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Updated: Jul 8, 2025

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Does planning to mixed feed undermine breastfeeding?

Stamatia Michalopoulou1, Ada L Garcia1, Linda Wolfson2

  • 1Human Nutrition, School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland, UK.

Maternal & Child Nutrition
|December 14, 2023
PubMed
Summary

Introducing formula, or mixed feeding, significantly increases the risk of early breastfeeding cessation, even without lactation problems. Specialist lactation support can help mothers continue breastfeeding.

Keywords:
breastfeedingbreastfeeding supportformula feedingmaternal and infant feeding survey

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Area of Science:

  • Maternal and Child Health
  • Infant Nutrition
  • Lactation Studies

Background:

  • Continued breastfeeding is crucial for infant health.
  • The impact of mixed feeding on breastfeeding duration is not well understood.
  • Early cessation of breastfeeding poses risks to infant well-being.

Purpose of the Study:

  • To investigate the association between mixed feeding and early breastfeeding cessation.
  • To explore the role of lactation problems in breastfeeding cessation.
  • To identify factors influencing mothers' decisions to stop breastfeeding.

Main Methods:

  • Analysis of data from the Scottish National Maternal and Infant Feeding Survey (N=1974).
  • Mothers reported feeding history, lactation issues, and reasons for formula use at 8-12 weeks postpartum.
  • Outcome measure: cessation of breastfeeding before 6-8 weeks and time to cessation.

Main Results:

  • Lactation problems were common (65%) and strongly linked to stopping breastfeeding (RR: 3.23) and mixed feeding (RR: 3.14).
  • Mothers planning to mixed feed (RR: 3.39) or using formula for practicalities (RR: 3.21) were more likely to cease breastfeeding, independent of lactation issues.
  • Specialist lactation support reduced cessation risk (RR: 0.63), while non-specialist support showed no effect.

Conclusions:

  • Intentional mixed feeding is a significant predictor of early breastfeeding cessation.
  • Lactation insufficiency is also predicted by planned mixed feeding and practical reasons for formula use.
  • Targeted specialist lactation support is effective in preventing breastfeeding cessation.