Supplementing is adding in additional breastmilk or formula along with nursing.

Feed the baby

A well-fed baby is better at breastfeeding.  

  • Aim for 8-12 feedings in a 24 hour period, going no longer than 4 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.
  • 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 my best serve as the upper limit of what 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.

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 4 supplemental bottles per day, pump 4 times.  If you are supplementing after every breastfeeding, aim for 6-8 pumps per day.
  • Make sure you are using a high quality double electric breastpump.  You should be pumping on the highest comfortable vacuum setting. It shouldn’t hurt!  Pump both breasts for about 15- 20 minutes.
  • Plan to pump within 15-30 minutes of finishing breastfeeding. You may not express very much milk and that’s ok!  Remember, the goal is to send your body a message to increase milk supply while the baby eats elsewhere, not collect a bunch of milk. If you get milk, great! If not, that’s ok!

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. You should be ideally seeing an IBCLC in person weekly to guide you through this very hard work!
  • 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 plan 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.