When the Pediatrician Says to Supplement Your Breastfed Baby: What to Do–on birth walk blog

What goes in the bottle?

So you have a brand new baby in your arms that you just birthed days ago.  You stare adoringly into her little face as you breastfeed her.  You take her for her first pediatrician appointment and are informed that she’s not gaining weight as quickly as they’d like to see.  And then you hear the dreaded words, “we’d like you to supplement”.

First of all, don’t panic, it’s time to do some investigation.

Before supplementing with ANYTHING, see a lactation professional such as and IBCLC.  Many hospitals have IBCLCs on staff and provide free help to mothers that birthed at their hospital.  Some hospitals have free programs for anyone, regardless of where they birthed.

When we don’t see optimal weight gain, there can be many minor things that can be contributing to the issue, such as:

  • A latch that needs adjustment to help baby get more milk at the breast.
  • breastfeeding management–are you following baby’s hunger cues and feeding immediately or are you scheduling feedings too far apart?  A newborn baby has a tiny tummy and needs to eat very frequently, as many as 10-12 times a day (around the clock).
  • Anatomical issues that need attention such as a tongue tie or lip tie.
  • Delayed milk production.  For some women, it takes longer than “average” for their mature milk to come in fully.

Most of the time, correcting any breastfeeding issue such as those above, will correct the weight issues.

If it is determined that supplementation will be necessary for the health of your baby, you HAVE CHOICES.  Many people in the health care field are not trained in lactation.  This means that even pediatricians and nurses may mistakenly recommend formula automatically when a baby needs additional nutrition.

The American Academy of Pediatrics recommends the following “hierarchy” for supplementation of infants:

  1. Your own expressed breast milk
  2. Donated human breast milk
  3. formula

In other  words, your own expressed breast milk is by far the best option, if you are able to provide it!

If you decide that formula is the best choice for your situation, it is not the end of the world! Overall, human breast milk is the optimal food for human babies.  It is more calorically dense than formula, meaning that breastfed babies need less of it than they would formula.   Ultimately, I think what’s most important is that you get to know your options and make your own choice.

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