I
have been advised to supplement my breastfeeding with
formula. Will this diminish the benefits of breastfeeding?
Also, can I feed 2-3 ounces of breastmilk then give her 2-3
ounces of formula? This is due to low milk production and Sophie
is still hungry after I drain both breasts. I thought the mixing
of both could be harmful. Please advise.
Editor's note:
Two varying opinions on this question are posted below.
Absolutely - you can mix breastmilk and formula. I don't know
how that rumor got started that you shouldn't mix them, but it
just isn't true.
Breastfeeding does not have to be all or nothing - ANY amount of
breastmilk is going to be beneficial to your baby. The
antibodies actually become more concentrated as a mother's
supply decreases. Because it is the antibodies that help
fight infection, this could actually be a lifesaving decision!
I would recommend offering the breastmilk first. Then follow
with formula. Babies tend to take more milk out of a bottle than
from the breast (for several reasons), and formula tends to
sedate babies. Also, it takes a longer time for formula to
digest. So formula-fed babies tend to eat larger feedings and
space them further apart than breastfed babies.
Your goal should be to decrease the amount of formula per
feeding (note you are not necessarily decreasing the amount per
day - just per feeding) so that your baby will be hungry about
every 2-3 hours during the daytime. This will allow you to
stimulate your breasts in a manner more conducive to building up
a good supply. Another idea would be to use a supplemental
feeding device, such as the "SNS" made by Medela. This
device allows you to feed your baby formula at the breast. You
can see this product at Medela's website.
There is also excellent information at this website on building
up your milk supply. I would recommend reading everything you can find
on the subject. You will find a wealth of information at
Breastfeeding.com as well as Medela's website and La Leche
League's website:
http://www.lalecheleague.org.
You might also try looking for a local La Leche League group to
join.
Basically what is required in building up your supply is
frequent emptying of the breasts. Lactation is controlled by
hormones, so the better you can get those hormones flowing, the
better it is for your milk supply. Renting a hospital grade
electric breastpump can make a difference in a hurry -
especially with double-pumping. Also, there is an herb called
fenugreek which you can buy at any healthfood store that is
helpful. Two to three capsules with each meal is a safe dosage
that, for most women, can help boost milk supply within a week.
I hope this information is helpful to you. Let me know if
I can be of further help.
Good luck!
Cher Sealy RN, BSN, IBCLC, LLLL
Cher is a Registered Nurse and private practice
Lactation Consultant in Montgomery, Alabama. She was certified as an IBCLC (International
Board Certified Lactation Consultant) in 1987 and re-certified in 1997. She has been a La
Leche League Leader since 1985.
Unless
there is medical indication, we do not recommend adding
formula to the diet of a breastfed baby. The American
Academy of Pediatrics recommends exclusive breastfeeding
for the first 4-6 months (at which time solids may be
added to the diet) and then breastfeeding for at least the
first 12 months. If an infant needs supplements, we
recommend that breastmilk be pumped and then fed by
bottle.
If there is a low milk supply, it may be decreased further
by adding formula, which takes longer to digest and
decreases your baby's hunger. One important factor in
increasing your milk supply is how much your baby is
nursing. Other remedies to increase your milk supply, such
as improving the latch, using herbal or prescribed
supplements, and pumping your milk, can be found at the
following links:
Andrea Eastman (MA, CCE, IBCLC) on re-estabishing
a milk supply after supplementing
Anne F. Norton-Krawciw (RPh, IBCLC) on the use of Domperadome
for increasing milk production
Dr. Jack Newman on Using
a Lactation Aid
Dr. Jack Newman's advice on Herbs
for Increasing Milk Supply, which includes two
additional articles on Fenugreek.
The Knox
Breastfeeding site.
Your concerns about the mixing of breastmilk and
formula are supported by research. In 1993, Vnuk published
findings about the effects of "Just one
bottle..." in the journal Breastfeeding Review.
Here is a summary:
Did you know...That just one bottle can have serious
consequences for both mother and baby? Unfortunately it is
very easy to give a breastfed baby "just one bottle
of formula" and the reasons for giving the bottle
often show concern and compassion. For example:
Letting the mother have a well deserved rest after a long
delivery.
Settling a hungry baby who is difficult to feed.
Giving the mother's sore nipples a rest.
"But studies have shown that 'just one bottle of
formula' can be harmful to both mother and baby by:
Increasing the likelihood of serious allergy to cow's milk
protein.
Increasing the chance of bowel infection and diarrhea by
changing the pH of the bowel. It may take up to one month
to return to normal, safer levels.
Causing nipple confusion.
Affecting the delicate supply and demand balance.
Increasing engorgement by not emptying the breasts.
Decreasing a mother's confidence in her ability to feed
her baby.
Reducing the duration of breastfeeding."
What is most important at this time is to know that you
ARE doing what's best for Sophie. Educating yourself and
getting all the information you can certainly demonstrates
that you are a concerned and caring mother. Sophie is
benefiting tremendously from all the breastmilk she has
received from you. Every bit helps and you've given her a
great deal!
- Joan Edelstein, MSN, DrPH, RN
Joan has been a Professor of Maternity Nursing at San
Jose State University School of Nursing since 1980 and an
Integrated Perinatal Education Coordinator/
Senior Health Educator at Kaiser Permanente in Hayward, CA
since 1999 (In January, 2001, Hayward became the 30th
hospital in the US to receive the prestigious
international certification as a Baby Friendly Hospital).
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