Striving for breastfeeding success

When Supplementation is Necessary

We sometimes recommend your baby be supplemented after breastfeeding. It’s okay! This does not mean you are failing at breastfeeding!

  1. Feed the baby. A well-fed baby is better at breastfeeding.

Aim for eight to 12 feedings in a 24 hour period, going no longer than four hours between feedings.

Breastfeed your baby on both breasts. When breastfeeding, be sure to have a deep latch. Look and listen for drinking, not just sucking without swallowing. Use breast compressions while the baby is sucking to encourage swallowing. While holding the baby with one arm, encircle your breast with your free hand close to the chest wall. Your thumb should be on one side of your breast and your fingers on the other—it doesn’t matter where, just do what is comfortable for you. When the baby sucks, squeeze and hold. Once the baby starts drinking, you may relax your hand. Do this again if the baby starts sucking without swallowing.

Source: Academy of Breastfeeding Medicine

Supplement your baby with infant formula or expressed breastmilk after breastfeeding. Volumes above are total volumes per feeding and include what your baby may be getting from your breast; therefore, these supplementation guidelines may best serve as the upper limit of how much to supplement your baby after breastfeeding. Feed this to your baby slowly using the paced bottle-feeding method. Milk comes out of a bottle much faster than it comes out of the breast, so be sure you give your baby frequent breaks and burps to give him time to realize his belly is full. There is no one bottle that is best; just focus feeding the baby slowly and watch for signs that he needs a break.

  1. Protect your supply. Make sure you tell your body that the baby is eating extra food elsewhere. If you don’t, your body won’t make enough milk for the baby.

Pump your breasts once for each supplemental bottle you give the baby. For instance, if the baby gets four supplemental bottles per day, pump four times. If you are supplementing after every breastfeeding, aim for six to eight pumps per day.

Make sure you are using a high quality double electric breast pump. You should be pumping on the highest comfortable vacuum setting. It shouldn’t hurt! Pump both breasts for about 15 to 20 minutes.

Plan to pump within 15 to 3o minutes of finishing breastfeeding. You may not express very much milk and that’s okay! Remember, the goal is to send your body a message to increase milk supply while the baby eats elsewhere, not to collect a bunch of milk. If you get milk, great! If not, that’s okay!

  1. Maintain balance. Breastfeeding is a marathon, not a sprint.

Remember, supplementing and pumping is a temporary plan to get your baby’s weight gain back on track so you can return to exclusive breastfeeding. Try not to get overwhelmed. Tell yourself that you can do this until the next follow-up appointment with your IBCLC.

During this stressful period, take good care of yourself. Take your prenatal vitamins with DHA. Drink plenty of water to thirst. Eat well. Take frequent naps. Don’t make any plans to go out or entertain guests.

These rules are not hard and fast and set in stone. In real life, you may not be able to pump as many times as is ideal; do your best and forgive yourself if you miss one.

Share the load. Ask for help. Manage your time. If you are able, have someone else feed the baby a bottle while you pump to save time. Consider buying or making a hands-free pumping bra (Simple Wishes is a great one!).

Join a support group online or in person. Talking and listening to women who have had similar experiences helps a ton!

  1. Schedule a follow-up visit.

Since you are supplementing, follow up with a trusted IBCLC ASAP! This can be an exhausting and nerve wracking plan, so you need support!