Mothers feel they are not producing enough milk → Gives bottle of formula to “top off baby” → Baby overeats and falls asleep → Their stomach has stretched and is full, causing them to sleep/skip through next feeding → Baby is now spending less and less time at the breast → Less milk is produced → Mom and baby are frustrated at the breast → further convincing mom her milk supply was not satisfactory on its own, and perhaps creating the very issue that may have not been initially present
Over 90% of the time, there is not a medical need for supplementation¹. If the baby is having all opportunities to go to the breast: no time restraint, no routine stopping them from completing a feed, your baby’s early feeding cues are acknowledged... truly feeding “on demand” and without pressure of a schedule or pacifier, and any struggles are addressed and handled by a lactation professional, milk supply adjusts to keep up. The woman’s body is trusted to sustain a baby’s growth throughout the pregnancy. We are not inherently designed to not produce enough food just because the baby is now born. Breastfeeding is designed for small and frequent feedings, which is not always understood or known. The body’s goal is to produce enough milk for the baby it has just made, or enough for multiples. Obstacles get in the way of that design, and supplementation becomes the answer, or a bandaid that too often does not get the instructions on how to get back to exclusivity, and how to protect milk supply.
There is a brilliant protein called, “FIL” - feedback inhibitor of lactation. If you skip a feed to bottle feed or wait to feel full, this protein sends signals to the brain to say the breast is full so do not send milk production signals at this moment. When the breast has been fed from or expressed, the protein does the opposite. Emptied breasts make more milk faster. In other words, a mother should not wait to feel full of milk to offer the breast. This protein communicates as a stopper when the milk storage in the breast tissue is full, but also a usage gauge, calculating supply needs. If feeds are prolonged or bottle feeding is needed, breastmilk still needs to be expressed for that feeding to tell the body it is still needed.
There may be many reasons why someone has dabbled into the supplementing spiral, and as long as mothers have an informed plan to return exclusively breastfeeding ( as WHO recommends for up to 6 months) or continue the supplemental feeds, or decide to exclusively by pump this is your BF journey and with the right educated advice and support you will be fine. IBCLCs are a great place for this type of planning.
For those who have problems regardless with milk production, do not produce enough milk- glandular tissue and conditions that put moms at risk, there is the need for supplementation and is what allows mothers to be feed their babies, while still offering breastmilk, where able. Formula is a tool, and when used appropriately, can help buy time for the mother to get help with breastfeeding. Other tools, such as SNS (supplemental nursing system), can be a wonderful way for babies learning to suck and latch. Mothers need professional support and resources during this time.
If you find yourself needing help, schedule an appointment today with an IBCLC.