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All About Supplementing

January 5, 2014 by HealthyFamilies BC

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Supplementing means giving your baby formula or expressed human milk in addition to breastfeeding. 

The decision to supplement is an important one - sometimes it's medically necessary.

The most common reason parents decide to supplement is concern for nutrition, especially in the first few days. You're just getting used to breastfeeding, and it may feel like your baby isn’t getting enough to eat, especially at night. Keep in mind that it can take time for both mom and baby to adjust to their new routine, and supplementing should only be started after consulting with your healthcare provider.

Parents may also wonder if they should supplement during babies' 'growth spurts,' which happen around two to three weeks, six weeks and around two to three months of age. At these times, babies want to feed more often and even though you are making enough milk, your breasts may feel soft. During a growth spurt, you may feel like you’re feeding all the time. That’s OK. By breastfeeding more, the baby is helping to increase your milk supply.

Supplementing may not be the break moms are looking for

Some parents think that offering a baby an occasional bottle will give the mom a break. But supplementing with formula can actually make breastfeeding harder. If your baby is no longer breastfeeding as well, or if you think your milk supply is decreasing, you may want to stop bottle feeding for a while. Any kind of bottle can pose a problem – even those advertised as being suitable for breastfeeding babies. Consult your health care provider for more information.

When the mom needs a break, bottle feeding may not be the best solution. That's because:

  • When bottle feeding replaces breastfeeding, the mother’s breasts often become so uncomfortable she has to express her milk. Pumping instead of breastfeeding is not much of a ‘break’. It may be simpler to breastfeed rather than pump and bottlefeed.
  • Pumps and bottles must be cleaned and sterilized. Formula must be measured, mixed and safely stored if not used right away. Breastfeeding can happen anywhere at any time without additional equipment.
  • Often, a mom actually needs a break from some of the other responsibilities that add to the stress of caring for a baby. Ask a friend or loved one to help you with household duties so you can focus on breastfeeding.

Types of supplements

If you plan to give your baby extra milk, offer:

  • Your expressed breast milk
  • Pasteurised donor breast milk - if available
    • Currently, there is one human milk bank in B.C
    • Families of high risk and ill children may be able to receive milk from the bank. Both donors and their milk are carefully screened at the milk bank and the milkpasteurized to ensure a safe product is provided.  Pasteurized donor milk is available by prescription. Ask your doctor or midwife if you need more information.

Other types of supplements

  • Store-bought formula
  • "Shared" breast milk
    • As more mothers learn about the importance of human milk, some women who make lots of milk offer to share with other moms. If you plan to use another mother’s milk, it’s important that you know her well and are confident that she is healthy and her milk is being carefully expressed and stored. Unpasteurized breast milk may contain viruses that can be passed through the milk. Breast milk must also be stored carefully to make sure it’s kept clean and does not spoil. Health Canada as well as medical authorities such as the Canadian Pediatric Society do not recommend the sharing of unprocessed milk.

Reasons for supplementing

Sometimes, supplementing is medically necessary. Some babies may need a little extra  nutrition for the following reasons:

  • Low blood sugar levels (hypoglycaemia)
  • Receiving treatment for jaundice (and if they are not feeding well enough at the breast)
  • Weight loss (where a mother’s milk has not increased and baby doesn’t gain weight despite frequent and effective breastfeeding)
  • Dehydration (not enough wet diapers)
  • Premature babies who are not feeding well enough at the breast
  • Meconium still being passed three to four days following the birth
  • Mother’s milk has not started to increase by the fourth day.

Alternatives to bottle feeding

Even new babies can get extra milk from a spoon or a cup, rather than a bottle. At six months of age, introduce solid food in addition to breastmilk. Offer expressed breastmilk or storebought formula in a lidless cup.

Resources & Links:
HealthLink BC: Breastfeeding
HealthLink BC: Combining Breast-Feeding and Bottle-Feeding 
HealthLink BC: Choosing Baby Bottles and Nipples 

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