on baby sleep for parents and practitioners, covering normal infant sleep, sleep safety, where and how babies sleep, SIDS and SUDI, parental sleep and free resources.

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If you felt you would like to donate your milk 

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If you felt you would like to donate your milk 

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http://www.ukamb.org/http://www.ukamb.org/

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Video about good attachment what to look for and how to achieve it

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Video about good attachment what to look for and how to achieve it

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Attaching Your Baby at the Breast – Breastfeeding Series

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My number 07946 471 069 and of course you have my email.

National Breastfeeding Helplines

NCT National Childbirth Trust 0300 330 0771

LLL La Leche League 0345 120 2918

ABM Association of Breastfeeding Mothers 0870 401 7711

BFN Breastfeeding Network 0300 100 0212

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When it comes to feeding their baby, some parents decide to exclusively breastfeed and some to exclusively formula feed. Many families decide to combine breastfeeding and formula feeding; this often called combination feeding or mixed feeding (NHS, 2019).

What is mixed feeding?

Mixed feeding usually means mixing breast and bottle feeding. The content of the bottle can be either breastmilk or formula milk.

Watch our video to find out more about mixed/combination feeding.

Why do some families combination feed?

You might start mixed feeding for a variety of reasons.

If you and your baby have some difficulties getting breastfeeding established or if there are concerns about your baby's weight, you might be advised to give some formula feeds alongside breastfeeding.

You might need to leave your baby for periods of time (for example, if you are returning to work).

Your partner might want to be involved with feeding.

You might be bottle feeding and want to start or resume breastfeeding.

It can be helpful to talk to a breastfeeding counsellor, a midwife or health visitor about your options and the potential impact on breastfeeding of mixed feeding (see below). You could also call our infant feeding line on 0300 330 0700.

How do I combine bottle feeding and breastfeeding?

Some families choose to express milk and feed it to their babies through a bottle. They might do this if someone else would like to feed the baby or if the mum has to be away from their baby for a while.

Others choose to substitute some breastfeeds for formula. If you want to do this, you and your baby will adjust more easily if you reduce the number of feeds gradually (NHS, 2019).

You can offer formula feeds before, during, after or instead of a breastfeed. Talk to your midwife, health visitor or a breastfeeding counsellor about this, as different options will suit different circumstances. And will also depend on what you wish to achieve ultimately.

There are some cases when formula might be given before a breastfeed (for example, with babies who are not breastfeeding well). In other cases, the formula feed might be given instead of a breastfeed. This might happen if you're not with your baby and can't breastfeed or if someone else is sharing the feeding.

Gradually cutting down breastfeeding reduces the chance of your breasts becoming uncomfortably engorged. It will also reduce your risk of developing mastitis (NHS, 2019). It helps to reduce the number of breastfeeds slowly, starting with the one which is convenient for you (NHS, 2020). If you substitute a breastfeed with a formula feed, it may take around five to seven days for the amount of milk your breasts are producing to adjust to missing that one feed (NHS, 2017).

If you 'top up' with formula during one or more feeds, rather than replacing an entire feed, this is likely to extend the gap between breastfeeds. It will also signal to your breasts to make less milk (NHS, 2020).

On the other hand, if you've been advised to 'top up' as a temporary measure and want to return to exclusive breastfeeding, it is important to express milk between feeds to prevent a decrease in the amount of milk you make (NICE, 2017). Try and feed your baby any available breastmilk before each formula feed.

What effect will combining breastfeeding and formula feeding have?

Your baby will enjoy the benefits of breastmilk, even if you're not exclusively breastfeeding. For instance, they will still gain some of the antibodies that will protect them against infection (NHS, 2019).

If you want to feed your baby with both breastmilk and formula milk, it is recommended to wait until feeding is firmly established before introducing a bottle (NHS, 2019). This can take up to a month (La Leche League, 2019).

It's best to wait until breastfeeding is established because breastmilk supply is generally driven by frequent, effective removal of milk from the breasts. Giving your baby formula reduces your milk supply, which is particularly important when you are both getting used to breastfeeding. If your baby breastfeeds less often, your breasts produce less milk (Daly and Hartmann, 1995).

You might have heard that babies can get 'nipple confusion' but there is no evidence that this exists (Kotowski et al, 2020).

How many breastfeeds does an older combination-fed baby need?

Older babies, beyond the newborn stage, can maintain your breastmilk supply alongside formula feeding as long as you breastfeed several times a day. Much older babies - from eight or nine months - can breastfeed just a handful of times a day, and there is still a supply.

Very well-established breastfeeding, with a baby who is one year or older, can continue with as few as one or two feeds in 24 hours.

If your baby is over six months they can use a beaker or cup rather than a bottle (NHS, 2020).

Tips to introduce a bottle to a breastfed baby

You might find your baby does not want to take a bottle at first. The different sensations may confuse them and they don't know the bottle contains food. But there are lots of different things you can try to help your baby:

Offer a bottle when your baby is relaxed and happy, rather than very hungry.

Maybe ask someone else to offer a bottle so they can't smell their mother's milk.

Try softening the teat with warm, boiled water.

Hold your baby in a different position from their usual breastfeeding one. It might help your baby get used to the new way of feeding.

Try a different bottle or teat, this might make a difference.

(La Leche League, 2019)

Unicef (2016) recommend feeding responsively, which means following your baby's cues, whether breastfeeding or bottle feeding. They also recommend using paced bottle feeding. The way a baby is fed with the bottle can affect their comfort, their control of the amount of milk they drink, and the transition between breast and bottle (Kotowski et al, 2020).

Tips for paced bottle feeding

Hold your baby upright, close to your body. (If your baby is lying back, they are less able to control how much milk they swallow, so they can overfeed.)

Touch the teat against the baby's top lip to encourage them to pull it into their mouth.

Hold the bottle horizontal, so that when the baby is actively sucking, they get milk and when the baby is pausing, they don't get milk.

Give the baby several breaks by removing the bottle from their mouth.

Watch what the baby is doing, rather than how much milk they have drunk. End the feed when the baby is no longer drinking.

(UNICEF, 2016; La Leche League, 2019)

This all helps to build a close, loving relationship, a responsive feeding relationship, and avoids overfeeding your baby.

Where can I go for breastfeeding support?

If you have questions, concerns or need support, you can speak to one of our breastfeeding counsellors by calling our infant feeding line on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions.

Further information

Healthtalkonline.org has a comprehensive library of face-to-face interviews where parents share their experiences about breastfeeding, birth, parenting and many other issues.

Best Beginnings has video clips from the 'Bump to Breastfeeding' DVD.

UNICEF have produced a summary guide for parents on how to responsively bottle feed babies.

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Mixed feeding: combining breastfeeding and bottle feeding | Baby & toddler, Feeding articles & support | NCT

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When it comes to feeding their baby, some parents decide to exclusively breastfeed and some to exclusively formula feed. Many families decide to combine breastfeeding and formula feeding; this often called combination feeding or mixed feeding (NHS, 2019). Mixed feeding usually means mixing breast and bottle feeding.

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Information For Tongue-tie Practitioners UK. Tongue-tie divisions.

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This video guides mothers on how to hand express and talks about the times when hand expression might be useful.

See the Breastfeeding Network website for FAQs and a leaflet all about expressing and storing breastmilk.

Problems viewing this video? Contact us.

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Hand expression video - Baby Friendly Initiative

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This video guides you through how to hand express, and talks about the times when hand expression might be useful for you.

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This information sheet gives a brief guide to the law and what to do if you are treated unfavourably because you are breastfeeding in a public place.

For more information on your rights to continue to breastfeed on return to work, see the information sheet Breastfeeding on return to work.

Breastfeeding in Public Places
What does the law say?
The Equality Act 2010 says that it is discrimination to treat a woman unfavourably because she is breastfeeding. It applies to anyone providing services, benefits, facilities and premises to the public, public bodies, further and higher education bodies and association. Service providers include most organisations that deal directly with the public. Service providers must not discriminate, harass or victimise a woman because she is breastfeeding. Discrimination includes refusing to provide a service, providing a lower standard of service or providing a service on different terms. Therefore, a cafe owner cannot ask you to stop breastfeeding or refuse to serve you.

How long does protection apply for?
There is no age restriction, the law protects you for as long as you wish to breastfeed your baby.

Where can a woman breastfeed?
You are protected in public places such as parks, sports and leisure facilities, public buildings and when using public transport such as buses, trains and planes. You are protected in shops, public, restaurants and hotels regardless of how big or small. You are also protected in places like hospitals, theatres, cinemas and petrol stations.

Am I protected if I am asked to stop breastfeeding at work?.
If your employer provides services to the public, your employer is also responsible for the actions of its employees.

The law does not currently provide a right to time off at work to breastfeed but you have health and safety rights at work as an employee and the right to ask for flexible work. For more information, see Continuing to breastfeed on return to work. Employers are not obliged to provide facilities for expressing and storing milk but they may wish to as a matter of good practice and they must take steps to protect the health and safety of an employee who is breastfeeding on return to work.
What protection is there for students?
Further and higher education bodies must not discriminate, harass or victimise a student who is breastfeeding in terms of admission or provision of education or by excluding the student or subjecting her to any detriment. This includes access to benefits, facilities or services.

Which associations are included?
An association must not discriminate, harass or victimise a person because she is breastfeeding by refusing membership or discriminating in provision of benefits, facilities or services.

An association includes clubs, such as golf clubs, that have rules of membership, with at least 25 members, where members have to apply to join. Private clubs, with less than 25 members, that have no formal rules of membership, such as a book club, would not be counted as an association. Clubs where you simply pay a membership fee to join are not counted as an association but would be considered to be providing public services.

Are there some places where I cannot breastfeed in public?
Yes, it is not against the law to prevent a woman breastfeeding in a service which is a single sex service for men. This single sex service must be justified, for example, where only one sex needs it or one sex needs the service more than the other. Voluntary groups or charities set up specifically to benefit one sex may be acting lawfully if they exclude women. Religious organisations may offer services to one sex if it is in line with the doctrines of that religion. In some cases, where single sex services are justified, it would be reasonable to object to members of the opposite sex being there.

It is not against the law to prevent a woman breastfeeding where there are legitimate health and safety risks, for example, near to certain chemicals or radiation.

What can I do if I am discriminated against because I am breastfeeding?
Firstly, you should make a complaint to the organisation that has discriminated against you. Most service providers, educational bodies and other groups should have a complaints procedure, if not, you should ask who to complain to.

If you cannot resolve the matter you can bring an action in a county court in England or Wales or a Sheriff court in Scotland but you should seek advice as these can be expensive cases to bring. You must start the case within 6 months of the date of the act you are complaining about. This time limit will only be extended where it is just and equitable. If you win your case the court can order compensation, an injunction or a declaration but if you lose you may be ordered to pay the other side's legal costs. Compensation can include an amount for injury to feelings.

If you have been refused a service or treated unfavourably you should seek advice.

Additional protection in Scotland
In Scotland a person has a right to breastfeed or bottle feed a child under two and it is a criminal offence to try to stop or to prevent a woman from feeding a child under two in any place in which the public has access and in which a child under two is entitled to be. Anyone who tries to stop or prevent a person feeding milk to a child under the age of two can be prosecuted and can face a claim under the Equality Act.

Employers are responsible for ensuring that their staff are fully aware of the law. If an employee tries to stop or prevent a woman from breastfeeding in the course of their employment, the employer may also be liable even if they were unaware of the incident. You should complain to the employer in the first instance and, if necessary, you can report the matter to the police.

This information sheet was produced in April 2016. It is important to get up-to-date advice.

Where to go for more help

Maternity Action
Advice on maternity rights and benefits for UK citizens and foreign nationals www.maternityaction.org.uk

Helpline: 0808 802 0029 (freephone) Wednesday 10am - 2pm, Thursday 3pm - 7pm, Friday 10am - 2pm

ACAS
For advice on employment rights or for Early Conciliation if you are thinking of making a tribunal claim
www.acas.org.uk
Helpline: 0300 123 1100 (offers telephone interpreting service)

Citizens' Advice
For information about your rights and to find details of local advice bureau
www.citizensadvice.org.uk
Factsheets available in English, Welsh, Bengali, Gujarati, Punjabi, Urdu and Chinese

The CAB is currently developing a national advice phone service. If you live or work in Wales call 08444 77 20 20. For England, call 08444 111 444 or check your local bureau's contact details as it is not available in all areas yet.

Civil Legal Advice
If you are eligible for legal aid you can get free legal advice on 0345 345 4 345 (offers translation service). To check your eligibility see www.gov.uk/civil-legal-advice

To search for specialist legal advisers or solicitors in your area see find-legal-advice.justice.gov.uk
Equalities and Human Rights Commission (EHRC)

For information and advice about discrimination law
www.equalityhumanrights.com Lawyers can get specialist help with discrimination claims from the EHRC Lawyers Referral Helpline 0161 829 8407.
Equality Advisory Support Service
Help and advice on discrimination and human rights http://www.equalityadvisoryservice.com/

Helpline: 0808 800 0082
Textphone: 0808 800 0084

Mon.- Fri. 9am - 8pm, Sat. 10am - 2pm

GOV.UK
The government's online information service
www.gov.uk

National Breastfeeding Helpline
0300 100 0212

National Childbirth Trust
NCT helpline 0300 330 0700

NCT breastfeeding support helpline 0300 330 0771
www.nct.org.uk
Working Families
For information and advice on benefits and rights at work, see
www.workingfamilies.org.uk
Phone: 0300 012 0312
Email:[email protected]

More Maternity Action information sheets

Pregnant at work 2016- a brief guide to your rights to maternity leave and pay

Rights at work for fathers and partners - a brief guide to rights for fathers and partners

Time off for working parents - rights to paternity leave, parental leave and time off in an emergency

Child friendly working hours - rights to ask for changes in your working hours to fit with your childcare or other caring responsibilities

Money for parents and babies - benefits and tax credits for working and non-working families

Rights for parents with more than one job - rights for parents working more than one job

Redundancy during pregnancy and maternity leave - your rights if you are made redundant

Pregnancy discrimination - what is pregnancy discrimination and what you can do about it

Discrimination during maternity leave - what you can do about discrimination during maternity leave

Pregnant during maternity leave - your rights if you become pregnant again whilst still on maternity leave

Breastfeeding on return to work - your rights if you wish to continue breastfeeding on return to work

Health and safety during pregnancy and on return to work - health and safety protection for new and expectant mothers

Breastfeeding in public places - your right to breastfeed when you are out and about

Agency workers - maternity and parental rights and benefits

Apprentices - maternity and parental rights and benefits
Adoption leave and pay - rights for parents Time off and pay for parents in surrogacy arrangements
Polish language information - rights at work for mothers, fathers and partners.

Spanish language information - your rights at work

Maternity rights for migrants- information for EU nationals and other migrants

Maternity rights for refugees, asylum seekers, refused asylum seekers and women with no recourse to public funds -information sheets for migrants subject to immigration control
Available at www.maternityaction.org.uk

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This information sheet gives a brief guide to the law and what to do if you are treated unfavourably because you are breastfeeding in a public place. For more information on your rights to continue to breastfeed on return to work, see the information sheet Breastfeeding on return to work.

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Welcome! This website was developed to provide evidence-based information on breastfeeding and parenting.

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Excellent info on expressing and storage of milk and 'Is it safe?' what you can take while breastfeeding

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