Supplementing Breast Milk

bottle fed baby, baby with bottle, bottle feeding breast milk

Can I Feed my Baby Breast milk and Formula?

Feeding your baby formula and breast milk together is not recommended under normal circumstances. If you breastfeed exclusively, it is the best thing you can do for your baby.

Unfortunately, there are a few times when a baby has to be supplemented with formula. In some cases, feeding the baby a combination of 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 and/or Water

  • An artificial nipple may cause nipple confusionsuck problems and refusal of the breast. This usually occurs, if a baby is younger than 6 weeks and an artificial nipple is introduced.
  • Supplementing will decrease milk supply. A baby might not drink from the mother as much and therefore her supply will decrease. 
  • Supplementing breast milk may lead to the breasts becoming engorged and painful. 
  • Most mothers who supplement, end up breastfeeding for only a short period of time.
  • To supplement breastmilk with formula will not help combat Jaundice, but will make it worse. Breast milk acts like a natural laxative to eliminate meconium and this helps in lowering bilirubin levels. A mother should only supplement, if she does not have enough milk.
  • Babies can not be treated for Hypoglycemia by supplementing breastmilk with formula. 
  • Formula contains cow protein, which can increase the risk of allergies. Breast milk protects a baby's gut and digestive tract. 
  • Formula increases the risk of diabetes in infants who are already at higher risk. 
  • Formula can change the flora of a 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 a 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 (preferably breast milk) 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. Babies who suffer from cleft lip/palate abnormalities are not always completely unable to breastfeed.
  • Babies who are separated from the mother because of illness. 
  • Low birth weight babies. In this case it would be even more important that a 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 a baby will need to be either fully formula fed or given donor supplement breast milk.

Should I give my breastfed baby Pedialyte?

Supplementation is Needed Temporarily

Stopping breastfeeding temporarily

  • The mother has taken a medication that could be dangerous for her baby such as anti-metabolites, radioactive iodine, or some anti-thyroid medications. So in other words, during the time that the mother has these drugs in her system, she should supplement with formula or donor breast milk (if available).
  • The mother is using street drugs such as heroine or cocaine. 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 she can give her baby formula and then continue to breastfeed afterwards.
  • The 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. This is a rare condition in which a baby cannot digest galactose in milk.
  • Babies with PKU who cannot tolerate phenylalanine. 
  • The mother is HIV positive. In some cases, mothers with HIV are advised not to breastfeed at all but, in lower standard of living cases, it is sometimes best if a mother continues to breastfeed. 

When it is Not Necessary to Stop

Some conditions in which breastfeeding should continue.

Hepatitis B, Tuberculosis, Lyme disease and Mastitis.

Breastfeeding Using a Lactation Aid with Dr. Jack Newman

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

* Ideal for long-term supplemental feedings at the breast

* Adjustable flow-rate system and Color-coded tubes for different feed rates

* Neck strap for maximum convenience...

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