As an IBCLC I often hear from moms who go into pregnancy with the plan to exclusively breastfeed– only to be disappointed if that plan has to shift. The goal to exclusively breastfeed is common amongst moms because breastfeeding, as we know, offers optimal nutrition, but also fosters a special bond between mom and baby that many moms fear they’ll be unable to achieve through the use of a bottle. Of course this isn’t to say bottle feeding or supplementing prevents mom and baby from bonding, but many women have this fear.
We need to remember that the path to exclusive breastfeeding might involve supplementation, and that’s perfectly okay! As moms, we so often have such high expectations of ourselves that it can feel incredibly disheartening when our plans shift course. We need to remember that our primary goal should be achieving a feeding routine that works for you and your little one. This plan may involve supplementation at some point, even if unexpected. By exploring the different facets of supplementation, highlighting the importance of maintaining your supply, and offering practical insights we can help you navigate your supplementation journey seamlessly. Ultimately, however you end up feeding your baby I want you to feel confident and fulfilled in your decisions as a mama.
There are many terms in the baby feeding world: exclusively breastfed, responsive feeding, pumping, breastfed, combination fed, formula fed, supplemented etc. So what exactly is exclusive breastfeeding? Well, exclusive breastfeeding involves directly feeding your baby at the breast–excluding bottles of breast milk or formula. Supplementation then, includes offering your baby a bottle of either breastmilk or formula–on top of feeding directly from the breast. You can think of supplementation as offering a bottle in addition to breastfeeding. Supplementation can be a family’s original feeding plan, or it may be necessary in some situations even when the plan was originally to exclusively breastfeed.
Who May Need Supplementation?
As previously mentioned some women choose to supplement as part of their initial feeding plan. For others, supplementation can be the result of baby needing further nutrition. Some of these special circumstances may include:
- If breastfeeding hurts!
- It is important to remember that breastfeeding is a learned skill by both you and baby. Sometimes, latching can be painful and this can alter your supply temporarily. Essentialy, because your baby is not going to the breast as long or as often, your supply may lower or not establish as much. This can be fixed! It means you will have to potentially supplement while we work on building your supply and getting your baby comfortably latched to the breast.
- Baby lost more than 10% of their birth weight in the first few days of life.
- These little ones may require a combination of supplementation, breastfeeding, pumping, and/or hand expression to support their feeding journey. It is imperative if this sounds like you, that you reach out to your provider and create a plan with their support.
- Women who have had minimal breast growth during puberty and pregnancy.
- This can make it challenging to produce enough milk for their newborns. If this is the case, creating a feeding plan with your healthcare provider, which may include supplementation, is important to ensure your baby reaches their milestones.
- Babies with jaundice.
- If your little one is jaundiced, they might struggle to feed due to increased sleepiness. Bilirubin levels rise when infants don’t pee and poop regularly. Supplementation is likely needed, and maintaining your milk supply is crucial during jaundice resolution.
Creating a Feeding Plan
Your healthcare provider is your partner in establishing a feeding plan tailored to your little one’s needs. This plan will detail the amount of supplementation required, methods to assess feeding success, and strategies to gradually reduce the need for supplementation over time. Remember, your input is crucial in shaping this plan to align with your overall breastfeeding goals and your voice should be considered in the planning.
If you are leaving your appointment feeling lost or confused about where to start, remember you have options. It is never a bad idea to get a second opinion or find someone who will work with you and ensure the plan is meeting your end goals as well as the goal of baby receiving optimal nutrition. We have many qualified Registered Nurses, Lactation Consultants, and Nurse Practitioners on our team who would love to help you and your baby with your feeding plan as well! You can book a nurse here who is trained in helping work with you to come up with a tailored plan to fit you and your little one’s needs and wants.
Maintaining Breast Milk Supply While Supplementing and the Role of Breast Pumps:
Many women never own a pump and feed their children exclusively at the breast until they are ready to wean. Once your child is meeting all of the goals set out at the start of your supplementation journey, there is no need to pump unless you would like to (i.e. building a freezer stash for date night!). While not mandatory, having a breast pump can be a valuable asset. Breastmilk production operates on a supply-and-demand system. A pump becomes handy in various scenarios, including pain during breastfeeding, damaged nipples, latching difficulties, or especially when there’s a need to increase milk supply for supplemental nutrition.
For those needing short-term supplementation, preserving and growing your breast milk supply is essential. When supplementing it is important to remember that every time you supplement you should be pumping to keep your supply up. If this sounds exhausting, consider power pumping in the evening to compensate for any missed sessions during the day. Remember that the flange size matters in this process and to pump the most effectively you will need to find a size that works best. Ultimately it is up to you and your preferences, but always remember there are options to rent pumps before making your final decision.
Create a Supplementation Routine With Your End Goal in Mind:
Although offering supplementation first is not common I encourage you to consider this to enhance your breastfeeding experience. When we start with the supplementation it teaches your child to eventually feel satisfied at the breast (finish the feed), they stay longer at the breast (which increases supply), and it also does wonders for your confidence (compared to trying first, feeling frustrated, stopping the breastfeed, and ending with a bottle). Often we see parents try to breastfeed first. This can lead to both mom and infant ending up frustrated, and the breastfeeding session cut short. This of course ends with supplementation. The aim of offering the supplementation first is that this will take the pressure off of breastfeeding. It will also fill baby’s belly so they have more patience to stay and learn at the breast.
To do this start with the supplement and then offer baby the first breast or their dinner. Once finished that breast, switch to the second breast and offer dessert. From here you can finish the remaining supplement if needed. Gradually the goal will be baby no longer needing the supplement at the end of the feed and eventually dropping the supplement altogether.
Remember Supplementation Can Be a Useful Tool on Your Feeding Journey
In the pursuit of exclusive breastfeeding, supplementation may play a vital role in ensuring your baby receives optimal nourishment. By collaborating closely with your healthcare provider, adopting thoughtful supplementation practices, and seeking support when needed, you can navigate this journey with ease. Remember, every breastfeeding journey is unique, and finding the right balance aligned with your goals and your baby’s needs is key to a fulfilling breastfeeding experience. Embrace the journey with love and confidence, you’ve got this! And remember if you are feeling like you need some extra support trying to navigate the many steps and processes associated with breastfeeding please reach out to one of our trained Registered Nurses or Lactation Consultants!
Buckley, K. M. (2009). A double-edged sword: Lactation consultants’ perceptions of the impact of breast
pumps on the practice of breastfeeding. The Journal of Perinatal Education, 18(2), 13–22.
Jain, S. (2020, October 29). How often and how much should your baby eat? Healthy Children. https://www.healthychildren.org/english/ages-stages/baby/feeding-nutrition/pages/how-often-and-how-much- should-your-baby-eat.aspx
Keim, S. A., Sullivan, J. A., Sheppard, K., Smith, K., Ingol, T., Boone, K. M., Malloy-McCoy, A., & Oza- Frank, R. (2021). Feeding infants at the breast or feeding expressed human milk: Long-term cognitive, executive function, and eating behavior outcomes at age 6 years. The Journal of Pediatrics, 233, 66-73. https://doi.org/10.1016/j.jpeds.2021.02.025.
Kent, J. C., Mitoulas, L. R., Cregan, M. D., Geddes, D. T., Larsson, M., Doherty, D. A., & Hartmann, P. E. (2008). Importance of vacuum for breastmilk expression. Breastfeeding Medicine : The Official Journal of the Academy of Breastfeeding Medicine, 3(1), 11–19.
Peterson, A., & Harmer, M. (2020). Balancing Breast and Bottle: Feeding Your Baby. 2nd ed., Breastfeeding Solutions, LLC.
Spatz, D. L., Froh, E. B., Schwarz, J., Houng, K., Brewster, I., Myers, C., Prince, J., & Olkkola, M. (2015). Pump early, pump often: A continuous quality improvement project. The Journal of Perinatal Education, 24(3), 160–170. https://doi.org/10.1891/1058-1243.24.3.160