As all of us know, breast milk is the most nutritious, most solidly made merchandise you could ever nourish your baby. However, for some women, like me, breastfeeding (or breastfeeding exclusively) is not really an option. This is a gut wrenching choice, but in the event that you can’t feed your baby breast milk exclusively, we here in the modern era are very blessed to have the option of feeding or supplementing your baby’s diet with formula.

Just like everything else associated with having a baby, this leads to a lot of questions and choices. How do I know whether I’m making enough breast milk? How can I know how much to feed my baby? When I do, and this formula should I choose and how do I be sure I am not over or underfeeding? Infants are designed to live on short rations. It took me a shocking three full weeks to realize my baby was not getting enough to eat and, a decade later, he is still flourishing. You will know whether your baby is not getting enough to eat since they’re also designed to let you know in no uncertain terms that they are still hungry whenever your breast milk is done flowing. Other than”un-latching” and trying to latch back , your baby will let you know with lip smacking sounds, rooting and, of course, crying and fussing. On the other hand, when a baby is fulfilled with his rations, he’s visibly satisfied, is usually nearly falling asleep and occasionally looks like he has just had one cocktail too many.

Babies that are getting enough to eat also obtain weight regularly following the first week, have more than five wet diapers a day and poop at least twice a day so don’t await your doctor to announce that your baby is”thriving.” Your baby needs approximately two ounces of breast milk or formula per pound of body fat so if your baby weighs in at ten pounds, you need to nourish him 20 ounces a day (this is an estimate! Your mileage may vary!) .

Pumping your breast milk for a day or two might allow you to confirm that you’re not making enough however, again, your baby is already telling you what you want to understand so listen up. Focus on your baby’s cues and if, as happened to us, you understand that you’re not producing enough breast milk, talk with your physician for recommendations and get some baby formula immediately.

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mother holding bottle for baby who is eating

Is it okay to supplement my breastfed baby’s diet with formula?

Yes, it’s perfectly safe to supplement a breastfed baby’s diet with formula. Some moms decide to supplement with formula when they go back to work. They may have trouble pumping regularly, but they don’t want to give up nursing entirely.

Others supplement because their baby isn’t getting enough breast milk to grow properly. And many moms just want the freedom to let a family member or babysitter give an occasional bottle.

Whatever your reasons for supplementing, keep in mind that any amount of breast milk is always better than none, so the longer you can nurse your baby, the better – even if it’s just once or twice a day. Although formula provides all the nutrients your baby needs, it lacks the unique immune factors that can protect your baby from some illnesses.

Will supplementing with formula affect my milk supply?

Your supply of breast milk depends on your baby’s demand for it, so the less often you nurse, the less milk your breasts will produce.

If you supplement with one or two bottles a week, the effect on your milk supply should be minimal. But if you start supplementing with formula regularly, even for just one feeding a day, your milk supply will diminish (at least until you reinstate the missed feeding).

You can also pump breast milk when you’re giving your baby supplemental formula to build up a bank of expressed milk to freeze and use later. This will help to keep your milk supply up, even as you’re bottle-feeding with formula or breast milk more frequently.

How do I know whether my baby’s getting enough breast milk?

Many mothers worry that they’re not producing enough milk for their babies, but most women make plenty of milk. Here are three ways you can tell whether your baby’s getting enough:

  • Plenty of dirty diapers. A baby younger than 1 month old who’s nursing well will have frequent mustard-yellow stools. Some babies have one after every feeding. Your baby will also have six to eight wet diapers a day if he’s getting enough breast milk.
  • Weigh your baby several times a week. He should be gaining an average of half an ounce to an ounce a day during the first three months, and half an ounce a day between 3 and 6 months.
  • Frequent, round-the-clock nursing. You’re breastfeeding at least seven times every 24 hours. (During your baby’s first month, you should nurse even more, at least eight to 12 times per day.) Even if your baby wants to nurse all the time, that doesn’t necessarily mean he’s hungry. Some babies nurse for comfort, have a strong urge to suck, or simply crave contact with their mother.
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What are some signs that my baby needs supplemental formula for growth?

Talk to your baby’s doctor if you have any concerns about your baby’s weight gain, growth, or eating habits. Here are some symptoms that warrant a call:

  • More than normal weight loss in a newborn. Babies lose up to 10 percent of their birth weight during the first five days of life. By day five, they start to gain about an ounce a day, and by 2 weeks they should be back up to their birth weight.
  • Your breasts don’t feel soft or empty after nursing, which could be a sign that your baby isn’t taking in enough milk.
  • Fewer than six wet diapers in a 24-hour period once your baby is 5 days old.
  • Fussiness or lethargy most of the time.

When can I start supplementing with formula?

If your baby is a newborn, you might want to wait until he’s at least a month old before you introduce formula. Lactation consultants recommend waiting this long to allow your breastfeeding routine and your milk supply to become well established so an occasional bottle won’t disrupt the routine too much. At this age most babies aren’t completely reluctant to try a bottle or a new food source.

What’s the best way to introduce a bottle?

Unfortunately there’s no perfect way to start supplementing, and it’s common for babies to refuse formula in a bottle initially. Don’t give up too easily – it may take more than a few tries to get your baby to drink formula from a bottle.

Some babies will just go with the flow and, if they’re hungry, take whatever you give them. Others may refuse a bottle the first few times it’s offered, especially if you’re the one offering it. That’s because your baby can smell you and would probably prefer the real thing, which is sweeter.

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If your baby is used to taking a bottle of breast milk, the transition may be a bit easier, though she may turn up her nose at what’s in the bottle.

To make this transition smoother, let your partner or a friend offer the first few bottles. You might also try giving the bottle when your baby is hungry rather than at a feeding when she might be nursing as much for comfort as for nourishment.

Can I mix breast milk and formula in one bottle?

Lactation consultants say it’s better not to mix breast milk with formula because you may end up wasting that hard-earned breast milk if your baby doesn’t finish the bottle. Instead, feed your baby the pumped breast milk first, and if he still seems hungry, offer a new bottle with formula.

How will supplementing with formula affect my baby?

If you start supplementing regularly, your baby might start refusing the breast. A bottle delivers milk faster than a breast, so if your baby’s an enthusiastic eater, she might prefer the bottle’s quick delivery system.

If your baby’s having any problems with formula feeding, our tool can help.

You might also notice that your baby’s willing to go a little bit longer after a meal of formula. That’s because babies don’t digest formula as quickly as they digest breast milk, so they’re likely to feel full longer.

Your baby’s bowel movements will be markedly different once she’s drinking some formula. They’ll be firmer than they were when she was drinking only breast milk, about the consistency of peanut butter. They’ll be tan or brown in color, have a stronger odor, and probably be less frequent than when she was drinking only breast milk.

If your baby’s vomit or stool contains spots of blood after you introduce formula, call your baby’s doctor. This is a sign of milk intolerance.

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