Rules of Supplementation

supplementation rules

Breastfeeding can be tough.  We’re exhausted, they’re crying (and sometimes we are too), and you can never be sure that they’re getting enough to eat.  I promise it will get easier!!!  It is totally normal for a breastfeeding baby to lose a good bit of weight in the first few days of life.  But if your little one has lost more than 10% or there are other medical concerns, your pediatrician may recommend supplementation.

The idea of supplementation really messes with a lot of parents’ heads.  Thoughts of destruction of milk supply and nipple confusion swoop thru their sleep deprived brains.  I totally get it.  Been there, done that.  But try not to stress if your doctor is recommending supplementation.  There are some rules you can follow to ensure good breastfeeding success.

Make a visit to your friendly neighborhood lactation consultant

If your baby has lost more than 10% of their birth weight, I nearly universally recommend an evaluation by the lactation consultant.  They can help you make sure your baby’s latch is good and can even check before and after weights to see how much milk your little one is transferring.  I know it can be awkward to just pop out the boobs, but your lactation consultant is a wonderful resource and they want you to be successful too.

Don’t overdo it

Unless specifically told to give more, limit your supplements to 15 ml after each breastfeeding session.  The goal of supplementation is to give just enough liquid and calories to give them a bit of energy to nurse more effectively.  But not enough to totally fill them up and make them not want to nurse in a couple of hours.  It’s a delightful balancing game.

Set a regular feeding schedule

Even if your mini is wanting to sleep all day, try to waken them every 2 hours during the day and every 3-4 hours at night.  Your goal for breastfeeding is 10-12 feedings per day.  It’s a LOT!!  The only way we can get our milk in is to make sure our babies are nursing a lot.

If you need to supplement, you need to pump

Breastfeeding is a supply and demand game.  So if we’re not making enough yet for our baby to gain weight, we need to tell our body to make more.  And giving a supplementation will help your baby, but gives no heads up to the breast tissue.  So every time you supplement, make sure you pump for 10 minutes on each breast as well.  In a few days, your milk supply will bump up and things will become much easier and the amount of supplementation will go down.

Try doing the supplementation with a syringe

For many parents, giving the 15 ml of supplementation with a syringe is much easier and really cuts down on some of the issues with nipple confusion.  You either use expressed breast milk or mix the formula and draw up 15 ml into a medicine syringe and then drip it into your baby’s mouth.  This is a quick and easy solution and tends to set the mind at ease as far as the latch goes.

Have your partner give the supplement while you pump

When you are having feeding and weight gain issues in the first couple of weeks, it will likely feel like you are participating in feeding related activities ALL THE TIME.  And really, you are.  To help make the feedings go more smoothly, I generally recommend for a family member to give the supplement while mom is pumping.  Your basic schedule may look a little like this..

  • Nurse 15 minutes each side (30 minutes)

  • Mom pumps for 10 minutes while family member gives supplement of 15 ml (10 minutes)

  • Mom passes out for well deserved nap while family member tends to and changes baby (1 hour 20 minutes)

  • Start over

Obviously this is a loose schedule, but you get the point.

Check in with your doctor

Don’t forget to check in with your doctor in a few days to make sure your baby’s weight is starting to pick up.  As your milk comes in, your baby will no longer need supplements.  Everyone may do it different, but I like to cut out the middle of the night pumping/supplementation sessions first.  Because we all need sleep.

For more information on getting sleep and breastfeeding, check out this post on how to help your breastfeeding baby sleep.

Author: Dr. Jenny Seawell

Dr. Jennifer Seawell is a board certified pediatrician currently practicing in Tennessee. She is married with 2 daughters aged 7 and 13.

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