Breastfeeding, mixed feeding or formula milk: when a baby is born, the way they are fed can become a source of doubt, expectations and pressure. Some mothers wish to breastfeed and encounter unexpected difficulties; others choose or have to use formula; still others combine multiple methods over time.
Health recommendations recognise the value of breast milk and encourage its protection and support. At the same time, every mother and every baby has a different story. Receiving correct information means being able to make informed decisions, without turning infant feeding into a test to be passed or a reason for guilt.
This guide offers general information and does not replace the advice of a paediatrician, midwife or other competent professional in breastfeeding and infant nutrition.
What do WHO and UNICEF recommend?
The World Health Organization and UNICEF recommend, when possible, to start breastfeeding early and to offer exclusively breast milk for the first six months of life. From the sixth month, appropriate complementary foods can be introduced, continuing to breastfeed up to two years and beyond, as long as mother and baby wish.
Exclusive breastfeeding means that the baby receives only breast milk, including expressed or donated milk, without other foods or liquids, except medicines, vitamins or solutions indicated by health personnel.
These recommendations represent a public health objective, but should not be used to judge individual families. UNICEF also emphasises the importance of creating an environment that allows women to breastfeed or to choose a breast milk substitute in an informed way.
You can find out more about the definitions used in healthcare on the Italian National Institute of Health's page dedicated to breastfeeding and infant feeding.
What are the benefits of breastfeeding?
Breast milk is a living and dynamic food, capable of adapting to the different growth phases of the baby. It contains nutrients, antibodies and other biologically active substances that contribute to the nutrition and protection of the newborn.
Among the benefits recognised by major health institutions are:
- adequate nutritional intake in the first months of life;
- protection against numerous gastrointestinal and respiratory infections;
- lower probability of developing overweight, obesity and diabetes later in life;
- immediate availability of milk, without the need for preparation;
- adaptation of milk composition to different phases of breastfeeding;
- reduction of maternal risk of breast and ovarian cancer;
- possibility of promoting contact and relationship between mother and baby.
However, talking about benefits does not mean promising that a breastfed baby will not get sick or never develop certain conditions. Health, growth and development depend on many genetic, environmental, family and social factors.
Breastfeeding, asthma and obesity: pay attention to percentages
Numerous studies have observed associations between breastfeeding and a lower probability of developing overweight, obesity and certain diseases during childhood. However, estimates can change based on the population studied, the duration of breastfeeding, the definitions used and other factors considered.
For this reason, it is not correct to present a single percentage as a valid guarantee for everyone. Breastfeeding can contribute to the child's health, but it does not solely determine their future weight, risk of asthma or the onset of other conditions.
For institutional information, you can consult the Ministry of Health's page on the benefits of breastfeeding and the Bambino Gesù Pediatric Hospital's in-depth analysis of breastfeeding.
Breastfeeding is not always immediate or simple
Breastfeeding is often described as a natural act. Natural, however, does not necessarily mean easy or automatic. Mother and baby need to get to know each other, find comfortable positions and learn to manage latch, feeding frequency and breast changes.
In the first few weeks, the following may occur:
- doubts about milk supply;
- difficulty with latch;
- sensitive or sore nipples;
- cracked nipples;
- very full or engorged breasts;
- fatigue and fragmented sleep;
- need to use a breast pump;
- difficulties related to the baby's growth or health;
- feeling unable to meet one's own or others' expectations.
Asking for help does not mean failure. A midwife, an IBCLC consultant, a paediatrician or other competent healthcare professional can observe the feeding, assess the latch and help the family understand which solutions are most suitable.
To prepare for the first few days, you can also read the MYSANITY guide on initial breastfeeding.
What is mixed feeding?
In common language, mixed feeding refers to a method that combines breast milk and infant formula. It can be used for a limited period or continue for longer, depending on the needs of the mother and baby.
Supplementation can be considered for different reasons: clinical indications, baby's growth, return to work, temporary separations, difficulties in milk production or transfer, maternal fatigue or family choice.
There is no single amount of formula or feeding schedule that works for everyone. Supplementation should not be improvised or calculated using generic formulas found online. The paediatrician must assess the baby's growth, age, condition and overall feeding.
When the mother wishes to maintain or increase milk production, the way in which feedings, supplements and possible expression are organised can be important. In this case, it is useful to receive personalised advice from a competent professional.
When is formula milk used?
Infant formulas are specifically regulated products intended to nourish babies when breast milk is not used or not available in sufficient quantities. They can be adopted due to clinical necessity, difficulties in breastfeeding, or a conscious decision by the family.
Using formula does not diminish the value of the parent-child relationship. Feeding a newborn also means keeping them close, observing their signals, respecting their rhythm, and responding to their needs.
The choice of product, quantities, and feeding frequency must be agreed upon with the paediatrician. It is not advisable to independently substitute a formula, modify its concentration, or add more or less powder than instructed.
Preparing formula safely
Powdered formula is not a sterile product. Therefore, preparation, storage, and cleaning of tools must strictly follow the instructions on the package and the pediatrician's advice.
In general, it is important to:
- wash hands thoroughly before preparation;
- keep bottles, teats, and tools clean and properly treated;
- use the exact quantity of water and powder indicated;
- do not add ingredients, biscuits, or thickeners without health professional's advice;
- respect storage times and methods;
- discard leftover milk after feeding according to safety instructions;
- do not rely on homemade recipes to replace an infant formula.
The World Health Organization provides specific guidelines on the safe preparation and handling of powdered formula.
Breastfeeding and costs: saving money should not become a pressure
Breast milk is available without having to buy infant formula. This can reduce some family expenses, but it does not mean that breastfeeding is always completely free of cost.
A mother may need professional consultations, a breast pump, breast pads, containers, specific bras or other accessories. The time dedicated to feeding and expressing also has value, especially when family and work support is limited.
Similarly, the cost of formula varies depending on the product, the child's age and the duration of use. It is therefore incorrect to indicate a fixed saving that is valid for all families.
The decision should not depend on the fear of spending too much or the fear of being considered a less attentive mother. The priority is that the child receives adequate nutrition and that the mother can be supported in her chosen path.
How to tell if the baby is getting enough milk?
The duration of feeding, the feeling of full breasts, or the amount expressed with a breast pump alone do not allow determining how much milk the baby is consuming.
The paediatrician assesses over time:
- growth trend;
- weight and weight recovery after birth;
- general condition of the baby;
- frequency of urination and bowel movements, relative to age;
- effectiveness of sucking and swallowing;
- any clinical conditions of the mother or newborn.
If there are doubts about growth, unusual drowsiness, difficulty feeding, reduced urine output, or other worrying signs, it is necessary to contact the paediatrician promptly.
Sore breasts, cracked nipples and mastitis: when to seek help
A slight initial discomfort may occur, but intense pain, deep cracks, bleeding, or pain that continues throughout the feeding should not be considered inevitable.
It is important to consult a professional if you experience:
- persistent or increasing pain;
- damaged or bleeding nipples;
- warm, swollen, red, or very painful breasts;
- fever, chills, or general malaise;
- difficulty for the baby to latch or swallow;
- concerns about growth or milk supply.
For more on hygiene, cracked nipples, and daily comfort, consult the MYSANITY guide on breast care during breastfeeding.
A nursing bra should support, not just cover
During breastfeeding, breasts can change in volume, become heavier, and be particularly sensitive. Many nursing bras are similar to elastic tops: they allow the cup to open, but do not always offer adequate support.
A good bra should support without compressing. The underband should remain stable, the cups should contain the breast even laterally, and the straps should distribute the weight without leaving deep marks.
It's useful to check:
- cups that are sufficiently deep and encompassing;
- a stable but not constrictive underband;
- adjustable straps proportionate to the breast;
- an easy-to-use opening;
- soft and pleasant fabric against the skin;
- seams and edges that do not exert localised pressure;
- the ability to adjust the circumference to body changes.
The bra does not increase milk production and does not prevent breastfeeding difficulties, but a correct fit can improve daily comfort.
You can delve deeper with the MYSANITY guide on mistakes to avoid when choosing a nursing bra.
An informed choice is not a competition between mothers
Breastfeeding, mixed feeding and formula are often presented as opposing sides. In reality, the path can change multiple times and depend on health, desires, availability of support, work, fatigue and the child's condition.
Promoting breastfeeding means offering expertise and concrete help to women who wish to breastfeed. It does not mean blaming those who use formula or considering their way of caring for the child less important.
An informed mother should be able to know the benefits, limitations, methods of use and possible difficulties of each choice. She should also be able to change course without feeling judged.
When to seek professional support
It is advisable to consult a paediatrician, midwife, IBCLC consultant or other competent healthcare professional when:
- the child is not growing as expected;
- feeding is always painful;
- the child struggles to latch or swallow;
- you wish to introduce a supplement while continuing breastfeeding;
- you want to gradually switch from breast to formula or vice versa;
- there are medical conditions of the mother or child;
- you have doubts about the quantities or preparation of the formula;
- breastfeeding is causing significant anxiety, suffering or exhaustion.
Frequently Asked Questions about Breastfeeding, Mixed Feeding, and Formula
Does breastfeeding always protect against asthma and obesity?
No. Studies show favourable associations for various health outcomes, but there is no absolute protection. Asthma, obesity, and other conditions depend on numerous factors.
How long is exclusive breastfeeding recommended?
WHO and UNICEF recommend, when possible, exclusive breastfeeding for the first six months. Afterwards, appropriate complementary foods are introduced, continuing to breastfeed until two years and beyond, if mother and baby wish.
Does mixed feeding decrease milk supply?
Milk production also responds to the stimulation and removal of milk from the breast. If some feedings are replaced, production can change. When aiming to maintain breastfeeding, it is helpful to plan integrations with a professional.
Is formula nutritionally adequate?
Infant formulas are regulated products intended for feeding babies when breast milk is not used or is insufficient. They must be chosen, dosed, and prepared following the paediatrician's and manufacturer's instructions.
Does someone who uses formula create less bond with the baby?
No. The bond is built through closeness, contact, listening, gazes, responding to needs, and continuity of care. The way milk is offered does not solely determine the quality of the relationship.
How to choose a nursing bra?
It should offer real support without compressing, have encompassing cups, a stable underband, adjustable straps, and an easy opening. The size should be checked because breast volume can change.
Sources and further information
- World Health Organization, Breastfeeding.
- UNICEF Italy, Together for Breastfeeding.
- Ministry of Health, Breast milk: instructions for use.
- Italian National Institute of Health, Definitions of breastfeeding and infant feeding.
- WHO and FAO, safe preparation and handling of powdered formula.
- Bambino Gesù Paediatric Hospital, Breastfeeding.
Information, support and respect for every path
Breastfeeding offers important benefits and deserves to be protected with correct information, competent assistance and concrete support. When mixed feeding or formula is used, the family has the same right to receive clear and safe guidance.
The best choice is not the one that satisfies the expectations of others, but the one that ensures adequate nutrition for the child and protects, as much as possible, the physical and emotional well-being of the mother.
To accompany your breasts through different phases, you can consult the MYSANITY nursing bra collection, designed to offer practical opening, adjustable fit, and support without compression.
This article is for informational purposes only and does not replace the advice of a pediatrician, midwife, or other healthcare professionals.