Approaching Infant Feeding with Flexibility: What We Can Learn from the Data on Combination Feeding (2024)

WHAT YOU’LL LEARN

  • What the State of Feeding Report Tells Us
  • How the Expectations and Pressure Around Feeding Impact Moms
  • How Breastfeeding Can Affect Mental Health (and How Combination Feeding Can Help)
  • The Systemic Lack of Support for Moms on Their Feeding Journey
  • Rights Related to Feeding that All Moms Should Know
  • Combination Feeding and the Value of Flexibility

If there’s one topic that brings up more unnecessary shame and guilt in motherhood than any other, it’s infant feeding.

No matter what choice moms make, they are often subjected to judgment, unsolicited opinions, and pressure.

The social pressures around feeding have changed over the years, with the pendulum swinging and telling moms that there is only one best or right way to feed their babies. And the comment section on any post about breastfeeding or bottle feeding often shows the heated opinions that so many moms have formed.

On one hand, it makes sense that the infant feeding method we choose would feel so high-stakes. After all, it is often one of the earliest decisions we make as moms—and it can feel strongly interwoven into our identities.

But there are so many elements that go into a family’s individual infant feeding journey, including financial impact, medical concerns, parental leave, mental health, and support systems.

Modern moms often feel pressured to stick to one rigid expectation around baby feeding—an expectation that doesn’t take into account any of that nuance. Yet, that expectation doesn’t become a reality for many families—and instead of questioning the system that often sets us up to struggle, we tend to blame ourselves.

That’s why I was so excited to hear about The State of Feeding, a research-driven report designed to shed light on the real feeding experiences moms are going through. Created as a partnership between Bobbie, Willow, SimpliFed, and Emily Oster, this report reveals so much about expectations, pressure, and the reality of infant feeding.

This week on The Momwell Podcast, I’m joined by Sarah O’Leary, CEO of Willow and Andrea Ippolito, CEO and founder of SimpliFed, to discuss the takeaways from the State of Feeding, why moms feel so much pressure around feeding, how to increase support for moms, and why combination feeding is valuable for so many families.

What the State of Feeding Report Tells Us

Despite so much pressure (and such rigid recommendations about breastfeeding), there has been a real lack of detailed data on how families are actually feeding their babies. This realization prompted the State of Feeding project.

The State of Feeding report takes a comprehensive look at what families are currently going through, what supports they need, and how we can advocate for systematic change to benefit all families, regardless of feeding method.

Here are just some of the insights revealed in the report:

  • 98% of expecting parents had a feeding plan (25% planned to exclusively breastfeed, 55% planned to both breastfeed and pump, and 11% planned to combine breastfeeding, pumping, and formula)
  • 80% of moms intend to exclusively feed breastmilk, with most intending to do so for 12 months.
  • 87% of moms ended up pumping
  • 74% of moms ended up using formula
  • 87% of respondents used a variation of breastfeeding, pumping, and formula

This data shows that we need more discussion and nuanced understanding of feeding—most parents aren’t just doing one thing or another.

The report also emphasized the emotional aspects of feeding. Many mothers feel immense pressure and guilt, often blaming themselves for not meeting the idealized standards set by society—despite the fact that so many families are turning to combination feeding in some form.

When asked if they were proud of their feeding methods:

  • 71% said they feel proud about breastfeeding
  • 45% feeling proud about pumping
  • And only 24% said they felt proud for formula-feeding

It’s clear that moms feel a stigma around introducing formula or not exclusively breastfeeding. But as moms, we experience so much pressure and unreasonable standards—and we should be able to feel proud for feeding our baby, whatever that method looks like.

How the Expectations and Pressure Around Feeding Impact Moms

This indicates that there are large-scale reasons why families lean on methods other than exclusively breastfeeding—and yet, the recommendations and expectations often still take a very black-and-white approach.

The AAP recommends exclusive breastfeeding for the first six months and continued breastfeeding for at least a year, while the WHO recommends continuing to breastfeed for two years or more.

These recommendations can contribute to feelings of guilt and shame when moms can’t breastfeed, or when they want to choose not to for any number of reasons.

The State of Feeding shows that most moms do want to breastfeed initially. But these goals can feel unattainable for so many moms. The report found that while 80% of parents plan to breastfeed for at least a year, only 41% meet their goals.

There are countless reasons why so many moms don’t continue exclusively breastfeeding, and many are very individualized. Others are systemic.

Moms should feel empowered on their feeding journey no matter how they feed their babies.

That’s why Andrea and Sarah both advocate for inclusive education and support. They want moms to feel empowered on their feeding journey no matter how they feed their babies. Sarah said that the expectations and pressures around breastfeeding can be detrimental to maternal mental health, particularly when moms are not given the flexibility to adapt their feeding methods based on their unique situations.

How Breastfeeding Can Affect Mental Health (and How Combination Feeding Can Help)

The postpartum period is a very vulnerable, and often challenging time for moms. And breastfeeding can impact maternal mental health. For moms whose journey does go smoothly, or those who are able to access support when they need it, allowing them to overcome challenges and ultimately breastfeed the way they envisioned, breastfeeding can be a very positive experience.

But for others, breastfeeding negatively impacts mental health. Breastfeeding often doesn’t come “naturally” the way we envision it—and not everyone can afford to bring in help and support along the way. This can leave moms feeling like they are failures, or that their bodies have failed them.

Other moms might find that sleep deprivation and bearing the brunt of night wakings due to breastfeeding ultimately becomes unsustainable.

Moms shouldn’t have to feel ashamed if they opt for other choices due to their mental health, or for any other reason. We should all be able to make choices that fit our reality without judgment or guilt.

We often think of the choice to breastfeed as all-or-nothing, but the data on a combination approach opens up a world of possibility for breastfeeding education.

For struggling moms, combination feeding, or the use of both breast milk and formula, can help alleviate some of the pressure. In fact, combination feeding can give moms the flexibility to continue their breastfeeding journey longer than they would have.

Combination Feeding and the Value of Flexibility

So if combination feeding can help support mental health, and if it’s so common…why isn’t it talked about more as a viable option from the beginning? Many moms mention that some hospitals or lactation consultants actively discourage them from using formula at all costs. But this rigid thinking keeps moms from embracing flexible solutions.

Combination feeding doesn’t just offer potential mental health benefits—it can bring relief to families on multiple levels. The State of Feeding Report revealed that many moms naturally gravitate towards combination feeding as a practical solution to the challenges they face.

For example, moms who exclusively breastfeed might feel that they can’t share nighttime labor. They might fear that any introduction of formula or pumping could derail their breastfeeding journey.

But for the majority of families, combination feeding works. It helps distribute the workload, reduce maternal sleep deprivation, and increase partner bonding.

Combination feeding can also help families navigate unforeseen or unexpected circ*mstances. Sarah shared her personal experience of using formula in the early days when her son was in the NICU, which allowed her to eventually establish a successful breastfeeding routine. For her, formula wasn’t a deterrent—it was a vital piece of the feeding puzzle.

It might be time to rethink rigid feeding goals and encourage families to take a flexible approach.

As more research such as the State of Feeding comes to light, it might be time for pediatricians, hospitals, lactation consultants, and organizations to rethink rigid goals and encourage families to take advantage of flexible options.

By normalizing combination feeding and promoting it as a viable option, we can help moms feel more empowered, and less judged, in their feeding choices.

The Systemic Lack of Support for Moms on Their Feeding Journey

A significant barrier to successful breastfeeding and overall maternal well-being is the systemic lack of support for new moms.

The State of Feeding Report highlighted that many mothers do not receive adequate support from healthcare providers, workplaces, or society at large.

One of these systemic issues is a lack of paid family leave. In the United States, 25% of moms go back to work just two weeks postpartum, making it difficult to establish and maintain exclusive breastfeeding.

We need better policies and infrastructure to support new moms.

While some moms attempt to juggle work and pumping, inadequate workplace accommodations can create barriers that make an already difficult load almost impossible.

We need better policies and infrastructure to support new moms, including access to lactation consultants and proper pumping facilities.

Rights Related to Feeding that All Moms Should Know

Moms are often unaware of their rights related to feeding. Understanding and advocating for these rights can make a significant difference in their feeding journey.

In the United States, insurance plans are required to cover breastfeeding support, including access to lactation consultants and breast pumps. However, many moms are unaware of these entitlements, and health plans are not always in compliance.

Andrea emphasized the importance of knowing workplace rights. Moms have a right to pump at work, and workplaces are required to provide a private, non-bathroom space for pumping, along with reasonable break times.

These rights are crucial for enabling moms to continue breastfeeding after returning to work, and empowering moms with this knowledge can help them advocate for the support they need to meet their feeding goals.

We are entitled to feeding support—and that should apply no matter how we feed our babies.

But Sarah and Andrea pointed out that our rights go beyond workplace pumping protections. Andrea said that under the Affordable Care Act, we are entitled to feeding support—and that should apply no matter how we feed our babies.

She said that breast pumps, donor milk, and formula should all be covered—and while some insurance plans might try to deny that, organizations such as the National Women's Law Center are advocating for change and helping moms navigate the world of insurance and access their rights.

What We Can Do to Support Moms: From Encouraging Combination Feeding to Increasing Legal Support

Ultimately, the more we can learn about the reality of infant feeding for different families, along with our rights and options, the more we can make empowered feeding decisions, not based on external pressures but instead on what works best for our families.

It’s clear from the State of Feeding that moms need more support, more encouragement, and more flexibility on their feeding journeys.

Modern moms deserve modern solutions that meet us where we're at.

Andrea said that modern moms deserve modern solutions that meet us where we're at. There is an idea that breastfeeding is supposed to be natural—that it should come easily to us because it did for so many moms before.

But in reality, moms historically had a lot more support—a village helping them, teaching them, and encouraging them along the way. They weren’t heading out to work with a new baby at home or trying to figure everything out on their own.

Modern solutions should include technological advancements (like the Willow pump and other devices created to help moms navigate the modern world), along with legal support for all families and babies.

They should also include recommendations and encouragements for families to take their diverse needs into account when making feeding decisions.

By acknowledging the realities of modern motherhood and advocating for policies that support all feeding methods, we can help mothers navigate their feeding journeys with confidence and compassion.

Struggling on your feeding journey or coping with guilt, pressure, and shame? You’re not alone—our mom therapists are here for you. Book a FREE 15 minute virtual consult today.

Approaching Infant Feeding with Flexibility: What We Can Learn from the Data on Combination Feeding (2024)

FAQs

What are the advantages of combination feeding for the baby? ›

Possible advantages of mixed feeding are:

Other caregivers can also feed the baby. Even if it is completely natural, some women do not like breastfeeding in public – a bottle also opens up new possibilities here. Work may be incompatible with family life. Recovery for sore nipples.

How do you combination feed an infant? ›

Always offer your breast first, for each feed, and slowly reduce the amount of formula you give your baby. It is also a good idea to have lots of skin-to-skin time and cuddles with your baby. This will help to boost your milk supply, as well as encouraging your baby to feed from your breast.

Why is it important to use responsive feeding strategies with infants? ›

Infants experience a predictable caregiver response.

Providing a consistent and predictable response to infants' hunger and fullness cues fosters trust and reassurance that caregivers know what they need. This can help foster self-regulation where infants learn to eat when they are hungry and stop when they are full.

Is combination feeding bad for babies? ›

Mixed or combination feeding is when you choose to breast feed sometimes and give formula at other times. The health advantages for you and baby are higher if you exclusively breast feed, however any breastfeeding is beneficial to both you and your baby.

What is the importance of mixed feed? ›

Mixing feed has advantages for both the farmer and livestock, as uniformly mixed feed components provide better nutrition, improved feed efficiency and cost, and the opportunity to reduce wastage. In dry times, when much of the feed is purchased off farm with higher costs, wastage and efficiency are even more critical.

What are the long term effects of mixed feeding in infants? ›

Long-Term Health Implications: Mixed feeding may increase the likelihood of a child developing chronic diseases in adulthood, including obesity and heart disease. This underscores the importance of exclusive breastfeeding in the first six months, which can provide long-term health benefits.

What is an example of combination feeding? ›

You could start your combination feeding schedule by swapping one breastfeed for a bottle feed at a time of day that works well for you and your baby. For example, if you'd like to get more rest, perhaps introduce a bottle for your baby's last feed, or first thing in the morning.

How to effectively combine feed? ›

Hints and tips when starting mixed feeding
  1. introduce the first bottle feed when your baby is calm, not tired or hungry.
  2. use a slow-flow teat to mimic the flow when breastfeeding.
  3. express your milk regularly between bottle feeds to help maintain your milk supply.

Why is mixed feeding not recommended for babies? ›

If your mixed feeding involves exchanging some breastfeeds for baby formula, then your baby will not receive as many benefits as they normally would if they were exclusively breastfed. As such, their immune system may not be as well protected from certain infections1.

What is the responsive feeding approach? ›

A responsive feeding approach is based on the central ideas of a responsive approach to parenting. Responsive behaviors are characterized by prompt responses to a child's communication, emotionally supportive interactions, contingent responses, and the provision of developmentally appropriate experiences.

How do you promote responsive feeding? ›

For caregivers, responsive feeding includes: 1) ensuring that the feeding context is pleasant with few distractions; that the child is seated comfortably, ideally facing others; that expectations are communicated clearly; and that the food is healthy, tasty, developmentally appropriate, and offered on a predictable ...

Why is feeding time so important in an infant's development? ›

If newborn babies aren't fed frequently enough, they are at higher risk for dehydration and underfeeding. So the American Academy of Pediatrics (AAP) advises parents to feed infants at least once every 2-3 hours — whenever babies show signs of hunger (AAP 2015).

What are the benefits of mixed feeding? ›

What are the benefits of combination feeding? Mixed or combination feeding allows you to share feeding responsibilities with someone else. This could be useful if you will need to be apart from your baby for any reason or if you are finding the demands of exclusive breastfeeding overwhelming.

When to start combination feeding? ›

When to start combination feeding
  1. It's best to wait until breastfeeding is nicely established to make sure you've got a good supply and baby is latching on correctly, before gradually introducing a bottle.
  2. Around 6 to 8 weeks is ideal before you introduce a bottle of expressed milk.

How common is combination feeding? ›

The practice of supplementing breastfeeding with infant formula, or combination feeding, is reported to be the predominant method of feeding for the human infant by 6 months-of-age.

What are the advantages of formula feeding? ›

If you choose to feed your baby formula, there are some benefits:
  • Anyone can feed your baby. Grandparents or babysitters can feed your baby while you work or get some well-deserved time with your partner.
  • You can get round-the-clock help. ...
  • You may not have to feed as often.

What are the advantages of feeding total mixed ration? ›

Advantages of feeding a TMR

Cows will eat a fixed amount of forages and concentrates needed for good production and health. It's harder for cows to be picky while eating. A TMR lowers the risk of digestive upset, stabilizes rumen pH and optimizes rumen feed digestion.

How many times to pump if combo feeding? ›

If you wish to maintain your milk supply while giving formula, you may need to breastfeed or pump frequently, up to 8 to 12 times per day. The exact number of times will depend on your breasts' storage capacity and the age of your baby.

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