How To Supplement With Formula While Breastfeeding
Breastfeeding parents who have low supply, want to make sure their baby is getting milk, or who just need a break, can supplement with formula. Here's how you can use this combination feeding method.Medically reviewed by Katie Drakeford, MA, RD, CSP, LD, CLCMedically reviewed by Katie Drakeford, MA, RD, CSP, LD, CLCGiving your baby formula in addition to breastfeeding is called supplementing. If you're currently breastfeeding, you may wonder how to supplement with formula. It might also help to understand the reasons why some breastfeeding parents choose to do so.Many families choose this type of combination feeding method out of necessity, convenience, or simply personal choice—and there's absolutely no reason to feel shame if you choose this feeding method for your family. In some cases, breastfeeding and providing formula may be recommended by a health care provider for medical reasons.The ultimate goal of every parent is to have a happy, healthy baby who is growing and thriving. Breastfeeding doesn't have to be all or nothing. Every baby and situation is unique, so a combination of breastfeeding and formula may work best for your family.
Parents / Brianna Gilmartin
Related: 20 Breastfeeding Tips Every New Parent Should Know
Reasons To Supplement With FormulaAAP recommends exclusive breastfeeding for "about 6 months" and WHO recommends exclusive breastfeeding for the first 6 months of life, and then continuing to breastfeed up to 2 years of age, along with the introduction of solid food.For this and other reasons, including emotions and cost, making the decision to supplement with formula may not be an easy one. But that by no means indicates that babies who are fed formula are not getting the nutrients they need. They are.While many parents breastfeed their babies and give them formula because they want to, others do so because they have to—for instance because of supply issues. Regardless of whether all or none of these reasons for supplementing apply to you, the decision is entirely yours.Here are some of the reasons for supplementing with formula:Medical issues: If your baby was born prematurely or with certain medical conditions, they may need more than just breast milk. Supplementing is often done for the purpose of helping a baby gain weight.Low supply: A previous breast surgery or certain medical conditions can interfere with the production of breast milk, though any person can experience low supply, especially if you are not pumping or nursing enough to keep up with demand. If you or your health care provider feel that your baby is not getting enough breast milk through breastfeeding alone, you may need to supplement with infant formula. You might also want to keep in mind that you plan to continue breastfeeding even part of the time, supplementing with formula means less removal of milk from the breast, which will in turn lead to a lower supply.Going back to work: It may be too difficult or stressful to pump at work, or you may have a decrease in your breast milk supply once you return to work. If you don't have a stockpile of breast milk stored in the freezer, you may have to supplement your baby's diet with formula.Partner participation: Your partner may want to take part in feedings (and you might welcome sharing the responsibility). If you do not want your supply to decrease—because remember, the less milk is removed from your breast, the less milk your body will begin to produce—you should offer pumped breast milk. If you aren't concerned about supply because you intend to breastfeed less frequently, you can give your little one a bottle of formula once in a while.Multiples: Exclusively breastfeeding twins or triplets can be a challenge. Not only do you have to build and maintain a large enough breast milk supply, but you'll be breastfeeding very often. You may just need a break a few times a day (both physically and mentally), and formula feedings can help with that.Personal choice: You may simply have a personal preference to breastfeed some of the time and give your baby formula the rest of the time.When Health Care Providers Recommend SupplementationWhen possible, most health care providers recommend exclusive breastfeeding. However, at certain times your physician may want you to supplement your breastfed baby with formula. This could include any of the following circumstances:Fewer than six wet diapers in a 24-hour periodFussiness and signs of hunger soon after feedingsSlow weight gain after the 5-7 days of lifeWeight loss of more than 10% of body weight in the first few days of life
Related: What Is Paced Bottle Feeding?
Introducing FormulaYou might need time to build up a healthy breast milk supply and ensure that your baby is breastfeeding well. After that point, you can slowly begin to add formula.While it is OK to put breast milk and formula in the same bottle if you have already prepared the formula, mixing them can lead to wasted breast milk if your baby does not finish the bottle. If possible, give breast milk first, then finish the feeding with formula.For safety reasons, you should never combine your breast milk with unmixed powdered or concentrated formula, as it can change the nutritional balance, unless directed to do so by a healthcare professional. Otherwise, always prepare formula according to the manufacturer's directions, using clean water.Before choosing an infant formula for your child, talk to your pediatrician. Most recommend an iron-fortified infant formula during the first year of life.If your baby develops a rash, vomiting, diarrhea, excessive crying, fussiness, or gas after starting formula, it can be a sign of intolerance or even allergy. Stop using the formula and check with the baby's doctor to discuss other infant formula options.How Adding Formula Affects YouSupplementing will be a change if you've been exclusively breastfeeding. If possible, add formula gradually so that your body and your supply can adjust. Consider these tips:Start with one or two formula bottles a day. Each day, your body makes breast milk based on the concept of supply and demand. When you start to add formula, it can affect how much breast milk you make. If you plan on supplementing one or two bottles a week, it shouldn't affect your breast milk supply. But if you give your child one or two bottles of formula a day, your milk supply will begin to drop.Add more formula slowly. Going from not supplementing to giving a lot of bottles in a short period could cause problems such as breast engorgement and blocked milk ducts. It may also cause your child gastrointestinal issues.Consider pumping or hand expressing. Removing your breast milk will help relieve the fullness that breast engorgement can cause, and help decrease your chances of developing mastitis. Only remove enough milk to relieve the pain. Removing a significant amount of milk will signal your body to make even more milk. Another benefit is that you can store your pumped breast milk to use at a later time. Depending on how you store it, breast milk can stay in the freezer for up to one year.How Adding Formula Affects Your BabyIf you've been exclusively breastfeeding your baby and begin to add formula to their daily diet, there are some things you may start to notice. Usually, these are just part of the transition and your baby will eventually adjust to the new routine.Here are some signs to look for as you begin supplementing:Refusing the bottle: Your child may refuse to take the bottle, especially if you're the one giving it to them. The transition may go more smoothly if your partner or another caregiver offers the formula.Waiting longer between feedings: Since your baby can digest breast milk more easily than infant formula, the latter allows them to feel fuller longer. They may not seem hungry as quickly after formula feedings as they do after breastfeeding.Refusing the breast: Drinking from the breast takes more work, and some babies end up finding formula more satisfying. If you are eager to breastfeed most of the time and didn't intend for your baby to be primarily formula fed, you may want to cut down on the number of times you offer formula so that you don't unintentionally wean your baby off breastfeeding. Changes in bowel movements: Adding formula to your baby's diet may change the pattern, color, and consistency of your baby's poop (e.g., it may be firmer, darker in color, and have a stronger odor than before). Your child may also poop less often once you start giving them formula. For more Parents news, make sure to sign up for our newsletter! Read the original article on Parents.
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