Sometimes, breastfed babies need to supplement temporarily in order to meet their nutritional needs. Learn the reasons why your baby may need supplement and how to navigate it as part of your baby feeding journey.
Sydney White
July 11, 2024
Have you ever worried that your baby is not getting enough milk? Or perhaps that you do not have enough milk for them, because they seem hungry all the time?
Many new parents are plagued by these fears.
Sometimes, breastfed babies need to supplement temporarily in order to meet their nutritional needs. However, just because you have to supplement does necessarily mean that you cannot meet your breastfeeding goals.
A Few Things to Remember with Supplementation
Supplementation can be with breastmilk or formula
Just because you have been advised to supplement does not necessarily mean that you have to use formula. If you desire to exclusively feed your baby your breast milk, you can still do that, even if you have to supplement.
To supplement with breastmilk, you will pump or hand express in addition to feeding your baby at the breast.
You do not have to use a bottle to supplement
If you do have to supplement, you can use a bottle, cup, syringe or SNS at breast-supplementer.
When using a bottle, practice paced bottle feeding to prevent breast refusal, overfeeding, and stomach upset. Watch a tutorial on how to do use paced bottle feeding below
When you are supplementing, you should have a plan to wean off of supplementing.
Supplementing (whether with breastmilk or formula) should be designed to be a short term plan.
Work with your pediatrician or a lactation provider to develop a plan to make sure your baby is meeting their nutritional needs and you can reach your feeding goals.
Regardless of how you feed your baby, it is important that your baby is fed and nourished.
Whether you exclusively breastfeed, supplement with breastmilk or formula, or strictly formula feed, the priority is that your baby is fed and well-cared for.
If your feeding journey is different than you expected, it’s ok to grieve that! Seek support from trusted professionals who can support your baby’s needs and your baby feeding goals.
Common Reasons to Supplement:
Baby is struggling to gain weight
If you or your pediatrician is concerned that your baby is not gaining adequate weight, they may suggest that you supplement.
Remember: Your newborn is expected to lose some weight after birth, then stop losing weight by day 5 of life, and be back to birth weight by two weeks of life.
On average, newborns will gain 1oz per day.
If your newborn is not meeting this expectation, seek support from a lactation provider who can evaluate your baby's latch and feeding pattern to help you reach your breastfeeding goals, and your baby's needs.
Your milk supply is insufficient for baby’s needs
This one comes with a caveat: Perceived low milk supply and actual low milk supply are very different.
Here are a few reasons why your milk supply may be insufficient (this is not an exhaustive list):
Not feeding frequently enough- a newborn should be fed between 10-12 times in a 24 hour period to satisfy their needs, and also to stimulate the mom’s breasts enough to establish a healthy milk supply
Inadequate breast and nipple stimulation (use of nipple shield, inverted nipples, poor latch, etc.)
Hormonal imbalance (could be due to a long term underlying medical condition, like hypothyroidism, or situational, such as retained placenta fragments.)
Previous breast surgery
Baby is dehydrated
If your baby is not peeing or pooping enough, then this could be a symptom of dehydration.
Newborns are expected to have 6 or more wet diapers in 24 hours after day 5 of life until 3 months of age.
Exclusively breastfed babies should have 3 or more dirty diapers after day 4 of life
If your baby has less wet or dirty diapers than expected, contact your pediatrician.
Dehydrated babies may also be lethargic, have sunken fontanelles (soft spot at the front and back of their skull), and cry without tears. If your baby exhibits these symptoms, contact your pediatrician right away.
→ If you read any of these and went “that’s me!”, do not be discouraged. It does not mean that you cannot breastfeed!
Seek lactation support from someone who will help you create tailored plan to reach both your baby’s needs and your breastfeeding goals.
Does the worry of wondering if your baby is getting enough milk keep you up at night?
You do not have to figure this all out on your own. Seek support from a lactation provider in your area who can work alongside your family and your pediatrician to create a personalized plan to reach your baby's needs and your breastfeeding goals.
Sydney White is a Registered Nurse and Certified Lactation Counselor providing in-home lactation services in San Diego, and telehealth lactation support anywhere.
Resources:
Bookhart, L. H., Anstey, E. H., Kramer, M. R., Perrine, C. G., Reis‐Reilly, H., Ramakrishnan, U., & Young, M. F. (2021). A nation‐wide study on the common reasons for infant formula supplementation among healthy, term, breastfed infants in US hospitals. Maternal & Child Nutrition, 18(2). https://doi.org/10.1111/mcn.13294.
Cadwell, K., & Turner-Maffei, C. (2022). Pocket guide for lactation management. Jones & Bartlett Learning.
Disclaimer: This information provided in this blog article is for educational purposes only and is not intended as medical advice. While we strive to provide accurate and up-to-date information, it is important to consult with your qualified healthcare professional before making any decisions about supplementation or addressing concerns about your baby's weight gain. This information is not a substitute for professional medical consultation, diagnosis, or treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. For further information, please consult with a pediatric healthcare provider or visit reputable medical sources such as the American Academy of Pediatrics or the World Health Organization
