Understanding your nursing options: Exclusive breastfeeding, pumping, combo feeding and more


by Vanessa Kelly, BSN, RN, IBCLC, LCCE

May 10, 2023

Mothers often face a lot of pressures on how they choose to feed their baby. Breastfeeding, much like parenting, is a personal decision that involves many factors. Every situation is unique, so it’s important not to compare your journey to someone else's.

Let’s talk about some of the benefits of breastfeeding and how to make sense of different breastfeeding options to decide what is the best fit for your family.

Why is breastfeeding the gold standard?

The American Academy of Pediatrics recommends exclusive breastfeeding for about six months, and then continuing to breastfeed while introducing complementary foods until your child is 12 months old or older.

Breast milk is the best source of nutrition for most babies. As the baby grows, the mother’s breast milk will change to meet her baby’s nutritional needs every step of the way.

Breastfeeding provides babies with many benefits, including protection against some short and long-term illnesses and diseases, as well as a lower risk of:

  • Asthma
  • Obesity
  • Type 1 diabetes
  • Sudden infant death syndrome (SIDS)

Breastfed babies are also less likely to develop ear infections and stomach bugs. Through breastfeeding, antibodies get passed from the mother to her baby through breast milk, helping babies develop a strong immune system and protect them from illnesses.

Breastfeeding has health benefits for the mother, too! Some cancers, Type 2 diabetes and high blood pressure are less common among women who breastfeed.

In some ways, breastfeeding is also more convenient for the mother. Mothers can breastfeed their babies on the go without worrying about having to mix formula or prepare bottles.

Understanding your breastfeeding options

While breastfeeding is always recommended if possible, some mothers may be unable to exclusively breastfeed for a number of reasons. A few of those reasons may include low milk supply, poor weight gain or latch difficulty.

If you’re experiencing any of these issues, you’re not alone—and you have options! Many mothers do not realize how many options are available when it comes to breastfeeding. Fortunately, it’s not all or nothing.

From exclusive latching, to combo feeding, exclusive pumping and supplemental feedings, there are more options for you to continue breastfeeding your baby in a way that works for you.

Exclusive latching

This may be a good option for mothers who plan to stay home or have the ability to be with their baby for all feedings. A few of the benefits to exclusively latching your baby are that the breast milk is always the right temperature and ready to be used, and there is no need to prepare or clean a bottle.

With many moms returning to the workplace, it is understandable that this option may not be right for everyone.

Combo feeding

Combo feeding includes a combination of pumping and latching. This means a mother may offer the breast and latch baby for some feedings and pump to offer breastmilk through a bottle for other feeds.

Many moms who return to work choose this option. This gives some flexibility to mothers to have the bonding time while latching and still be able to offer their breast milk when away from baby.

Exclusive pumping and bottle-feeding breastmilk

This might be a good option for moms or babies who may struggle with latching. Latch can be difficult for a number of reasons. Sometimes it may be due to a tongue tie, breast anatomy or positioning that can be improved by working with a lactation consultant.

When latch is not working out or is not the preferred option for mom, exclusive pumping may be a good choice. This still gives you the ability to be able to provide the many benefits of breastmilk to your baby.

Supplemental feedings

Supplemental feedings means offering formula in addition to breast milk. This may be medically necessary for moms with a low milk supply or for babies who are not gaining weight appropriately.

This can be done in a variety of ways. Moms may choose to latch and/or offer pumped milk in addition to offering formula feeds. Parents should seek the advice of their pediatrician on how often and how much formula to feed. It is also important to follow proper formula preparation instructions listed on the formula packaging.

Getting support for breastfeeding

If you’re struggling with breastfeeding or not sure which option is right for you, know that you’re not alone. Breastfeeding is a special, but sometimes difficult, journey, and it looks different for every mother and baby. Ultimately, you need to make the decision that you feel best fits your family.

Thankfully, there are many resources available to support breastfeeding mothers. Most hospitals offer outpatient lactation consults and lactation consultants who make home visits are becoming more common. Many pediatrician offices also have a lactation consultant on staff to assist when needed. Most insurance companies will cover lactation consult visits.

If you’re doubting your ability to breastfeed, remember that you’re not in this alone. Reach out for help from a board-certified lactation consultant, or talk to your OBGYN or pediatrician. All of these members of your care team are here to support you and your baby.

Here are a few additional resources you might find helpful for breastfeeding support:

Talk to your OBGYN or find an OBGYN near you today for help getting connected with lactation support.


About the Author

Vanessa Kelly, BSN, RN, IBCLC, LCCE, is a lactation nurse supervisor at Baylor University Medical Center in Dallas.

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