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How to Balance Breastfeeding and the Bottle

How to Make Supplementing Work for You

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a baby being bottle fed breast milk

While all moms are amazing, no mom is great at everything. Some struggle through tears while breastfeeding and end up stopping before they’d really like to. But this is one instance in life where you really can have it both ways—that is, you can provide your baby with the nutrients breast milk supplies while also having the freedom of letting him have some bottles some of the time. Of course, nothing but breast milk is best for babies until they're at least 6 months old. But some breast milk is way better than no breast milk.  Whatever your reason, your challenge will be first of all deciding whether this is really the route you want to go, and then, if the answer is yes, keeping up enough of a milk supply so that you don't end up weaning your baby before you're ready to give up those precious nursing moments. (If you're going back to work, supplementing involves a different bag of tricks that you can read about here.)

Why Supplement?

Supplementing means that in addition to nursing your baby, you’re also giving him bottles of formula. Moms start supplementing for all kinds of reasons: it's hard to pump at work; someone is pressuring you to stop breastfeeding; you're worried the baby isn't getting enough milk; you want one less stressor in your life; or you need more time and flexibility to tend to other responsibilities, such as older children.

Outside influences If you're thinking of supplementing because your mom, aunt, mother-in-law or some other relative is pressuring you to start the baby on formula or solids, think twice. Technology and what we know about nutrition may have changed a lot since they had infants, plus this should be your decision. If you and the baby are doing OK with breastfeeding, keep it up till your baby is 6 months old or, even better, a year. Breast milk is the best form of nutrition, even after your baby starts solids.

The baby isn’t getting enough to eat

This could be a good reason to supplement, but how do you know it’s true?

  • “I started pumping and only a tiny bit of milk came out!” Actually, that’s completely normal for first-time pumping. The first few times a mom pumps are generally an almost “dry run.” If you relax, the reflex that causes more milk to come out will be stimulated and you’ll be good to go.

  • “I think the baby is hungry even though I'm feeding her - she’s crying and demanding food all the time." That might be true, but your baby is likely just going through a growth spurt; her need for more milk is actually increasing your milk production. If it works for you, go with the flow and let her nurse, nurse, nurse, nurse. This will pass in a few days once your supply has increased. If you’re about to tear your hair out, consider supplementing!

  • If you have doubts, ask your pediatrician. If the doc is satisfied that your baby is thriving, you don't need to supplement in order to keep your child well fed.

To take the pressure off. If your gut tells you that a bottle a day will reduce your stress level, go with your gut. Many moms find that a little formula boosts their comfort level and the baby’s calorie intake while still giving him those perfect nutrients and precious antibodies that only breast milk contains.

You’d like a little more freedom. If this is your issue, start by realistically determining how much freedom you need. If you just want a hair cut or to go out to dinner once or twice a week, the baby can be given a bottle and your milk supply shouldn’t be affected. If you can pump to make up for the missed meal that’s great (the baby can have the pumped milk next time you need a break), but it’s not essential.

You need a lot more freedom. Whether you’re going back to work or just don’t have time to be nursing as much, keep in mind that if you’re not nursing or pumping, your milk supply will dwindle. Consider continuing to nurse in the morning or at night or pump at least once during the day to safeguard your milk supply and continue providing the baby with antibodies.

How to Make It Work for You

Supplementing with formula can put you on that slippery slope toward not breastfeeding at all. If you’re not emptying your breasts of milk regularly, your milk supply will diminish. If the baby is given bottles regularly, he may start refusing the breast – especially if there’s not much milk left in your breast for the effort. Here are a few ways to increase your chances of success.

Here comes the bottle. By the time a baby reaches 12 weeks of age, sucking is no longer a reflex and some babies become picky. One baby who used to gladly take a bottle may start refusing it; another might start rejecting the breast. Many babies prefer bottles because they can get more milk in a shorter time and with less work. To counter that tendency, find nipples for your bottles that are designed to be like yours and opt for slow-flow nipples, which are harder work for the baby.

Don't be the bottle giver. Have someone else give the bottles if you can. If you do bottle as well as breast duty, the baby might get confused and wind up refusing the breast when you want him to nurse.

Pick your bottle size. Start slow with supplementing and keep portion size small - you might start out by offering a 4-ounce bottle that’s only about half full. An 8-pound baby needs about 20 ounces of milk day and a 10-pound baby needs about 25 ounces.

Restrict bottles - and tell others to. If you’re going out, be sure you explain to the caregiver that you don’t want the baby to get stuffed - if that happens he might refuse to nurse, especially if your milk supply is depleted.

Pump when you can. If the baby only nurses only in the morning and at night, your milk supply may plummet. That could cause the baby to lose interest in nursing - and be weaned before you’re ready. If you don’t want to nurse during the day, to keep milk production up try pumping (or nursing) once in the middle of the day as many days as you can during the week. The difference between pumping just once a day and not at all is tremendous.

 
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