Supplementing Breast Milk

Can I feed my baby breastmilk and formula?

Feeding baby formula and breastmilk together is not recommended under normal circumstances. If you breastfeed exclusively, it is the best thing you can do for baby. Unfortunately there are a few times when a baby has to be supplemented with formula. In some cases feeding babies breast milk and formula is necessary.

Always remember though that breast milk is the number one choice, then the second best is donor breast milk and lastly formula!

Ultimately, it is your choice what you do, but here are the facts…

Possible disadvantages of supplementing with formula or water

* An artificial nipple may cause nipple confusion (suck problems and refusing the breast) This usually happens if baby is younger than 6 weeks.

* Supplementing will decrease milk supply. Baby will not drink from Mom as much and therefore her supply will decrease.

* Supplementing breast milk, may lead to the breasts becoming engorged.

* Most moms who supplement end up breastfeeding for only a short period of time.

* To supplement breastmilk with formula will not help Jaundice, but will make it worse. Breast milk acts like a natural laxative to eliminate meconium and this helps in lowering bilirubin levels.

* Babies can not be treated for Hypoglycemia by supplementing breastmilk with formula.

* Formula contains cow protein which can increase the chance of an allergy.

* Formula increases the risk of diabetes in infants who are at higher risk.

* Formula can change the flora of baby’s gut.

* Formula supplements can also cause weight loss.

Water supplementation

* Extra water is not needed. A breastfed baby (even in the hottest climates) does not need extra water, breast milk contains everything baby needs.

* Water is sometimes given to lower bilirunin (babies with Jaundice), but this just makes the Jaundice worse.

* Water supplements do not prevent dehydration and they may even cause weight loss.

When is breast milk supplementation with formula acceptable?

(Feeding baby breast milk and formula)

* A breast milk supplement (if donor breast milk is not available) can be given to babies who are too weak to suck at the breast.

* A supplement with formula may be give to babies who have severe oral abnormalities. Even babies who have cleft lip/palate abnormalities have a chance at breastfeeding.

* Babies who are separated from the mother because of illness.

* Low birth weight babies. In this case it would be even more important that baby gets donor breast milk instead of just formula.

* Very premature babies who are born before 32 weeks. (Also always consider donor milk first)

* When there is not sufficient breast milk produced. Supplementing due to low supply.

* Dehydrated or malnourished infants .

* The death of the mother means that baby will need to be either fully formula fed or given donor supplement breast milk.

Stopping of breastfeeding temporarily (supplementation is needed)

* Mom has taken a medication that could be dangerous for baby such as anti-metabolites, radioactive iodine, or some anti-thyroid medications. So in other words, during the time that mom has these drugs in her system, she should supplement with formula or donor breast milk (if available)

* Mom is using street drugs such as heroine or cocaine. (A mother may continue to breastfeed with the use of tobacco and alcohol) While a mom has street drugs in her system, the baby will need to drink formula or donor breast milk only.

* The mother has the Human T-cell Leukemia Virus

* The mother has Varicella zoster (virus similar to chicken pox) During the infection mom can give baby formula and then continue to breastfeed afterwards.

* Mother has herpes simplex virus on her breasts. Once the sores have healed, breastfeeding is safe.

Babies who cannot drink breast milk

* A baby with galactosemia (rare condition in which baby cannot digest galactose in breast milk.)

* Babies with PKU who cannot tolerate phenylalanine.

* The mother is HIV positive. In some cases, moms with HIV are advised not to breastfeed at all but, in lower standard of living cases, it is sometimes best if mom continues to breastfeed.

Conditions in which breastfeeding should continue. (when it is not necessary to stop)

Hepatitis B, Tuberculosis, Lyme disease and Mastitis.

Tracy Behr, CBC, CLD (CBI)


Course information on supplementation.

Other pages on breastfeeding problems in connection with this page on supplementing breast milk

* Immunity that breast milk provides

* Mixing breast milk and formula

* Breast milk vs formula

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