Four Ways to Supplement Breastmilk

Written by NPN Guest on February 18th, 2011

Edited by Suchada @ Mama Eve

Balance, Breastfeeding, Breastfeeding Alternatives, Feeding With Love, Work and Family
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baby learning to suck from bottle

Breastfeeding at the breast is the most normal way to feed a baby. Babies are born hard-wired to expect it and to seek it out.

When that normal feeding relationship is interrupted, what’s a mom (and her baby) to do? Breastfeeding doesn’t have to be all or nothing; that includes how you get the milk from point A to point B! (Or point Boob to point Baby!)

Here are some alternatives to at-breast feeding with their pros and cons. Note that this is a really cursory look, so you’ll need to research anything you’re planning to do more in-depth.

At-Breast Supplementation
When it comes to working to keep baby feeding at the breast, one of the best methods of supplementation is the Lact-Aid. (The Medela SNS or Supplemental Nursing System is also an option. I find most moms vastly prefer the Lact-Aid, though.) The concept is to fill a vessel with the supplement (expressed milk or formula) and feed baby at breast. A tube from the supplement runs into baby’s mouth. Without interrupting baby’s latch, baby is able to get both milk from mom’s breast and the supplement. This is incredibly important, since the baby will start making the association that suckling mom=food. There’s no nipple confusion here and every feeding counts toward re-establishing direct at-breast feeding with no supplement.

Alternate Supplementation (temporary)
If baby needs supplementation for some reason, some breastfeeding pros prefer to avoid artificial nipples. This avoids nipple confusion, which happens when the baby learns to suck the artificial nipple and then can’t coordinate the more complex movements of at-breast suckling. Methods include cup feeding (picture a soft medicine cup out of which baby sort of laps milk), dropper (picture an eye dropper), syringe, spoon, and finger feeding (finger feeding is done with a Lact-Aid or similar tool and is used where babies won’t latch at the breast at all).

Bottle Feeding (breastmilk or formula)
Expressed breastmilk is almost always preferable to formula (formula is only preferable in very rare circumstances). Regardless of what’s inside the bottle, though, there are some things caregivers can do to make bottle feeding a more positive, healthy experience for baby. The typical image of a bottle-fed baby is one of a baby cradled in-arms, on his or her back. This positioning doesn’t allow baby to pace the feeding. Here are some ways to make a bottle feeding session more like one at the breast (and there’s more at Kellymom.com):

  • Artificial nipples drip milk even when they’re not being sucked, so it’s akin to an adult chugging a drink – the goal is just to keep up with the flow. To avoid this, try to feed baby in an upright position.
  • Let the baby lead the feeding and decide how much to eat (the goal is a happy, fed baby; not an empty bottle and a note of “4oz.” on the care log).
  • There should be lots of pauses for baby to breathe. Note that there’s no standardized system for grading the flow of nipples, so testing them to see what’s truly slow-flow is necessary (because one company’s “slow” may be another’s “fast”).1 Also, never microwave or shake expressed milk; reheat it in hot water to avoid microwave hot-spots and swirl it to preserve the nutritional properties of the milk.

Exclusive Pumping (“EP’ing”)
Direct at-breast feedings are always preferable to expressed milk from a health perspective. Lactating breasts have the amazing ability to “read” baby’s saliva and produce custom antibodies to any bugs they’ve been exposed to. Sounds like science-fiction, right?! Feeding directly at breast fosters normal oral-motor development (which means less braces later!). Feeding with an artificial nipple doesn’t put baby’s mouth in the same position as breast; this could be another connection between formula feeding and SIDS. There are a lot of reasons to skip EP’ing if it’s at all possible. But expressed breastmilk fed via a bottle is still SO superior to any formula that it’s worth it, if it’s the only breast-milk-feeding option. It’s also great to give whatever breastmilk you can, even if you feed formula, too – every drop counts!

Those sum up a few options for supplementation and expressed milk feeding. Of course, if you’re working to supplement your way back to full-time at-breast feeding, the best thing you can do is work with a lactation pro who can help you plan the steps to meet your goal. If you’re going to be working or away from your baby regularly and using bottles to feed formula or expressed milk, learning the ways to make that experience as close to breastfeeding is a great way to mitigate any disadvantages. Even the exclusively bottle-fed baby can have a breastfeeding-like experience if baby’s caregivers all educate themselves on how to make that happen. At the end of the day, if you’re reading this, you’re probably doing your best to feed your baby the very best way you can – and that’s awesome!

Photo Credit: thedayhascome on Flickr

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Amy West is a Certified Lactation Counselor (and breastfed her daughter for 26 months!). She writes at Just West of Crunchy about transitioning from a disposable, toxic lifestyle to one that’s sustainable and people/earth-friendly.

  1. The authors of Balancing Breast and Bottle have done this; if bottle feeding is in your future long-term, this may be a good book to get.

7 Responses to Four Ways to Supplement Breastmilk

  1. Acacia

    Amy, thank you for sharing this information. I had no idea that some of these options existed. I will be happy to pass this information on to mommies I know who need it!

  2. Dou-la-la  

    Excellent article! This is a great resource. And thank you for the link!

  3. Alicia  

    “Lactating breasts have the amazing ability to “read” baby’s saliva and produce custom antibodies to any bugs they’ve been exposed to.”
    ^I am very interested in a source for the above information. I’ve heard the claim lots of times, but have not been able to find a primary source for this information. If true, this would really be a big difference between at-breast feeding and breast milk feeding. I read the above linked article from Dr. Jack Newman, but didn’t see this actual claim. We know that “the mother synthesizes antibodies when she ingests, inhales or otherwise comes in contact with a disease-causing agent” as the linked article states, but the question at hand is whether there is additional exposure specifically through the infant’s saliva at the breast. I, myself, have been challenged by others to find a source to back up this claim when I stated it, and I was only able to find very weak evidence. If you have a good primary source for this, I would love to read it! Thanks!

    • Amy West  

      @Alicia, there’s a link in the post that goes to Kellymom, which has sources for that info (did you click through the links at the bottom, which are the sources for Newman’s article there?). It’s definitely true, and so there really is a huge difference between at-breast and breast-milk feeding.

      • Alicia  

        I am very familiar with Kellymom, but I did not find a source that supported that specific claim. The link was to an article by Dr. Jack Newman, and I quoted his claim, which is of course very well documented, but not the same as what I am looking for. I am referring specifically to the claim that mother is exposed directly from saliva at the breast, as opposed to from the general shared environment. The latter is obviously very well-documented.

      • Amy West  

        There were 4 citations at the end of Newman’s Kellymom.com post. Those weren’t enough/suitable/what you were seeking?

  4. Amy West  

    There were 4 citations at the end of Newman’s Kellymom.com post. Those weren’t enough/suitable/what you were seeking?

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