What do I need to know about supplementing with formula, breastfeeding, and pumping?

TheresaMA, RD

If your baby is not gaining weight well, sometimes formula supplementation is recommended.  However, this does not need to be the end of your breastfeeding journey! If your goal is continued breastfeeding, there are strategies that can help protect your milk supply, as well as potentially build it up. 

When it comes to milk supply, what’s most important is how often we pump or feed, and if we are emptying the breast. The more we take milk out of the breast, the more milk the body will make. Should you like to continue breastfeeding, it is likely necessary to pump regularly in order to keep up your supply. 

For example, if you are giving formula during a time that you would normally be breastfeeding, pumping during this time will ensure the body knows baby still needs that milk.  If your goal is to increase supply, you may consider pumping after each time baby feeds to help stimulate the body to make more milk.

Seeing a lactation consultant in person will be most helpful in detecting correctible problems with latch, position and supply.*

What order do I feed breastmilk/formula and pump in?

If you are striving for an increased milk supply, your goal would be to nurse the baby, supplement with formula and then pump. This can be quite an intensive process for a mom of a newborn, and while some moms may find this schedule worthwhile, you may reevaluate your feeding goals over time.

If the goal is not to eventually exclusively breastfeed, or if mom plans to wean to formula, simply breastfeeding then providing formula may be a great strategy.

Your pediatrician and/or lactation consultant will guide you as to how much and how often you should be giving your baby a bottle of supplemental formula.

Supplementing with breastmilk

In many cases the ability to supplement with breastmilk instead of formula is possible, so be sure and discuss this option with your pediatrician. Once you get into the routine of nursing, feeding and pumping, you may be able to build up a stash of breastmilk that can be used to supplement baby instead of formula.

Feed on demand, use a slow flow nipple and use paced bottle feedings to minimize nipple confusion.

Babies latch differently at the bottle than they do the breast, which may cause a shallow more painful latch when breastfeeding. It is also easier for babies to get milk from the bottle compared to the breast, sometimes creating a frustrated baby when trying to breastfeed. Here are a few things you can do to help minimize nipple confusion.

Paced bottle feeding: Place the bottle at the tip of baby’s lips or stroke lips with the bottle. Keep the bottle as horizontal as possible – without letting air into the nipple – to allow milk to be drawn out rather than dripped into the baby’s mouth.  Baby will be mostly upright when feeding, rather than lying back. Frequently pause and tip the nipple down after every few suck/swallow cycles in order to help baby attain a natural rhythm that mimics nursing at the breast.

Hand massage / expression: Before putting baby to the breast, hand express or massage the breast until you feel milk is about to come out. This way breastmilk is ready to go, just like with a bottle, when baby latches. This can help reduce frustration.

Every infant feeding journey is different.

While making the decision to supplement is never taken lightly, you have to do what is best for you and your baby.  Providing breastmilk in any amount will help your little one continue to reap benefits beyond tailored nutrition, including immune factors, probiotics, and antibacterial properties.  Reaching out to a lactation specialist can help you achieve your goals and ensure your baby is well nourished.

*to find a lactation specialist, check out the following resources:

We know parenting often means sleepless nights, stressful days, and countless questions and confusion, and we want to support you in your feeding journey and beyond. Our Happy Baby Experts are a team of lactation consultants and registered dietitians certified in infant and maternal nutrition – and they’re all moms, too, which means they’ve been there and seen that. They’re here to help on our free, live chat platform Mon-Fri 8am-8pm (EST), and Sat-Sun 8am-4pm (EST). Chat Now!

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