MS, RD, LDN, CSSD, CBS
Rachel holds a Master’s in Nutrition Communication from Tufts University and is also a Board Certified Specialist in Sports Dietetics. She works as a nutrition and wellness coach with focuses on infant and maternal nutrition, and mindful eating.
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We always want to do what is best for our babies, and sometimes that means introducing formula to make sure you and your baby are happy and healthy.
When introducing formula or transitioning from breastmilk to formula, you might feel upset or guilty about changing your breastfeeding relationship with your baby or ending it earlier than planned. You may also feel relieved. All of these emotions are normal. Rest assured that a fed baby is what matters most.
There are plenty of situations in which supplementing with formula or switching from breastmilk to formula makes sense. Whether out of medical necessity or by choice, you will continue to support your baby’s growth and sustain a nurturing relationship when transitioning partially or fully to formula.
Here are some situations where supplementing with formula or switching from breastmilk to formula may be suggested:
Chat with a Happy Baby Expert to help you explore your options. Reach out to our team of registered dietitians and lactation consultant for free! They’re here to help on our free live chat from Monday – Friday, 8am-8pm (EST) and Saturday – Sunday, 8am-4pm (EST). Chat Now!
When bottle feeding a breastfed baby, the initial formula feeding pattern will mimic your breastfeeding pattern. For example, if you usually breastfeed 8 times per day, continue to offer formula that often. Listen to your little one’s hunger and fullness cues to know when they are ready to eat, and when they are ready to stop feeding from the bottle.14, 15
If you are taking out just one or a few breastfeeding sessions, such as if you are going back to work and are choosing not to pump, or do not have enough pumped milk available, offer a formula bottle for each breastfeeding session skipped.
Read more: Should I Feed On Demand or on a Schedule?
Learn about: Understanding your Baby’s Hunger and Fullness Cues
Generally, a breastfed baby will take about 3 to 5 ounces each feeding, so you can start with that amount of formula per bottle.16 Provide more or less depending on your little one’s hunger and fullness signs. Try not to make your baby finish a bottle if they are showing signs that they are satisfied.15
If you are transitioning fully to formula, eventually your little one may begin taking more ounces per bottle and eating less frequently.17 Follow their lead to know when they are ready for this transition.
Using paced bottle feeding can help with knowing when your baby is full. This type of responsive feeding will help you know you are giving your little one the right amount of formula.
Learn more: Paced Bottle Feeding
Read about: How Much Formula Does My Baby Need?
Read more: Everything You Need to Know About Preparing and Storing Infant Formula
When introducing a bottle and/or formula, many babies may become temporarily a bit gassier. This can be normal.
Formula may cause gas if a lot of bubbles or foam formed when shaking the powder and water together.20 This may allow baby to swallow more air. Let the bottle sit in the fridge until all bubbles have dispersed.
Good news: Most formulas can be prepared up to 24 hours in advance and kept in individual bottles in the refrigerator, allowing for plenty of time for the bubbles to reduce.
Incorrect bottle feeding and latch may also cause baby to swallow more air, which results in more gas.21 Used paced bottle feeding to help with this.
Be aware: Some babies may have a food intolerance or allergy to an ingredient in the formula. If you also notice changes in baby’s stool, such as mucous or blood; forceful vomiting; or excessive crying or fussiness after a feeding, chat with baby’s pediatrician about this possibility.22
Read more: How Do I Relieve Gas in my Formula or Bottle-Fed Baby?
Formula often causes stool to be a green, brown, or darker yellow color.30 These changes are usually normal.
Your little one knows what they like and what they are familiar with, and often that’s you! Moving to a latex nipple can be quite the adjustment for some babies.
Here are some tips to help your baby take a bottle
If your baby is refusing the bottle after a few days, try a different bottle and/or nipple.
For a younger infants, a small flexible cup (such as a medicine cup or a soft infant cup feeder), syringe, or spoon may be used.23, 25 These feeding methods require specific techniques, so call baby’s pediatrician before trying and consider meeting with a lactation consultant for personalized guidance.
For older infants try a slightly larger flexible cup (such as an infant or toddler training cup) or a sippy cup.27 By 6 months, littles ones are ready to learn to drink from a cup, so this transition may be a bit easier.29
Know that most little ones will begin to accept the bottle over time and with consistent introduction.
If your little one is refusing the bottle and you want to try one of the above methods, reach out to our team of registered dietitians and lactation consultants, chat here! Call baby’s pediatrician before making a switch to these methods.
Sometimes moms of fussy babies become nervous and assume they are not making enough milk and feel they should add formula. But milk production is a supply and demand relationship: you have to empty your breast in order for it to make more.31 By giving baby a bottle instead of putting them to your breast or pumping, you may be jeopardizing your milk supply.
If you are considering switching from breastmilk to formula because you are concerned that your supply is too low, or because breastfeeding is painful or challenging, consider contacting a lactation consultant first. A lactation consultant can help you assess your milk supply as well as baby’s latch.
Read more: Dealing with a Low Milk Supply
Breastfeeding is not all or nothing. Your baby will reap the benefits of breast milk for whatever duration you provide it, and in whatever quantity.33 If there is no medical indication to stop breastfeeding, you may want to breastfeed for one or two feedings (or more) and offer formula the remainder of the day.
Choose a time of day that feels right to you. Many moms breastfeed at night or first thing in the morning when the milk supply is highest. This lets the baby continue to receive breast milk’s immune properties and growth factors. Most women will continue to produce enough milk for breast feeding sessions while also down regulating supply for when formula is provided instead.35
But be sure to monitoring weight gain and diaper output to ensure your little one continues getting enough.32
Read more: What Do I Need to Know about Supplementing with Formula, Breastfeeding, and Pumping?
If your need for formula feeding is temporary (due to a medication you must take, for example), it’s important to pump to maintain your supply. This allows you to go back to nursing when it is safe to do so. Pump as many times as baby takes a bottle of formula to let your body know your baby still needs that much milk.32 Dump this milk if you must or freeze it if the milk is safe for your baby to drink later.
Read more: Everything You Need to Know About Pumping
Weaning too quickly may lead to engorgement, clogged ducts, and even mastitis. If possible, wean over several weeks, taking out only one to two breastfeeding sessions every few days and replacing them with formula.33
Your body will slowly reduce your breastmilk supply.
If you feel uncomfortable and engorged between feedings or pumping sessions:
Read more: How and When to Hand Express
Learn about: Preparing to Wean your Child
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 dietitian nutritionists certified in infant and maternal nutrition – and they’re all moms, too! They’re here to offer personalized support on our free, one-on-one, live chat platform Monday – Friday 8am-8pm (EST), and Saturday – Sunday 8am-4pm (EST). No appointment needed, no email or sign-up required. Chat Now!
Read more about the experts that help write our content!
For more on this topic, check out the following articles:
Pros and cons of cups sippy cups and straws for babies and toddlers
Choosing the right bottles and nipples for your baby
How much formula does your baby need?
Choosing the right bottles and nipples
Does your Baby Need a Sensitive Formula?
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2. Raghuveer TS, Garg U, Graf WD. Inborn errors of metabolism in infancy and early childhood: an update. Am Fam Physician. 2006 Jun 1;73(11):1981-90. https://pubmed.ncbi.nlm.nih.gov/16770930/
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6. Demirci, J., Schmella, M., Glasser, M. et al.Delayed Lactogenesis II and potential utility of antenatal milk expression in women developing late-onset preeclampsia: a case series. BMC Pregnancy Childbirth18, 68 (2018) https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-1693-5
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14. Centers for Disease Control and Prevention. Signs Your Child is Hungry and Full. Accessed 30 September 2021. https://www.cdc.gov/nutrition/infantandtoddlernutrition/mealtime/signs-your-child-is-hungry-or-full.html
15. American Academy of Pediatrics. Is Your Baby Hungry or Full? Responsive Feeding Explained. Accessed 30 September 2021. https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Is-Your-Baby-Hungry-or-Full-Responsive-Feeding-Explained.aspx
16. Institute of Medicine (US) Committee on Nutritional Status During Pregnancy and Lactation. Nutrition During Lactation. Washington (DC): National Academies Press (US); 1991. 5, Milk Volume. Available from: https://www.ncbi.nlm.nih.gov/books/NBK235589/
17. Breastfeeding USA. Breast Versus Bottle: How Much Milk Should Baby Take? Accessed 30 September 2021. https://breastfeedingusa.org/content/article/breast-versus-bottle-how-much-milk-should-baby-take
18. Dias CC, Figueiredo B. Breastfeeding and depression: a systematic review of the literature. J Affect Disord. 2015 Jan 15;171:142-54 https://pubmed.ncbi.nlm.nih.gov/25305429/
19. Yate ZM. A Qualitative Study on Negative Emotions Triggered by Breastfeeding; Describing the Phenomenon of Breastfeeding/Nursing Aversion and Agitation in Breastfeeding Mothers. Iran J Nurs Midwifery Res. 2017;22(6):449-454. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684792/
20. American Academy of Pediatrics. Breaking Up Gas. Accessed 30 September 2021. https://www.healthychildren.org/English/ages-stages/baby/diapers-clothing/Pages/Breaking-Up-Gas.aspx
21. Sferra TJ, Heitlinger LA. Gastrointestinal gas formation and infantile colic. Pediatr Clin North Am. 1996 Apr;43(2):489-510. https://pubmed.ncbi.nlm.nih.gov/8614612/
22. American Academy of Family Physicians. Infant Formula. Accessed 30 September 2021. https://familydoctor.org/infant-formula/
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24. Maxwell C, Fleming KM, Fleming V, Porcellato L. UK mothers’ experiences of bottle refusal by their breastfed baby. Matern Child Nutr. 2020;16(4):e13047. doi:10.1111/mcn.13047 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503095/
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26. Breastfeeding Support. Cup Feeding a Newborn. Accessed 30 September 2021. https://breastfeeding.support/cup-feeding-newborn/
27. Australian Breastfeeding Association. Cup-Feeding. Accessed 30 September 2021. https://www.breastfeeding.asn.au/bfinfo/cup-feeding
28. International Breastfeeding Centre. Finger and Cup Feeding. Accessed 30 September 2021. https://ibconline.ca/information-sheets/finger-and-cup-feeding/
29. Holt K., Woolridge N. Bright Futures: Nutrition Supervision, third edition. American Academy of Pediatrics. 2011 https://brightfutures.aap.org/Bright%20Futures%20Documents/BFNutrition3rdEditionSupervision.pdf
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31. USDA Women Infants and Children. How Breastmilk is Made. Accessed 30 September 2021. https://wicbreastfeeding.fns.usda.gov/how-breast-milk-made
32. Centers for Disease Control and Prevention. Pumping Breast Milk. Accessed 4 October 2021. https://www.cdc.gov/nutrition/infantandtoddlernutrition/breastfeeding/pumping-breast-milk.html
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34. Weaning from the breast. Paediatr Child Health. 2004;9(4):249-263. doi:10.1093/pch/9.4.249 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2720507/
35. Kelly Bonyata. Partial Weaning and Combination Feeding. Accessed 4 October 2021. https://kellymom.com/ages/weaning/wean-how/weaning-partial/