Does Supplementing with Formula Reduce the Benefits of Breastfeeding

Does Supplementing with Formula Reduce the Benefits of Breastfeeding

Breastfeeding is proven to provide optimum benefits for mothers and their babies. Still, there are a lot of moms who end up supplementing formula milk to their baby, either due to medical considerations or personal reasons. If you’re a mom considering supplementary feeding, you might be wondering how your baby will get the most out of breastfeeding while also giving formula.  I did some research regarding this topic to offer you some credible answers.


So the question is, does supplementing with formula reduce the benefits of breastfeeding? Supplementing with formula will not negate the numerous benefits that your breast milk provides. However, the benefits of breastfeeding could be reduced, particularly if supplementation is introduced in the first six weeks postpartum. Six weeks is the approximate time it takes for you to establish your milk supply. Supplementing with the formula too early has the potential to reduce your milk supply. It can also cause nipple confusion and may also shorten the duration of breastfeeding. This will, therefore, reduce the benefits of breastfeeding.

A baby drinking milk from a formula milk bottle

You might be worried that your baby isn’t getting enough milk. Maybe you’re going back to work soon and you feel you need to switch to formula feeding when you’re away. You might also be feeling confused as to whether or not it’s okay to use formula as a ‘top-up’ to breastfeeding or to combine feed your baby later. So let’s take a closer look at some of the most common reasons why moms introduce formula and if it’s preventable. We’ll also list some of the essential factors to be considered and the risks associated with supplementing formula milk to breastfeeding.

Common Reasons for Supplementing Formula to Breast milk

Apart from certain medical considerations, deciding whether to exclusively breastfeed or to supplement with formula often relies on what works best for both the mother and her baby. So what are some of the common reasons as to why breastfeeding moms resort to supplementing with formula milk?

Low supply of breast milk

First- time parents may mistakenly perceive some signs that their baby is not getting enough breast milk. There may be times when their baby gets fussy at feeding time, refuses the breast or wants to feed at more frequent intervals. These signs can be normal with a newborn and with the appropriate help from a professional the right guidance can be given.

During the first few days after giving birth, mothers should be informed that their first milk called colostrum is expected to be low in volume, and their milk supply will gradually increase as their babies continue to breastfeed.

In some instances, mothers have physiological reasons which could impact their milk supply, for example, having undergone breast reduction surgery or an existing thyroid problem. In such cases, they are advised to top up with formula to meet their baby’s nutritional needs.

Baby’s low weight gain, dehydration or low blood glucose levels

Supplementing with formula milk could be prescribed by your doctor if your baby isn’t gaining the ideal weight, is dehydrated or has low blood glucose levels especially during the neonatal period. One important factor to be considered is that newborns are expected to lose around 7 to 10 % of their birth weight within a week after they are born. They will generally regain this weight within two weeks. If you’re worried about your baby’s weight, consult a professional prior to making a decision. They will advise you whether giving a supplement is necessary for your baby.

Going back to work

Many moms choose to supplement with formula when they return to work a few months after giving birth. Most working moms who wish to continue to breastfeed resort to leaving some formula milk with the caregiver when they are away from home. However, it is important to note that there are many working moms who are able to continue breastfeeding by expressing their milk and leaving frozen breast milk for their baby. Also, many moms may need to express anyway if they are away for long periods to reduce discomfort and ensure a continuous supply of milk.

Concerns about breastfeeding in public

Some mothers find it uncomfortable to breastfeed while they are out in public places with their baby and choose to bring formula milk during these occasions. Nevertheless, a lot of public places are now more welcoming towards breastfeeding moms. There are now more people who are open-minded and considerate when seeing mothers who are breastfeeding in public. In 2018 it has been made legal to breastfeed in public in all 50 states.

How Supplementing With Formula Impacts Breastfeeding and therefore Reducing the Benefits

It is now widely known the multiple benefits that breast milk provides to your baby. This includes a reduced chance of getting an infection, allergies and possibly developing from diabetes and obesity in later life to name a few. However, in relation to supplementing a baby with formula, there are a number of changes that can occur that can affect your breastfeeding pattern and will, in turn, reduce the benefits that breastfeeding can give to your baby.  Below are some factors for mothers to consider if supplementing with formula and how their decision can affect the benefits of breastfeeding. So here are some of the risks associated with introducing formula milk to babies:

Reduces your milk supply

When you are giving your baby formula, this means there is less room in baby’s tummy for breast milk. Your baby will take in less of your milk and this, in turn, will give a signal to your body that you need to produce less milk. The end result means you will produce less milk affecting your supply. Formula milk also stays longer in your baby’s stomach which may reduce your baby’s desire for more of your milk.

Alteration in baby’s suck pattern

Silicone nipples are firmer and often provide a faster flow of milk. So when baby adapts to bottle feeding with formula, it may interfere with his ability to latch onto your breast and will affect his typical breastfeeding pattern. This makes breastfeeding a little more challenging for both baby and mom, which may also lead to giving up breastfeeding earlier than what is expected.

Infant’s gut microbiome

Breastfeeding in the first few months gives your baby the necessary time for their intestines to develop and receive the good bacteria your breast milk provides. This will create a protective barrier to protect against infections and reduce the incidence of allergies. Introducing formula in the first few months can disrupt the natural flora in your baby’s intestines. The good bacteria present may not be as protective as the bacteria present in an exclusively fed baby. This study states that alterations to the neonatal gut environment from formula supplementation can be responsible for mucosal inflammation and disease, autoimmunity disorders, and allergic conditions in childhood and adulthood

Likely to reduce the duration of Breastfeeding

As mentioned above your milk supply will most likely be reduced due to less intake of breast milk by your baby. As time goes on, your baby will most likely lean more towards taking more formula as the milk flows faster from the silicone nipple making less work for your baby. Some of the major health organizations including the World Health Organization (WHO), the American Academy of Pediatrics (AAP), and the American Medical Association (AMA) recommend exclusive breastfeeding for infants until 6 months of age and breastfeeding along with solids until 2 years old. Unfortunately, the likelihood of a child breastfeeding to this age is very low if also supplementing with formula.

How To Supplement With Formula Without Reducing Your Milk Supply

A common concern when supplementing is whether your baby will begin to prefer feeding from a bottle. Your baby will get milk at a faster rate with less effort when drinking from a bottle. In many cases, this leads to a preference for the bottle while suckling at the breast will be reduced or maybe cease altogether. So what can we do to prevent this from happening?

Method Of Feeding Formula To Baby

How you give formula to your baby could have an impact on the duration and success of breastfeeding and the benefits it gives to your baby. Of course, the method used depends on how old your baby is and the suitability can differ in each situation. Below is a list of methods used to give formula to your baby.

Method Of Feeding Formula To Baby
Cup
Spoon
Bottle and Teat

Cup

According to Wombach & Riordan in Breastfeeding and Human Lactation (2016), cup feeding is least likely to alter infant suck in ways that can compromise breastfeeding. The oro-motor skills used in sipping and lapping from a cup differ from those used while suckling at the breast. Full-term and low birth weight infants can be cup fed from birth. It is most commonly used when your baby is unable to latch onto the breast when the mother is not present and to avoid nipple confusion. Always check with a trained professional such as a lactation consultant if this method would be suitable for your baby. This technique can sometimes be difficult to learn and requires close supervision at the beginning.

Spoon Feeding

This method of supplementing can also be used under close supervision from a trained professional. Ensure that a suitably sized clean spoon is used at each feed. Your baby should always be held in an upright position. With the supplement on the spoon, bring it to your baby’s lips. Gently tilt the spoon so that when he opens his mouth it rests lightly on his lower lip and the milk will just touch his lips. Tip the spoon slightly so that the milk flows into the baby’s mouth. Give the baby time to swallow, refill the spoon, and repeat as needed.

Select The Right Bottles And Teats

When choosing bottles and teats, select a nipple that will allow your baby to suck, swallow and breathe at a comfortable pace. Unsuitable nipples can flow at a faster rate make it uncomfortable when your baby is feeding. There are many shapes and sizes. Those that are shaped similar to the human nipple with a slower release rate will help prevent nipple confusion.

Supplement Before Feeding

La Leche League in The Womanly Art of Breastfeeding has suggested one way to make breastfeeding more appealing to your baby. This involves feeding your baby with the supplement before offering a breastfeed. The advantages of this method include:

  • your baby being more likely to feed longer and effectively at the breast and breastfeed more patiently even when the flow is slow
  • this increased interest will have the effect of maintaining and even boosting your milk supply while you are also supplementing your baby
  • when your baby has finished feeding at the breast, you will see him full and satisfied making it more likely you will continue breastfeeding

Reduce the amount of supplement by a small amount to prevent your baby from filling up. This will ensure he still has an appetite to feed from the breast. To get the balance right some trial and error will occur. If you feel your baby has not taken much milk from the breast, try giving a little less supplement at the next feed. Alternatively, if you find that he is still hungry after the breastfeed, offer him the other breast or offer more supplement if this has not satisfied him.

Skin To Skin Contact

When you are feeding your baby with formula try to keep her as close as is comfortable for both of you. Position your baby as close as to when you have been breastfeeding. This will help support and maintain your milk supply and will most likely increase the chances you will continue breastfeeding.

Nursing Supplementer

A nursing supplementer can be used on a temporary or long term basis to help maintain a mothers milk supply and help baby keep the same suckling pattern as is natural when feeding from the breast, while also ensuring your baby is getting the nourishment he needs. While your baby is suckling on the breast he is also receiving milk from the supplementer at the same time. This device consists of a container to hold breast or formula milk. A length of thin tubing connected to the container runs towards the mother’s nipple. The tube is secured in place by a piece of tape or can also run under your nursing bra or nipple shield. When your baby starts to suckle at the breast, the milk supplement will also be released at the same time.

A nursing supplementer is mostly used in circumstances where:

  • moms milk supply needs to be re-established also known as relactation. Low milk production can occur in situations where mom and baby have been separated due to prematurity or illness.
  • primary lactation insufficiency. This is where there is not enough functional breast tissue to provide a full milk supply for the baby.
  • certain genetic, anatomic, or neurologic conditions are present in an infant
  • a woman has undergone breast reduction surgery resulting in loss of functional breast tissue

This method needs to be closely monitored by a trained professional such as a lactation consultant to ensure your baby is getting an adequate milk supply and deciding when and if it is appropriate to wean from the device.

Supplementing With Formula Can Actually Help Some Moms Breastfeed For Longer And Reap The Benefits

A research study (source) had been carried out to determine what effect a limited amount of formula had on the duration and exclusivity of breastfeeding.

The results concluded that early limited amounts of formula may reduce long term formula use at 1 week and increase breastfeeding at 3 months for some babies. They also mentioned that a limited amount of formula can be successfully used as a temporary coping strategy for moms in supporting breastfeeding newborns with early weight loss. Limited amounts of formula also have the potential to increase the rates of mothers breastfeeding their babies in the longer term without supplementation.

This piece of research shows that small quantities of formula can actually improve the duration of breastfeeding for some mothers and can reduce the amount of formula consumed by some babies in the longer term.

Related Questions

Are breastfed babies healthier than formula fed?

Breastfed babies are found to have extra protection from certain illnesses, allergies and chronic diseases due to the natural immunity being passed on from their mother’s breast milk. However, it doesn’t necessarily mean that breastfed babies are healthier than formula fed babies. There are many other factors to be considered with regard to a baby’s health. Examples include conditions in their immediate environment, health and nutritional status of the mother and other family members. The presence of genetically inherited conditions is also a factor.

Can I give my breastfed baby formula at night?

Yes, you can feed your baby formula at night, however, this may result in some unwanted effects if you want to continue breastfeeding your baby. Particularly in the early months, you will find that your breasts will become very uncomfortable and engorged if you do not feed your baby. To reduce this discomfort you either need to feed your baby some of the time during the night or express your milk. This article specifically discusses supplementing your baby with formula at night.

When should I introduce formula to a breastfed baby?

The best time to introduce formula to a breastfed baby really depends on you and your baby’s individual needs. Every baby is unique and as mentioned earlier, there are certain conditions that will determine when formula will be introduced. These include a baby’s low weight gain, dehydration and low blood sugar levels which may indicate introducing supplement formula early. Some mothers may also have difficulty in producing enough milk for their baby and will need to use formula milk to meet their baby’s needs. The introduction of a bottle may need to start at week four or five for some babies as they may get used to feeding at the breast. In some cases, they may refuse to feed from a bottle at first and will need some extra time to adjust to using a bottle.

Whether you decide to use formula milk as a temporary supplement or for other reasons that are individual to you and your family, the most important thing to know is that your baby will benefit from any amount of breast milk. If you feel you’re unable to breastfeed exclusively speak with your health care provider. Experts often note that a mother’s milk, no matter what quantity, has a positive impact on a baby’s health and wellbeing.

Recommended Topics

References:

https://www.jpeds.com/article/S0022-3476(17)31770-5/fulltext
https://journals.sagepub.com/doi/full/10.1177/1941406415591208
https://www.dartmouth-hitchcock.org/obstetrics/dhmc_formula.html
http://americanpregnancy.org/breastfeeding/breastfeeding-and-bottle-feeding/
https://www.breastfeeding.asn.au/bfinfo/mixed-feeding

Wiessinger, D., West, D., Pitman, T. (2015) La Leche League International. The Womanly Art of Breastfeeding. 8th Edition. (p. 424) London, Pinter & Martin Ltd

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