Is it okay to supplement my breastfed baby's diet with formula?
Yes, it's perfectly safe to supplement a breastfed baby's diet with formula. Some moms decide to supplement with formula when they go back to work. They may have trouble pumping regularly, but they don't want to give up nursing altogether. Others supplement because their baby isn't getting enough breast milk to grow properly. And many moms just want the freedom to let a family member or babysitter give an occasional bottle.
Whatever your reasons for supplementing, keep in mind that some breast milk is always better than none, so the longer you can nurse your baby, even if it's just once or twice a day, the better. That's because even though formula provides all the nutrients that your baby needs, it lacks unique immune factors that can protect your baby from some illnesses.
Remember that your supply of breast milk depends on your baby's demand for it, so the less frequently you nurse, the less milk your breasts will produce. If you start supplementing with formula regularly, even for just one feeding a day, your milk supply will decrease (at least until you reinstate the missed feeding). On the other hand, if you supplement with one or two bottles a week, the effect on your milk supply should be minimal.
How do I know whether my baby's getting enough breast milk?
Many mothers worry that they're not producing enough milk for their babies, but most women make plenty of milk. Here are three ways you can tell whether your baby's getting enough:
- A baby under 1 month old who's nursing well will have frequent mustard-yellow stools. Some babies have one after every feeding. Your baby will also have six to eight wet diapers a day if he's getting enough breast milk.
- Your baby's gaining an average of an ounce a day during the first three months and half an ounce a day between 3 and 6 months.
- You're nursing often, at least seven times every 24 hours (during your baby's first month, you should nurse even more, at least eight to 12 times per day).
What are some signs that my baby needs supplemental formula for growth?
You should talk to your baby's doctor if you have any concerns about your baby's weight gain, growth, or eating habits. Here are some symptoms that warrant a call:
- More than normal weight loss in a newborn. Babies lose between 5 and 10 percent of their birth weight during the first five days of life. By day five, they start to gain about an ounce a day and by 2 weeks they should be back up to their birth weight.
- Fewer than six wet diapers in a 24-hour period once your baby is 5 days old.
- Fussiness or lethargy most of the time.
- Your breasts don't feel soft or empty after nursing, which could be a sign that your baby isn't taking in enough milk.
When can I start supplementing with formula?
If your baby's a newborn, you should probably wait until he's at least a month old before you introduce formula. Lactation consultants recommend that you wait this long to allow your breastfeeding routine and your milk supply to become well established, so an occasional bottle won't disrupt the routine too much. At this age most babies aren't completely reluctant to try a bottle or a new food source. If your baby is over a month old, you can offer formula at any time.
What's the best way to start supplementing?
Unfortunately there's no perfect way to start supplementing. Some babies will just go with the flow and, if they're hungry, take whatever you give them. Others may refuse a bottle the first few times it's offered, especially if you're the one offering it. That's because your baby can smell you and would probably prefer the real thing. If your baby is used to taking a bottle of breast milk, the transition may be a bit easier, though he may turn up his nose at what's in the bottle.
To make this transition smoother, let your partner or a friend offer the first few bottles. You might also try giving the bottle when your baby is hungry rather than at a feeding when he might be nursing as much for comfort as for nourishment. Don't try a bottle for the first time when your baby is so hungry that he's crying, though. He'll be too frustrated to try something new.
Can I mix breast milk and formula in one bottle?
Lactation consultants say it's better not to mix breast milk with formula because you may end up wasting that hard-earned breast milk if your baby doesn't finish the bottle. Instead, feed your baby the pumped breast milk first, and if he still seems hungry, offer a new bottle with formula.
How will supplementing with formula affect my baby?
If you start supplementing regularly, your baby might start refusing the breast. A bottle delivers milk faster than a breast, so if your baby's an enthusiastic eater, he might prefer the bottle's quick delivery system. You might also notice that your baby's willing to go a little bit longer after a meal of formula. That's because babies don't digest formula as quickly as they digest breast milk, so they're likely to feel full longer.
Your baby's bowel movements will be markedly different once he's drinking some formula. They'll be firmer than they were when he was drinking only breast milk, about the consistency of peanut butter. They'll be a tan or brown color, have a strong odor, and probably be less frequent than when he was drinking only breast milk.
You may find that your baby goes a few days between bowel movements because there's more protein in formula, which slows down the digestive system. If your baby's vomit or stool contains spots of blood after you introduce formula, call your baby's doctor. This is a sign of milk intolerance.
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