Supplementing Breastfeeding with Formula at Night
a mother supplementing her baby with formula at night

Supplementing Breastfeeding with Formula at Night

Breastfeeding is a fantastic bonding experience with your baby, but it’s not always easy, and sometimes we all need a little extra help. Every mother has her own unique experience, and it is undeniable that there are times when exclusive breastfeeding isn’t possible. Supplementing with formula at night can sometimes mean the difference between continuing or giving up breastfeeding. If you are among those breastfeeding moms considering formula feeding at night, here are some handy tips to make the transition easier. So what do experts say about supplementing breastfeeding with formula at night?

So is it possible to supplement breastfeeding with formula at night?. Yes, supplementing breastfeeding with formula at night is possible provided you and your baby is ready. It’s best to wait 4 to 6 weeks to introduce formula to your baby in order to establish breastfeeding, build up your supply and prevent nipple confusion. When first introducing formula at night it’s best that you ask your partner to feed your baby as she will recognize your scent and will prefer to breastfeed. This could result in her refusing to take a bottle. Pumping at some point during the night is needed to help prevent discomfort and maintain your milk supply.

Though most healthcare organizations recommend exclusive breastfeeding for the first six months of life, the American Academy of Pediatrics (AAP) recognizes the need for formula milk supplementation in certain situations. For example, when a mom cannot provide enough breast milk for their baby, or if the infant fails to gain weight following optimal support and encouragement for breastfeeding.

What Does The Evidence Say Regards More Sleep?

I identified four studies whose purpose to establish what type of feeding has an impact on a mother and her baby’s length and quality of sleep.

In a study of 132 infants (source), it was found that breastfed infants are significantly more likely to wake at night than formula-fed infants. Another study of 44 mothers (source) revealed that there is a significant increase in night time wakings for breastfeeding mothers and less night-time sleep for their breastfed babies.
These studies concluded that formula feeding at night may decrease nighttime wakings and promote better sleep for mothers and their babies. However, there are other more recent studies that appear to contradict these results.
In 2014, a study (source) was carried out on 120 first-time mothers. Results revealed that women who breastfed exclusively at night have an average of 30 minutes more sleep compared to mothers who used formula at night. One explanation is that raised prolactin levels in the breastfeeding mother promotes better sleep and relaxation. Another study of 80 participants (source) concluded that there was no significant difference in maternal sleep patterns between exclusively breastfeeding, exclusively formula feeding or combination feeding mothers.

These studies suggest that there is no clear cut evidence to show a clear difference in the sleep patterns of a breastfeeding baby or a baby that is being supplemented with formula at night. In the end, the decision to breastfeed exclusively or supplement with formula depends on each family’s unique set of needs and expectations. In this article I discuss more in-depth to see does supplementing with formula decrease the benefits of breastfeeding.

Reasons for Supplementing Breastfeeding with Formula at Night

Exclusive breastfeeding is encouraged from birth to 6 months. However, some mothers need to supplement due to a variety of reasons. Supplementation may be required in some of these situations during the day as well as supplementing at night. These include:

Baby’s Medical Condition

Your pediatrician may require supplementing with formula if conditions such as poor weight gain, baby being born premature or having a medical condition that needs prompt attention.

Low milk supply

With the proper technique and guidance, many mothers manage to develop a good supply of breast milk for their babies. However, some mothers will experience a low milk supply even with optimal support. This can occur if mom has undergone previous breast surgery, breast implants, or may have a medical condition that interferes with her ability to produce an adequate supply of breast milk. Examples include hypothyroidism, diabetes, polycystic ovarian syndrome, and other hormonal disorders. If upon evaluation, your lactation consultant feels that your baby is not getting enough breast milk, then supplementing with formula may be indicated.

Going back to work

Pumping while at work so your baby will have enough stored breast milk while you’re away can be challenging. Is your workplace supportive of breastfeeding mothers?. Do you work long or unsocial hours such as a night shift schedule?. These situations may necessitate supplementing your baby with formula milk, particularly at night.

Multiple babies

Choosing to breastfeed if you have twins or triplets is a challenging job. You’ll need to maintain a large supply of breast milk and breastfeed frequently. Feeding your babies with formula or expressed breast milk at night can give you a much-needed break and recharge your energy for the next day.

Shared responsibility

Supplementing breastfeeding with formula at night formula can make feeding your baby a shared responsibility between you and your partner. Alternatively, some mothers choose to have a caregiver to take care and feed their baby at night.

When to Supplement with formula at night

If supplementing with formula has not been indicated due to medical reasons, most experts would recommend waiting at least 4 to 6 weeks before you begin to introduce formula milk in a bottle.

Why do you need to wait?

To establish breastfeeding with your baby

Time is needed for you and your baby to learn and become acquainted with breastfeeding. Give your body enough time to adjust to its new job. Your baby will also need time to learn this new skill before you plan to introduce another one.

To build a good breast milk supply

Breast milk for your baby works on a supply and demand basis. Waiting at least a month before you introduce formula is essential to building a good supply right from the start.

To minimize nipple confusion

Effective breastfeeding involves a good rhythm of sucking and swallowing, which your baby needs time to learn. Feeding from the breast differs from feeding on a silicone nipple. Frequent bottle feeding while very young has the potential to lead to nipple confusion. Young babies may end up refusing the bottle or refusing the breast if breastfeeding is not well established before you introduce bottle feeding.

How to Introduce Supplementing Breastfeeding Formula at Night

Once you have well established your breastfeeding relationship, you can now start to introduce some formula for your baby. Consult with your pediatrician first so that she can help you find the right formula to suit your baby’s needs. Most babies use iron-fortified cows milk formula. Sometimes breastfed babies can find it difficult adjusting to feeding from a bottle. While following your doctor’s recommendations, here are some tips that can help while introducing formula to your baby at night:

Learn how much to feed

Your doctor will advise the right amount of formula to introduce at each feeding. Generally, newborns consume around 2 to 3 ounces of formula per feeding every 3 to 4 hours. However, the amount will increase as your baby grows.

Have someone else to feed your baby for the first few days

a father about to give his baby a bottle of formula milk at night
a father about to give his baby a bottle of formula

There is a better chance your baby will accept the bottle feed if she is not near you. If you first choose to feed her, she may not accept the feed as she will recognize your scent. Ask your partner or somebody else to help feed your baby at night until such time that your baby readily accepts both breastfeeding and formula feeding. Baby spending more time with your partner including feeding time has the additional benefits of strengthening the bond between the other more important person in their life.

Do it gradually

You can start by replacing one feed a night this week and then to 2 feeds the next week. This will provide ample time for your baby to adjust and for your body to accommodate the shift in the demand for breast milk. As your baby gets older, he will be able to sleep through the night without a feed or either formula or breast milk.

Introduce the formula at the right time

The best time to introduce a new feeding routine is when your baby is relaxed, alert, and not too hungry. However, some babies will also accept a bottle if they are a little sleepy. Most importantly, you need to observe your baby and respond according to her cues.

Observe your baby when introducing formula during the day or night

Vomiting, diarrhea, weakness, red and scaly skin are some signs of formula allergy. If observed, discontinue the formula and contact your doctor immediately.

How to Supplement at Night without Affecting Milk Supply

Another challenge to combination feeding is how to maintain a good milk supply despite also giving formula into your baby’s nighttime feedings. Here are some tips that can help:

Gradual replacement of nighttime feedings

Try dropping one feed per week until you have replaced all your baby’s nighttime feedings to formula if that is what you wish to do. This will offer enough time for your body to adjust to the change in demand and decrease discomfort on your part.

Pump your breast milk

To minimize discomfort, engorgement, and to maintain a good supply, you can pump your breast milk during the usual time that your baby feeds at night. This article explains how to combine breastfeeding and pumping. This might seem to contradict the idea of getting some extra rest while dad is feeding the baby. However, breast pumps have come a long way in recent years. The Freemie Liberty Mobile Hands Free Breast Pump has an auto shut off timer where the pump will shut off automatically after 40 minutes. Each cup can hold 8 ounces of milk and has advanced noise reduction technology. This pump is a great way to give you the chance to get some extra sleep. In the meanwhile, you will have just expressed to prevent discomfort and maintain your breast milk supply. Expressed breast milk can then be stored in your freezer for your baby in the weeks ahead.

Maximize breastfeeding time

The key to maintaining your milk supply and your breastfeeding relationship is to maximize your bonding during the day. Encourage skin-to-skin and offer your breast whenever your baby demands it during the day. This way, your body can recognize that there is a greater demand during the day and less at night, and adjust to this new routine without ruining your milk supply.

Night Feeding Schedule with Formula at Night

Night feeding schedules widely differ from one baby to another. Here are some circumstances you might come across with regards to your baby’s night feeding schedule:

Increasing the amount

As mentioned earlier, it is expected that young babies will consume formula milk every 2 to 4 hours. However, as he grows, this night feeding schedule will slowly change. As your baby becomes more active, she’ll have a greater demand for calories and may not be satisfied with the same amount of formula per feeding. Try to increase one ounce at a time and observe for your baby’s hunger cues.

Decreasing frequency

Once your baby reaches 2 to 4 months or weighs at least 12 pounds, most formula-fed babies drop their middle of the night feedings. Remember that formula milk stays longer in your baby’s stomach when compared to breast milk, and this keeps them feeling full for a longer period of time.

Breastfeeding while supplementing with formula at night can be challenging. But remember that any amount of breast milk will benefit your baby. Here I look at the pros and cons of both types of feeding. Be it due to a need or simply a personal preference, supplementing breastfeeding with formula at night can be a way to help many families be happy and productive while ensuring optimum nutrition for their babies.

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1778851/?page=1
https://www.ncbi.nlm.nih.gov/pubmed/9423387
https://pedsinreview.aappublications.org/content/21/6/191
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927438/
https://pediatrics.aappublications.org/content/126/6/e1562.long#ref-23
https://www.nhs.uk/conditions/pregnancy-and-baby/combining-breast-and-bottle/
https://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/How-much-formula-does-my-baby-need.aspx

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