If you are exclusively breastfeeding and your baby is not meeting the minimum weight gain requirements or is having difficulty transferring milk at the breast it may have been recommended by your pediatrician to supplement your baby. Ignore that mommy guilt, you are still doing a great job! There are probably as many opinions about how to supplement your baby as there are lactation consultants themselves. Each method has pros and cons.
First off, if you have any breast milk in your refrigerator or freezer, use this milk first before formula. Your baby needs it more than the freezer does. There may be other opportunities to replenish your stock pile later. If you have a very young baby and do not have any milk stored formula may be initially advised. Another option is to mix breastmilk with formula for supplementation if you have a small amount stored. Rest assured this is usually a temporary measure until your milk production increases. Be sure to discuss a plan for supplementation with your pediatrician and IBCLC including how much you should give and how often. Regular weight checks during this time will help to gauge when supplementation can be decreased. Gradually weaning down on the amount/frequency of supplementation while continuing to monitor baby’s weight and diaper output is usually the best course of action.
Whenever your baby gets any form of supplement away from your breast, you need to be stimulating your breasts by pumping or hand expressing. This goes back to the supply and demand of breastfeeding. Extra stimulation is demanding your body to make more milk.
A supplement does not always need to be given in the form of a bottle. If your baby has not taken a bottle yet and a supplement is needed, ask an IBCLC about options available to you. Often times if a bottle is introduced early on, especially if baby is having difficulty nursing at the breast it can pose complications. A baby can become used to the fast flow of a bottle and refuse the breast. Some babies may also start to prefer the firm shape of a bottle nipple over mom’s soft breast. Let’s review several of the options you can use to offer a supplement to your baby. One option is a Supplemental Nursing System, also known as an SNS. This device allows the baby to be fed extra milk through a small tube while latched onto your breast. If the SNS is not an option for you, your baby can be supplemented by giving breastmilk in a cup, spoon, oral syringe, or by finger feeding. Finger feeding is a method where your baby gets extra milk through a small tube attached to your finger while they suck. You may find that you need to try out several of these options to find the best one that works for you and your baby.
If a bottle is the only option for you and your baby, the best way to offer it is through paced bottle feeding. Please refer to one of our previous blog posts for further details on paced feeding.
Remember, supplementation may be a temporary situation. It is important to choose a supplementation method that is the most comfortable for you to prevent yourself from getting “burned out”. Call the Care Connection at 716.725.6370 to talk with an IBCLC to explore which option may be best for you and your baby. We can work through this together!