Supplementing a Breastfed Baby

A supplement is a feeding provided to a child in addition to, or as a substitute for, breastfeeding. When choosing a supplement, the best choice is your own expressed breast milk. Other safe supplements are infant formula or donor breast milk that's been screened and pasteurized. An older child can receive cow's milk, but cow's milk should not be used as a supplement for a child under the age of one year.

Why a Breastfed Baby May Need to Be Supplemented

Most babies can exclusively breastfeed for the first six months of life. However, there are some situations when a supplement may be necessary. Here are some of the reasons your doctor may recommend a supplement for your baby:

• Your baby is not latching on to the breast
• Your child is not gaining weight
• Your baby has a sucking issue such as a weak suck, a cleft lip/palate, or tongue-tie
• You're breastfeeding a premature baby
• You've decided to breastfeed your adopted child
• You have a low breast milk supply
• You're breastfeeding after breast surgery
• You have very sore nipples
• You have stopped breastfeeding and wish to start again

How to Supplement Your Breastfed Baby

A Nursing Supplementer: A nursing supplementer is a device that delivers a supplement to your baby while she's latched onto your breast and breastfeeding. A nursing supplementer is the preferred method for providing additional nutritional support to a breastfed baby since it doesn't interfere with breastfeeding. The supplementer consists of a container filled with your expressed breast milk, donor breast milk, or infant formula. The container connects to a tube that's secured at the tip of your nipple. The tube acts like a straw. As your baby nurses, she draws the breast milk from your breast along with the additional milk from the supplementer into her mouth. A nursing supplementer helps to ensure that your baby gets enough nutrition while allowing your child to continue to stimulate your breasts to build up your breast milk supply.

Finger Feeding: If your baby is having trouble latching on the breast, or if you have extremely sore nipples that need a break from breastfeeding, you can try finger feeding. Finger feeding is similar to breastfeeding with a nursing supplementer device. Except, instead of attaching the supplementer to your nipple, you attach the tube to the tip of your finger. Then, you place your finger in the baby's mouth. As your child sucks on your finger, the feeding will be drawn from the supplementer into her mouth.

Cup Feeding: Babies can drink from a cup, even small babies. To feed a baby using a cup, bring the cup filled with the supplemental milk to the baby's mouth and let him drink it. After each swallow, repeat the process until the desired amount of supplement has been given. It's really important that the milk is not poured into the baby's mouth. Just go slow and let the baby take the milk on his own. If you're supplementing an older baby, cup feeding is ideal. Infants can begin learning how to drink from a sippy type cup by approximately six months of age.

Spoon, Dropper, or Syringe Feeding: Milk placed on a spoon, in a dropper, or in a syringe can be slowly placed into the baby's mouth in very small amounts. Each time the baby swallows, a little more is introduced into the mouth until the feeding is complete. These types of feedings are best for very young infants who only require a small amount of supplementation.

Bottle-Feeding: Bottle feeding is perhaps the most common and most convenient way to provide a supplement. Bottles and nipples are readily available and easy to use. There are many brands and types of bottles and nipples, so you may want to try a few different styles to see which your baby prefers. A bottle with a slower flow nipple is usually better for a breastfed baby. Faster flow nipples make it easier to get milk out of the bottle, which for some babies can lead to a preference for the bottle. If you're having trouble deciding on a bottle, talk to the baby's pediatrician for recommendations.

Which Alternative Feeding Method Is The Best?

A nursing supplementer is the preferred method for supplementing a breastfed baby if the child can latch on and nurse. Finger feeding is a good alternative to a nursing supplementer when breastfeeding is not possible. Bottle feeding may be the easiest way to supplement a baby, but it's the method most likely to undermine breastfeeding. Although some infants can go back and forth between a bottle and breastfeeding without a problem, other infants may develop nipple confusion or refuse to breastfeed once a bottle is introduced.

A Warning About Alternative Feeding Methods

Cup, spoon, syringe, and dropper feedings must be carried out carefully. These methods are not as safe as using a nursing supplementer or a bottle. If too much milk is given to the baby at one time, or the supplement is allowed to flow continuously into the baby's mouth, it could go into the child's lungs. The inhalation, or aspiration, of a supplement into the lungs is a very dangerous situation. If your doctor or lactation consultant recommends cup, spoon, syringe, or dropper feedings, be sure that you are taught the correct technique for these feedings, and that you feel comfortable using them.