Mixed Feeding Day by Day: Formula Top-Ups After Breastfeeding, Triple Feeding and Keeping Track (Australia)

To give a formula top-up after breastfeeding, feed your baby from both breasts first. Then offer a small top-up by paced bottle, cup or supply line, just enough to settle your baby until the next breastfeed. Use your own expressed milk first if you have it. Your midwife, lactation consultant or GP sets how much and how often.

Top-ups often start after a weigh-in or feeding check: slow weight gain, a feeding problem or a worry about supply. Suddenly your day holds breastfeeds, bottles and pumping sessions, often split between two people. This guide covers the Australian rules for topping up, a worked mixed-feeding day, triple feeding and what to record.

How do you give a formula top-up after breastfeeding?

Breastfeed from both sides, then give a small top-up, ideally of your own expressed milk. Australian guidance agrees on the order: breast first, then the top-up. The Australian Breastfeeding Association(opens in a new window) (ABA) sets out the steps for formula top-ups:

• Both breasts first. Feed from both sides before any top-up. After a short break, you can offer both breasts again.
• Expressed milk before formula. The NHMRC Infant Feeding Guidelines(opens in a new window) make expressed breast milk the preferred supplement. The ABA suggests expressing between feeds so you can use your own milk.
• Small top-ups. The ABA's advice is "just enough to keep baby satisfied until the next breastfeed".
• Paced feeding, a cup or a supply line. Paced bottle-feeding(opens in a new window) uses a slow-flow teat, an upright baby and a bottle held nearly flat, with pauses every few minutes. It lets your baby take what they want and no more.
• Separate bottles for breastmilk and formula. The ABA's facts about formula(opens in a new window) say not to mix them in one bottle. Offer the breastmilk first, then formula if needed.
• The same feed each day. If you replace whole feeds with formula, the ABA says to be consistent with which feed you replace and how much you offer.

Top-ups are part of a plan, and the plan belongs to you and your health professional. Raising Children Network(opens in a new window) suggests talking with your midwife, child and family health nurse, lactation consultant or GP before you start. That conversation covers how much formula, how many times a day and for how long.

What does a mixed-feeding day look like?

A typical top-up day is mostly breastfeeds, with top-ups after the feeds where your baby is still unsettled, often in the evening. The ABA notes that many mums find the morning breastfeeds go better. That makes the later feeds the usual place for top-ups.

The example below is for an imaginary 3 week old weighing 4 kg. Mum is breastfeeding, giving two small formula top-ups on a lactation consultant's plan and expressing twice a day. After the late breastfeed, her partner gives one bottle of expressed milk. The numbers only show the layout. Your baby's plan sets the real amounts.

Three things make this day easy to read later:

• Every bottle names its milk. Formula and expressed milk go in separate bottles, so they get separate lines and separate totals.
• Top-ups sit beside the feed they followed. Anyone reading the day can see the breastfeed came first.
• Pumping and expressed bottles get separate columns. The 70 mL is milk expressed that day. The 60 mL bottle is milk given, from an earlier session.

Does a mixed-feeding day add up to 150 mL per kg?

No, and it can't be made to, because a breastfeed's volume isn't measured at home. The NHMRC figure of about 150 mL per kilogram a day is for bottle-fed babies up to 6 months. For the 4 kg baby above, that would be about 600 mL a day if every feed were a bottle.

The bottles in the example total 140 mL. The rest of the day's milk came from eight breastfeeds. Subtracting 140 from 600 doesn't tell you what the breasts made. The ABA explains why bottle amounts mislead:

Australian Breastfeeding Association · Does my baby really need a top-up?

You can't judge your breastmilk supply by how much your baby takes from a top-up feed. Regular extra formula can reduce your supply.

Bottles flow faster, babies have a strong urge to suck, and they may drink even when they're full. A baby who drains a top-up isn't proof that the breastfeed fell short.

So judge a mixed-feeding day the way you'd judge any breastfed day.

The ABA's signs of enough(opens in a new window) are at least 5 heavily wet disposable nappies (or 6 very wet cloth) in 24 hours, soft poos, good skin tone and bright eyes, and a baby who is generally content and gaining weight. Our guide to how many wet nappies a day has the count by age.

The bottle total still matters for one thing: its direction from week to week. Your nurse or lactation consultant compares it with your baby's weight to decide whether top-ups can come down.

If you'd like the per-kg figures for full bottle feeding, they're in our guides to how much milk a baby drinks and formula feeding in Australia.

What is triple feeding?

Triple feeding is a three-step routine at each feed: breastfeed, give a top-up, then express. It aims to feed your baby enough now while the pumping builds your supply. It is meant as a temporary plan that your midwife or lactation consultant reviews as your baby's weight changes, and it steps down as your baby feeds better.

A clinical guideline from King Edward Memorial Hospital in Western Australia, written for babies who have lost more than 10% of birth weight, sets the routine out step by step:

• 1. Breastfeed: Both breasts, at least 8 times in 24 hours, about every 3 hours. The feed is kept shorter than usual, so there is time to top up and express.
• 2. Top up: Expressed milk first, by finger feed, cup or bottle. Formula is added after a medical review, or if you ask for it.
• 3. Express: Hand and electric pump after the feed; double pump until the flow slows. The milk goes into the next top-up.

The same guideline has the plan reviewed every 24 hours in hospital, until the baby has gained at least 30 g on two days in a row and is back within 10% of birth weight. At home, you express after every breastfeed, and the visiting midwife keeps checking weight against the same targets.

How long does triple feeding usually last?

No Australian source sets a number of days or weeks for triple feeding. It lasts until your baby breastfeeds well and gains weight, then steps down slowly. The ABA says to cut formula by another small amount every few days while nappies and weight stay good, always on your health professional's advice. If either drops, hold at the same level or go back a step.

The NHMRC guidelines(opens in a new window) describe the same step-down. Put slightly less in the bottle each time, or cut one top-up daily or on alternate days. An Australian Journal of General Practice article(opens in a new window) gives an example of reducing about 30 mL of formula over 24 hours, with weekly weighing.

Making triple feeding take less time

A full round can fill most of the gap before the next feed. The ABA's pages on stopping top-ups(opens in a new window) and increasing supply(opens in a new window) suggest ways to make it shorter:

• Ask your lactation consultant whether a breastfeed can replace a pumping session. Babies usually remove more milk than a pump, so a breastfeed is more effective and takes less time.
• Express one breast while your baby feeds from the other, or pump both at once.

If someone else is home, split the jobs. Your partner can give the top-up while you express, so the two steps overlap.

How much formula should a top-up be?

There is no single right amount; the person managing your plan sets it for your baby. The ABA's rule is small top-ups, just enough to keep your baby satisfied until the next breastfeed. Pregnancy, Birth and Baby(opens in a new window) says to start with small amounts and increase gradually if you need to, while breastfeeding often.

An Australian Journal of General Practice article, written for GPs about babies with slow weight gain, suggests supplements start at 30 to 60 mL, matched to your baby's feeding cues. Your baby's plan may set a different amount, especially in the first days.

A top-up follows a breastfeed, so it only needs to fill a gap. That is why the guidance keeps it small. The ABA also notes that a baby with a strong urge to suck may take more from a bottle than they need, which is one more reason to pace it.

How do you protect your supply while topping up?

Keep breastfeeding often, offer the breast before every top-up and use expressed milk in place of formula where you can. The ABA says the more formula your baby takes, the less milk your breasts make. Pregnancy, Birth and Baby adds that keeping a strong supply while mixed feeding can be especially hard in the first 6 weeks.

Once your baby is breastfeeding well, and with your nurse or lactation consultant's OK, the ABA's pages on top-ups(opens in a new window), increasing supply(opens in a new window) and stopping top-ups(opens in a new window) suggest:

• Feed more often. Most young babies have 8 to 14 feeds in 24 hours, and some have more.
• Offer each breast more than once a feed. After both sides, try a "top-up" from the breast before any formula.
• Check the latch, and use breast compressions to help the milk flow.
• Leave top-ups to the later feeds. Breastfeed only in the morning, when feeds often go better.
• Express between feeds and give that milk as the top-up in place of formula.
• Build supply with short pumping sessions: 5 to 10 minutes, a few times over an hour or two, finishing with hand expressing. For the amounts to expect, see how much breast milk to pump.
• Offer a little less formula each time, just enough to settle your baby.
• Watch the nappies and the scales as top-ups come down, with regular check-ins with your child health nurse.

When your partner gives the bottle

Some breastfed babies resist a bottle at first. Raising Children Network and Pregnancy, Birth and Baby both suggest asking your partner or a family member to offer it. They also warn that a baby who gets used to the faster bottle flow may start to refuse the breast, which is why paced feeding matters.

A partner-given bottle is also the usual way to share night feeds. Our guide to splitting night feeds with your partner covers how to fit one in without losing supply.

When to call the midwife, nurse, GP or 000

Mixed feeding often starts because of a weight or feeding worry, so keep the checks going.

For help with the plan itself:

• Australian Breastfeeding Association Breastfeeding Helpline: 1800 686 268 (1800 mum 2 mum). It is free, 24 hours a day, 7 days a week(opens in a new window), and ABA counsellors can help you plan to build supply and reduce top-ups.
• Pregnancy, Birth and Baby: 1800 882 436, a free call with a maternal child health nurse, 7am to midnight (AET), 7 days a week.
• Your lactation consultant, midwife, child health nurse or GP, who set and review the plan.

What to track while mixed feeding, and why

When you are reducing top-ups, the ABA says your nurse or lactation consultant may ask about how much formula your baby has, the number of breastfeeds and expressed milk feeds, wet and dirty nappies, and your baby's behaviour after feeds. Keeping these across complete 24-hour days makes that conversation quick.

• Breastfeeds: Write the time, side and minutes. This shows how often your baby is at the breast, the main driver of supply.
• Top-ups: Write the time, mL offered and taken, and milk type (formula or expressed). The formula total, week on week, shows whether top-ups can come down.
• Expressing: Write the time and mL. This shows how often you pump and how much milk is on hand for top-ups.
• Nappies: Write wet, dirty or both. This is the everyday check that your baby is getting enough.
• Weight: Write each weigh-in. With the nappy count, it decides whether top-ups can come down.

A sheet on the fridge works if everyone who feeds the baby writes on it. Our guide to a baby feeding diary shows a filled 24-hour example.

BabyLog's free plan puts breastfeeds (timed, with the split between sides), bottles in mL and pumping sessions on one timeline. The bottle entry holds the mL only, so write "formula" or "expressed" in its note. Your partner can log the bottles they give on their own phone, and you can start free in the browser.

If your lactation consultant has asked for a few days of records, you can keep them free in BabyLog and bring your phone to the appointment.

Common questions