You have many options for feeding your baby, from exclusively breastfeeding to exclusively pumping to combo-feeding to formula supplementation. What do all these terms mean, though?

How are you going to feed your baby?

For most new parents, the first answer that comes to their head is the question of breastfeeding versus formula feeding. But options are more nuanced than that. When it comes to how you provide nourishment for your baby, you have lots of great options.

Exclusively breastfeeding is what most people think of when they think of breastfeeding. It means that your baby only gets breastmilk for the first 6 months of their life. No formula, no water, no solid foods.

“Breast milk provides all the nutrition your baby needs for the first six months of life, along with a host of benefits other than just basic nutrition,” shares Nest Collaborative IBCLC, Robin Williams.

The benefits of exclusively breastfeeding your baby are many.

• Breast milk provides the ideal nutrition for babies. More than just sugar, fats, proteins, and water, it also delivers essential antibodies that support your baby’s developing immune system. In addition, the immune system protection breast milk offers lasts as long as your baby breastfeeds—and, in fact, longer given the intimate relationship between microbiome, breast milk, and health. What’s more, when nursing is part of exclusively breastfeeding, the immune system protection is better than exclusively pumping given the saliva-breastmilk exchange.
• Exclusively breastfeeding reduces the risk of childhood illnesses, including diarrhea, pneumonia, ear infections, allergies, and more.
• Reduces the risk of childhood cancers for your baby and breast and ovarian cancer for you.
• Breast milk, especially colostrum, supports a healthy gut microbiome.
• Improved oral development, including decreased risk of tooth decay, fewer orthodontic problems, speech improvement, and more.
• Breastfeeding can help parents lose weight after delivery.
• Breastfeeding can reduce the risk of perinatal mood disorders.

• Managing the time commitment of breastfeeding
• Adjustment to an on-demand feeding schedule, including nighttime feedings every 3 hours for months (or more)
• Anxiety about meeting your baby’s nutritional needs if you have an undersupply
• Difficulty in learning the necessary skills like latching
• Potential discomfort with breastfeeding in public or in front of others
• Lack of support from family, friends, or partner

• Start breastfeeding as soon as possible after your baby is born—ideally, within the first hour.
• Breastfeed on-demand rather than on a set schedule and don’t limit your baby’s time on-breast.
• Don’t limit nighttime feedings—your milk production is highest in the early morning hours.
• Teach your baby how to latch well. A good latch is the foundation for successful breastfeeding.
• Get support for your breastfeeding journey:
  • Work with a lactation consultant
  • Take a breastfeeding class before—or after—your baby is born
  • Join a breastfeeding group
• Come up with a breastfeeding plan for when your baby is born—and enlist your partner’s help! 
• Avoid pacifiers and bottles for the first 4-6 weeks postpartum.

When we talk about exclusively breastfeeding, we’re really just talking about exclusively providing breast milk. We’re not talking about how your baby gets the milk.

That’s why exclusively pumping is part of exclusively breastfeeding. You’re still providing breast milk as the sole source of your baby’s nutrition. You’re just using a breast pump and bottle to feed it to them.

Exclusive pumping also means that nursing isn’t part of your breastfeeding journey. That doesn’t make it any less meaningful or valuable for your baby, though. Williams points out that, “Breast milk, no matter how it’s given, is beneficial to your baby.”

Each parents makes their breastfeeding decisions based on a range of personal circumstances. Remember, you don’t have to justify your decision to breastfeed—or how you breastfeed—to anyone else. That being said, when you’re making these decisions yourself, it’s helpful to understand why some parents decide to exclusively pump.

• Slow or low weight gain
• Difficulty establishing nursing after a NICU stay
• Physical reasons like tongue-tie or cleft palate
• Relactation
• Aversion to nursing for the parent

• Greater confidence in how much breast milk your baby is receiving.
• Greater ability to share responsibility for feeding babies with your partner and other caregivers.
• Weaning from the pump may be easier as there is less emotional attachment involved.
• More flexibility in your schedule if you have a freezer stash of breast milk.
• Insurance covers the cost of a new breast pump when you have a baby.

• Pumping is time-consuming—you have pumping time and cleaning time in addition to feeding your baby.
• Your milk supply might not respond as well to a pump as it does nursing, leading to a lower supply.
• Balancing baby and pumping can be challenging.
• Exclusively pumping can be challenging, especially if you wished to nurse your baby.
• Breast pumps can be uncomfortable to adjust to.

• Use a double electric pump to decrease your time at the pump.
• Use a hands-free nursing bra to free up your hands.
• Set up a pumping station with all your supplies to make pumping easier
• Follow guidelines for safe milk storage to ensure your baby is getting all the nutritional benefits of breast milk.

While most breastfeeding parents can make enough milk to exclusively breastfeed, that doesn’t mean that it always works out that way. But parents shouldn’t be hard on themselves for how things work out, or don’t.

“ANY amount of breastmilk has a great benefit to your baby,” enthuses Williams.

That’s where combo feeding comes into the picture. Combo feeding involves feeding your baby both breast milk—whether from nursing, pumping, or donor breast milk—and formula.

Exclusively breastfeeding for the first 6 months of your baby’s life is recommended by both the CDC and WHO. However, exclusively breastfeeding can be a challenge—for you, your baby, or both of you. Reasons for combo feeding include:

• Breastfeeding challenges
• Nipple pain or damage
• Recurrent blocked ducts
• Mastitis
• Thrush
• Flat or inverted nipples
• Difficulty with latching
• Tongue and/or lip-ties
• Low milk supply
• Can be temporary or ongoing milk supply challenges
• Low or slow weight gain and/or failure to thrive
• Poor response to pumping
• Work schedule

• Providing your baby with the benefits of breast milk
• Reducing stress and time commitment involved with pumping
• Allows your partner and other caregivers to help with feeding the baby

• Maintaining your milk supply
• Potential difficulty with maintaining baby’s latching skills
• Managing two different forms of feeding
• Higher likelihood of ending breastfeeding journey early
• Increased risk for postpartum depression

• Use paced bottle feeding
• Have skin-to-skin contact during bottle-feeding sessions
• Switch sides when you’re supplementing with a bottle just like you would when nursing
• Provide breast milk first followed by supplementary milk or formula
• Talk with a lactation consultant about your breastfeeding goals and how combo feeding can help you meet them.

Not sure what’s best for you and your baby? Our IBCLCs can help you evaluate your options and figure out how to meet your goals. Book a convenient online video appointment today.