Very often mothers are being asked to supplement their babies either in the hospital after birth, or by their pediatrician in the early weeks. It is no surprise to me that doctors prefer a mother to supplement their baby with a bottle, in a fashion that will allow them to chart an exact amount of what a baby is eating. I wish there was a meter on the breast that told you exactly how much your baby was drinking, alas there is not so we work with what Mother Nature has given us. Thankfully, Mother Nature has actually given us a lot to work with, and there are quite a few ways to know that your baby is getting plenty of milk, but that is a whole other post!
There are many different reasons your doctor may suggest supplementing your baby. Did you know that supplementing with infant formula is not the only option? You can, and it is preferable to, supplement your baby with your own expressed breastmilk! Did you also know that you do not need a bottle to supplement? That is right! There are other methods other than a bottle to supplement your baby. I am not saying that you should not bottle feed your baby, and I am not concerned about nipple confusion. I am concerned however about baby preferring the ease of a bottle over the work required to nurse at the breast. When given a bottle, the bottle has control of the milk flow, whereas at the breast baby is in the lead. I always recommend waiting until baby is at least six weeks old to introduce a bottle, and when you do to use a paced method of feeding.
In the case that you and your doctor decide that supplementing is best course of action for your situation, I always advise that you get in contact with your professional breastfeeding support person. She can help you navigate the process of supplementation and maintaining your milk supply- especially if your reason for supplementation is that your baby isn’t able to nurse. When you find yourself needing to offer your baby expressed milk, there needs to be a balance between how much and often baby is given the milk and how often you are stimulating your breasts to ensure you will have an adequate milk supply for your baby when they are nursing exclusively at the breast again, if that is your goal.
There are different methods you can use to express your breastmilk for your baby. The first, obvious method is an electric breast pump. It is important if you are using a breast pump to ensure that it is fitting you properly. The flange, or breast shield, is not a one size fits all piece of equipment. You may need to change the size you are using, and sometimes even need different sizes for each breast depending on your anatomy. If you are not using the proper size breast shield pumping will not be as effective as it could be and you may damage your nipples. Ouch! The other method for milk removal is hand expression. Hand expression is highly effective, and preferred during the first 24-48 hours after giving birth. This is especially so if you had IV fluids during your birth as the fluids can cause excess swelling in your breast tissue that can interfere with using an electric breast pump. Hand expression is fast, easy, and more conducive to milk collection when you are producing colostrum.
During the first few days your body will produce colostrum, which is measured in drops. Trying to collect colostrum in a pump doesn’t work, as the colostrum drops will dry to the pump parts before it has a chance to collect into the attached bottle. This is extremely discouraging to a mom who may already be fearful that she will not produce enough milk for her baby. When using hand expression, you can collect your milk in the same vessel you plan to use to feed your baby. You can use a spoon, or a small cup with a rounded edge like the one in the picture. It is very easy to fill up a spoon with drops of milk. It would take no time at all! All you need to do then is bring the milk to your baby’s lips and allow baby to lap up the milk like a kitten- yes your baby will do this! You can also use a syringe to extract the milk from the spoon or cup and slowly drip the milk into baby’s mouth, sometimes even while they suckle on your pinky. This method is favored by doctors so they can measure the amount in milliliters (ml), though you could also test to see how many ml of liquid your spoon holds, and track that way too!
Your baby’s belly is extremely tiny in those early days. At birth your baby’s tummy is about the size of cherry and can hold about a teaspoon of milk per feeding, that’s only about 5 ml! Your baby’s stomach will slowly increase over the first weeks until eventually reaching maximum capacity which is average 3.5oz per feeding. The amount of milk your baby should be eating depends on their age and their weight until baby is over 10lbs. Once baby is 10lbs you can expect baby to drink 25-32oz in a 24 hour period, and it will not increase after that. Always check in with your breastfeeding expert and your pediatrician to know exactly how much milk your baby should be drinking.
It is important to make sure to always offer the breast to your baby first before offering a supplement. This will ensure adequate stimulation at the breast, and allow baby to have their suckling needs met. After a nursing session, offer the supplement to your baby and be sure to express breast milk every time a supplement is given. Your milk supply works on a process of supply and demand. So, if baby is drinking the supplement, it will take time away from the breast, so you need to make up that time by either hand expressing or pumping your milk. Your breastfeeding professional can assist you with this process. If your baby is not latching at the breast, or you are separated from your baby, it is imperative you seek professional breastfeeding support so that you can create a plan of action to establish your milk supply and make sure your baby’s feeding needs are being met.
My hope for all of my clients, and every mom, is that breastfeeding goes well from the start and no intervention is ever needed. When intervention is needed, I am confident however that with the right support virtually anyone can have the breastfeeding relationship they desire, however long they desire it to be. I wish you all healthy pregnancies and easy breastfeeding!
Your Successful Breastfeeding Expert Kelly
Kelly Maher, CLC, CLE