Parenting

How should I introduce formula to a breastfed baby?

ParentingPublished Sep 8, 2017
By Bianca Mendez
mother and dad feeding babyiStock.com/SelectStock

If you've been exclusively breastfeeding and are getting ready to begin supplementing, you probably have questions about the best way to proceed. Get advice here from experts and moms who've successfully supplemented.

*Disclaimer: The advice on CafeMom.com is not a substitute for consultation with a medical professional or treatment for a specific condition. You should not use this information to diagnose or treat a health problem without consulting a qualified professional. Please contact your health-care provider with questions and concerns.

Go Slowly

"Begin with one feeding of formula each day for three days and see how baby tolerates it. If she tolerates the formula, you can slowly increase the formula-to-breast milk ratio. Signs of intolerance may include: vomiting, diarrhea, constipation, colic, bloody stools, reactive airway problems, and skin rashes. If your child is prone to allergies or has had any kind of intolerance or adverse reaction to breast milk or formula, consult your pediatrician before changing anything." -- Heidi Miller, pediatric speech pathologist and feeding specialist, Heidi Miller Speech LLC, Florham Park, NJ

Be Patient

"Try replacing one feeding in the afternoon with a bottle and see how your baby does. Some babies adjust well, while others take time to get used to the taste, texture, and actual use of a bottle. Give your baby as much time as he needs. The less stressful the process is, the more success he or she will have with it! As they get more comfortable, start replacing other feeds with formula as tolerated." -- Skyler Gardner, RN, BSN, Boston Children's Hospital, Boston, MA

Mix It Up

"My doctor recommended I slowly mix the formula into the breast milk. You can also use the breast milk supply you have and just continue to offer mixed bottles. The older they are, the easier it may be to introduce formula with fewer issues."

Breast Before Bottle

"I always nurse baby on both sides before giving her the supplement in the bottle. So, if you need to give eight ounces of formula per day for example, count back from bedtime and give two ounces after each of  the four daytime feedings."

Replace One Daily Feeding

"I replace one nursing session with a bottle of formula every other day, but not right before nap time or bedtime -- do that in the last couple of days, as he's more likely to resist if he's tired. You can even pump instead of nurse so he'll get used to the bottle."

We Used a 1:4 Ratio

"When we started supplementing formula for my daughter, she was pretty difficult about it. We mixed the formula at a 1-to-4 ratio of formula to breast milk and gradually increased the ratio. That helped reduce her resistance to it. Good luck!"

General Rules Vary Based on Age

When a nursing infant is supplemented with a formula feeding, it is important to first know that supplementing is different based on the infant’s age. A general rule of thumb is to supplement only 10 ml every 3 hours after the breastfeed during that first week of life if it is needed. You can also use an oral syringe or cup if a bottle is not desired. In fact, breastfeeding success has been measured to be greater if the mother uses this type of supplement strategy. If starting formula later, it is a good guideline to provide a similar skin to skin experience for the infant while bottle feeding as breastfeeding- hold the infant, and maintain some eye contact- don’t feed the bottle propped or in the car seat. --Christina J. Valentine MD,MS,RD,FAAP

Dr. Christina J. Valentine is a neonatologist, nutritionist, mom of 3, and proudly directs medical affairs for North America at RB

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