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Heartbreaking, isn’t it?
When you have determined to exclusively breastfeed your newborn since birth..
But things didn’t go as planned.
You already nurse your baby all day and night.
Your nipple bled.
But.., your baby keeps losing weight…
With poor diaper counts
And finally that sentence-that-you-don’t-want-to-hear was out
Your lactation consultant asked you to start supplementing.
It seems that the earth stops spinning
You feel inadequate as a mom
How could you not provide enough for your baby?
You almost choked as you feed your baby with his first formula
Deep inside your heart, you wonder, “Could this be the end of my breastfeeding journey?”
Let me tell you something…
Breastfeeding is not all or none.
Yeah, you read that right.
If you cannot exclusively breastfeeding your baby, that’s totally fine.
Some breast milk is still better than none, and while you do supplement, please keep continue your breastfeeding effort.
But you ask, “How can I?”
Supplementing has such a BAD reputation of ruining breastfeeding journey.
Is that true?
The truth is.. the answer depends on YOU.
We all know that unnecessary supplementation will do more harm than good.
But we also know that if you have milk supply problem, the number 1 rule is to feed your baby! Be it with donor milk or formula, you got to do it.
But at the same time, do your best to find out what cause your milk supply issue, and how to solve it.
I myself started supplementing my first baby when he was 3 days old. That supplementing continued..
That supplementing continued.. until he was 18 months old.
But did I stop breastfeeding?
Nope, not at all..
I still breastfed him until he was 24 months old.
Are you supplementing while breastfeeding?
Or, do you plan to?
And so in this article, I would like to share some of the things that you should know about supplementing while breastfeeding.
1. Know how much exactly the amount of supplementation that your baby needs.
If somebody told you that a 2-day old baby need 60 ml milk per feeding, that’s totally bullshit.
Newborn has such a tiny tummy, approximately as big as a ping pong ball at day 3, which equates to 22-27 ml milk per feeding (Learn more about newborn tummy size here).
If you feed him with 60 ml of milk, that’s definitely overfeeding and it will do more harm on your milk supply since your baby will take less milk from you.
The most accurate way to calculate how much supplementation he needs is by consulting with a lactation consultant.
She may do a weight-test, i.e. weighing your baby before and after breastfeeding so that you know exactly how much milk that he got from your breast milk. Then, based on a baby chart, your lactation consultant could help you to determine the amount of supplementation by subtracting the amount of breast milk from the needed amount of milk that he needs in one feeding.
2. Avoid bottle-feeding before breastfeeding is truly established
I would discourage you to bottle-feed your baby in the early days.
Yes, I know, some mothers do it anyway, but if you can afford it, please please avoid bottle at first.
Bottle-feeding in the early days may gives you MORE problems and put your breastfeeding at risk.
This is because bottle-feeding can introduce nipple confusion and babies who accustomed to bottle’s fast flow may refuse to nurse at the breast (also known as breast refusal) because they have different mechanisms.
At the breast, the baby needs to do more efforts to stimulate let-down to get the milk flow. This is very different with bottle-feeding whereby the flow is almost instantaneous as you tip the bottle towards your baby’s mouth.
So now, how can you feed your baby?
If your goal is to supplement temporarily while building your supply, I strongly recommend you to try at-breast supplementer, such as Medela SNS.
Using this system, the milk is put inside a hanging bag, and fed to your baby with a little tube that is taped next to your nipple.
Does this sound troublesome?
Wait until you read these benefits of using supplemental nursing system:
- Using SNS allows you to feed the baby at your breast, just like real breastfeeding, allowing for more intimacy and bonding between you and your baby
- Since your baby is placed right to your skin, you are doing a lot more skin-to-skin contact, which is proven to help increasing milk supply
- Your baby will suck your nipple as he gets his milk. What does this mean? Yes, your breast get its most needed stimulation to make more milk!
Compare if you choose to spoon-feed your baby?
You need to spare other time to pump to stimulate your breast. Using SNS is much more convenient looking from this point of view because you save a lot of time.
Still not interested with SNS?
Okay, that’s fine.
You can choose to spoon-feed your baby. Simply place the milk inside a cup (I used Avent VIA Cup) and spoon the milk with a baby spoon.
I did it with my first baby until he was 2.5 months old.
If you think it sounds troublesome due to the possibly spilled milk, remember that your goal is to make this supplementation temporary.
So, you won’t do this forever.
3.If you don’t have option except by introducing bottle
If you don’t have other choice other than bottle-feeding, do consider the following:
- Choose a bottle teat with very slow flow (newborn flow) and keep at it no matter how old your baby is as long as your baby does not complain.
You don’t want your baby prefer bottle’s instantaneous fast flow due to careless nipple choice.
Research has shown that a teat with a wide base resemble breast more than the narrow ones, and helps your baby to keep his wide latch juat as he’s nursing at breast.
- Use paced-bottle feeding to let your baby controls how much milk he needs from the bottle.
We are all very accustomed to kind-of pushing the baby to finish the bottle, which can lead to over-feeding. Let baby decides how much milk he needs by pacing frequently while bottle-feeding him. Read more details here.
4. Should you put your baby at breast first, then supplement or the other way around?
The traditional wisdom is always to put your baby at breast first so that he can remove all the milk from the breast, and only if he’s still hungry, supplementation comes to the rescue.
But this approach has its drawback.
It may make baby thinks that happiness is associated with supplementation. After all, he would only feel content after he got his supplementation.
And additionally, an impatient baby may not be patient enough to deal with the slow milk flow from the breast (if you have milk supply issue) and will scream hard demanding his milk, leading to only very short nursing session before supplementation.
Diana West in her book, “A Breastfeeding Mother’s Guide to Making More Milk” offers a different perspective.
To slowly wean off from supplementation, she suggests to do ‘Finish at Breast’ method.
That is, to give the supplementation first to your baby, and after that, continue with breeastfeeding.
What benefits you get from Finish At Breast method:
- your baby is more patient in drawing milk from the breast, because he’s not in too-hungry state anymore
- your baby associates breast as a source of satisfaction (and so you do). Because he achieves his total fullness while nursing at the breast.
But how could this be used to wean off from supplementation?
The trick lies on the amount of supplementation that you give.
Once you figure out how much supplementation your baby need (see step 1), reduce that amount further – very slowly and gradually- from 0.25 ounce, then half ounce, and so on.
As you reduce the amount of milk you give, please observe how your baby responded.
Does he feel content even though you reduced the supplementation? You may also do your own weight test to ensure your baby gets adequate milk from you and the supplementation.
Don’t reduce too drastically!
The key is to do it very slowly and gradually. Or else, you will end up need to supplement before and after nursing. Read more details about this approach in her book.
5 How breast milk differs from formula and how your baby’s behavior may change
Do you supplement with formula?
Here are some of the things that you need to know about how formula feeding differs from breastfeeding.
- Formula milk needs longer time to digest compared to breast milk
And that’s why your baby appears to be content for much longer (and sleep longer) after formula feeding.
On the other hand, breast milk is easily digested, and a breastfed baby will need to nurse more often.
How this affects your confidence?
Of course, if you don’t know this fact, you may begin to think that your breast milk is not satisfying your baby, which is WRONG.
This can become even worse if people around you, say your mother/mother in law, make a comment on how easily your baby cry for more milk after breastfeeding.
And they may push you to give more formula so that the baby can sleep longer. Does this sound familiar?
Does this sound familiar? It happened to me before.
So, know this fact, so that if someone push you to give more supplementation unnecessarily, you know how to defend yourself.
- Your baby’s stool would be different in terms of consistency and frequency
A breastfed baby’s stool is characterized with the famous yellowish mustard paste. While the frequency may differ across babies, from as often as 10x every single day to as less frequent as once in two weeks. And yes, your baby is fine. Very few breastfed babies got diarrhea or constipated (except he’s ill).
What if you introduce formula milk to your baby?
The color of your baby’s stool may change. It may not be yellowish anymore.
Frequency-wise, formula-fed baby should be stooling at least once a day.
If he has not passed motion in 24 hours, watch out for the possible constipation.
6 Ensure correct latch for effective breast milk removal
While you nurse your baby, ensure that your baby is correctly latched. This is important as poor latch leads to ineffective milk removal, and hence, less breast stimulation to make more milk. Click here to learn more about ways to increase milk supply naturally.
7 Boost your milk supply with regular pumping
Remember, you don’t want to supplement forever.
To prevent your milk supply from diminishing further, do a regular pumping to stimulate your breast to make more milk.
You may only get drops at first, but if you continue doing it, you will see the amount increasing day by day. Read this guide to learn more how to pump milk effectively.
8. Increase your milk supply by consuming lactogenic food.
Additionally, don’t forget to eat milk-booster food or supplements. Fenugreek or nursing tea are popular among nursing mothers. If you are interested to know other food that can help boosting up your milk supply, these 10 foods may help you out.
I hope this article gives you a clearer overview on how to supplement while still breastfeeding your baby.
Remember, supplementation is not the end of your breastfeeding journey.
If done correctly, supplementation may even help you to breastfeed longer.
I can do it, and I believe, you can too!
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