Formula Feeding FAQs: Supplementing

The major health organizations — including the American Academy of Pediatrics (AAP), American Medical Association (AMA), the American Dietetic Association (ADA), and the World Health Organization (WHO) — agree that breast milk is the ideal form of nutrition for babies (especially during the first 6 months). However, it's your choice to decide what's best for you and your baby.

Whether you've decided to formula feed your baby from the start, are supplementing your breast milk with formula, or are switching from breast milk to formula, you're bound to have questions. Here are answers to some common inquiries about formula feeding.

I'm breastfeeding but also want to start giving my baby formula. Is this OK?

The AAP recommends exclusively breastfeeding (that is, giving the baby no other food, beverages, or formula) for the first 6 months. The many health benefits of breastfeeding continue during the entire time you are breastfeeding, and that helps keep your baby healthy.

Unless your child's doctor recommends it, avoid giving your baby breast milk and formula (this is called supplementing) at least until your milk supply has had a chance to develop and both you and your baby are used to the concept of breastfeeding. Most lactation professionals recommend that parents wait at least 1 month before offering pacifiers or artificial nipples of any kind to avoid nipple confusion. Early supplementing also can lead to a reduction in your milk supply.

If you are having a hard time pumping or need to go back to work, you might want to consider meeting with a lactation consultant to devise a plan to help. This might enable you to store milk in the freezer for later use. If you find that you need to supplement breast milk with formula, then continuing to offer as much breastfeeding and breast milk as possible. Add formula as needed. The more breast milk your baby gets the better!

If I want to begin giving my breastfed baby formula how should I start?

If you are using formula because you're not producing the amount your baby needs, nurse first. Then, give any pumped milk you have and make up the difference with formula as needed.

If you are weaning from one feeding at the breast or from breastfeeding altogether, you can begin to replace the desired amount of breastfeeding or pumping sessions with bottle feeds. To eliminate a feeding at the breast or a pumping session you should pump to comfort so you won't have problems with plugged ducts or mastitis.

As you eliminate breastfeeding sessions, your milk supply will decrease and your body will begin to adapt to produce enough milk to accommodate your new feeding schedule. Starting your breastfed baby on formula can cause some change in the frequency, color, and consistency of your baby's stools (or poop). Be sure to talk your doctor, though, if your baby is having trouble pooping. If your baby refuses formula alone, you can try mixing some of your pumped breast milk with formula to help the baby get used to the new taste.

Should I give my baby the bottle at first or should I have someone else do it?

If possible, you should have someone else give your little one the bottle at first. Why? Because babies can smell their mothers and they're used to receiving breast milk from mom, not a bottle. So try to have someone else — such as a caregiver or partner — give a breastfed baby the first bottle.

Also consider either being out of the house or out of sight when your baby takes that first bottle, since your little one will wonder why you're not the doing the feeding as usual. Depending on how your baby takes to the bottle, this arrangement may be necessary until he or she gets used to bottle feeding.

If your little one has a hard time adjusting to this new form of feeding, just be patient and keep trying.

Reviewed by: Joseph DiSanto, MD, and Karin Y. DiSanto, IBCLC
Date reviewed: February 2012

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