Supplementing with Formula

• at the breast;
• via pumped or breastmilk by cup, spoon, or infant feeding tube (oral), i.e. NOT by bottle;
• with pasteurized, screened, donor milk from one of the several human milk banks in the USA (yes, really and it’s safe–see the Human Milk Banking Association, www.hmba.org); and, lastly,
• with artificial baby milk–ABM for short–also known as infant formula. (World Health Organization (WHO), 2003).

In most cases, as you can see, WHO advises that infant formula be given only as a last resort to your baby. If breastfeeding is managed properly, there are only a few situations in which a baby needs more milk than its mother can provide; there are even fewer in which breastfeeding needs to be stopped.

You should also know that the most expedient way of undermining breastfeeding is to tell a new mother that she needs to supplement with formula as it can destroy her confidence in her body’s phenomenal ability to make milk. Supplementing during the first few days and/or taking the baby off the breast – even briefly—can be a slippery slope leading to breastfeeding problems and failure, often causing more problems than it attempts to solve.

e’ve seen many women encounter difficulties that could have been avoided; difficulties which were then not managed properly by health care providers. The end result is that the mother stops breastfeeding before she wants to, and thinks she couldn’t breastfeed, when in fact most of the time she was simply not properly supported to be successful.

That said, let’s talk realistically about ABM, or formula. While giving your baby a little formula will certainly not ruin him forever, it does have decided consequences for your baby and for breastfeeding. Supplementing with formula:

• will completely change – for many weeks or more — the healthy balance of beneficial gut flora that breastfeeding achieves in your baby. The healthy bacteria and infection-fighters contained in your colostrum and milk are responsible for jump-starting your baby’s immune system and protecting him from common infections like strep, staph, e.coli, rotovirus, etc. (Hanson, 2004);
• can wreck your confidence in your ability to breastfeed without the help of artificial milk. Basically, being told that formula is needed can be the equivalent of being told that you or your milk are just not enough for your baby. Many mothers lose their confidence right then and there — especially first-time mothers — and never fully get it back. They wind up doubting their ability to satisfy their babies in general and give up nursing prematurely. There are many reliable studies which prove that giving even one bottle of formula in the early days of life (Hall et al, 2002; Hornell et al, 2001) and taking home a “free” diaper bag with formula samples (Rosenberg et al, 2008), will have the effect of shortening the overall duration that that mother breastfeeds.
• can compromise your milk supply. Your breasts need the constant stimulation of your infant’s suckling to bring on a full and perfect milk supply. Adding formula to your baby’s diet will mean less breastfeeding, which means you may produce less milk; and
• can teach baby some bad latching habits! Breastfeeding is instinctive, but there is a learning curve involved – usually about 4-6 weeks. Most babies need to practice milking the breast for a few days to master the skill of suckling. Milking a breast is nothing like sucking on an artificial (bottle) nipple. Many newborns who receive early bottles will quickly develop a preference for the faster flow of a bottle and become accustomed to sucking that way. When it’s time to get your baby back on the breast, you may have a hard time with getting the baby to be patient at the breast and/or with sore nipples from your baby’s new “bottle” latch.

We are certainly not saying that you should not use formula if it is medically necessary. We are saying that those circumstances are actually few, and that the current recommendations are to try human milk supplementation before formula if possible because there are real consequences for you and your baby from supplementing early on. Ask your hospital if they keep  frozen, donated, screened and pasteurized human milk.