I'm Told my Baby Needs Supplementation...Now What?

Written by Danielle Blair, MS, IBCLC

If you are planning to exclusively breastfeed your baby, the thought of being told to offer supplements (meaning extra milk in addition to direct breastfeeding) for your baby may be downright terrifying.  You may be concerned about nipple confusion, milk supply, or exposing your baby to formula.  Hopefully by learning about common reasons for supplementation and supplementation methods, you can avoid unnecessary supplementation and learn how to offer supplements in ways that are less likely to interfere with breastfeeding.


Why might a baby need to be supplemented?

There are many common reasons why a baby might need supplemental feedings.  It is important for you as a parent to advocate for your baby by making an informed decision that the supplement is medically necessary.  Some common medical issues that can arise shortly after birth that may lead to supplements are prematurity, low birth weight, poor feeding, low blood sugar levels (hypoglycemia), elevated bilirubin levels (jaundice), dehydration, excessive weight loss or poor weight gain.  In all of these cases, the first step is to ensure that baby is breastfeeding effectively.  If not, a supplement might be called for as part of the baby's medical treatment.

Gerber to the Rescue (Or So They Want You To Think)

We’ve all been there. 

You’ve been home with your new baby for a few days/weeks.  It’s 2am and you’re tired and overwhelmed.  You’ve never felt such bone-aching exhaustion.  All you want to do is crawl in bed and sleep uninterrupted.  Just for a few hours…. even ONE hour.  But your baby is crying and won’t stop.  You’ve tried everything – a fresh diaper, breastfeeding, you’ve shushed, swaddled and swung to the point of fatigue.  And the baby won’t stop crying.  You’ve woken your partner, called your mom or sister and none of the advice is helping.  You’re worried that you’re doing something wrong or that you’re doing nothing right, that something is wrong with your little one, that you’re not making enough milk.  You’d try almost anything at this moment to soothe your baby’s distress.

It’s exactly this vulnerability that formula companies prey upon when they make commercials like the one below:

The commercial for Gerber claims that the specially-created formula is effective in calming ‘excessive crying and colic.’  Nothing is more upsetting to a mother than the sound of her baby crying – we are biologically designed to physiologically respond to our own children’s sounds of distress, to do whatever we can to stop the baby from crying.  Gerber is just PRAYING that a frustrated and exhausted mother will see this commercial and think that this new formula the answer to her struggles.  Some moms may decide to introduce the formula to an exclusively breastfed baby, initiating the slippery slope of decreased supply and increasing ‘need’ for supplementation - just what formula companies are hoping for.

What Gerber fails to mention in the commercial is that the probiotic they have included (L. reuteri) has been studied and shown to exist in breast milk.  Or that breast milk also has all the calories, protein, fat, carbohydrates and vitamins that your baby needs – AS WELL as antibacterial, antiviral, and antimicrobial factors specifically formulated to protect your baby.  That breast milk contains all the probiotics AND prebiotics your baby may need.  Or that human milk changes in composition as the baby grows, continually providing a unique superfood specific to YOUR baby. 

Gerber also doesn’t explain to the new mom why her baby may be crying.  The first three months of a baby’s life is often called the “fourth trimester” and should be treated as such.  Just days ago, your baby was safely tucked in your womb, with constant warmth and soothing sounds and movements.  Upon birth, the baby is thrust into his new environment, which is often cold and bright and always unfamiliar.  Gerber doesn’t share the statistic that babies who are worn 3 or more hours a day cry 50% less than babies who aren’t.  Gerber doesn’t remind the new mom that her 2-week old baby may be experiencing a growth spurtand the constant nursing and fussiness is a normal part of this, that the baby is doing all he needs to boost mom’s milk supply as he grows big and strong.  Gerber doesn’t educate the mom on what she can add to or remove common allergenic or inflammatory foods (such as gluten, dairy, and soy) from her own diet to help soothe a colicky baby. (Check out our Boob Group podcast episode: GERD, Reflux and the Breastfed Baby for an explanation on symptoms, causes, and remedies for GERD, reflux, and colic.)

There are many reasons for a crying and colicky baby, and a number of solutions.  One action that is never the answer is replacing any amount of breast milk with an artificial milk.  Shame on Gerber for suggesting to an unsure and overwhelmed mother that her breast milk is lacking in something that could soothe her crying baby!

Supplement Options: Donor Breastmilk, Milk Banks, and Formula

This past week, we released one of my most favorite episodes on The Boob Group: Low Milk Supply: Donor Milk, Milk Banks, and Formula.  I had the esteemed pleasure of interviewing Amber McCann, an International Board Certified Lactation Consultant, fierce supporter of all things mothering, and dear friend.  I wanted to know what options were out there for mothers who needed to supplement their babies, as well as the pros and cons of each.

I pulled out the most salient points for this blog article, but you can click here to listen to the Boob Group episode in its entirety: Low Milk Supply: Donor Milk, Milk Banks, and Formula.


What are your options if you need to supplement your baby?

When feeding an infant, the World Health Organization lists a hierarchy:

  • Milk taken directly from the mother’s breast
  • Expressed milk from baby’s mother
  • Expressed milk from another mother (wet nurse, donor milk, milk from a milk bank, etc.)
  • Breastmilk substitute (formula)

Does A Free Can of Formula Really Benefit Anyone?

Just last week, the American Academy of Pediatrics approved a resolution that advised pediatricians not to provide formula company gift bags, coupons, and industry-authored handouts to the parents of newborns and infants in office and clinic settings.

In their rationale, they explained that: Research has demonstrated that the free distribution of commercial materials, such as formula samples, diaper bags, formula coupons, or other gifts via commercial infant formula marketing implicitly endorses formula feeding and creates the impression that clinicians favor formula feeding over breastfeeding, and research demonstrates that this activity decreases exclusivity and duration of breastfeeding.

Enfamil bag with free formulaSo, how does this really affect both breastfeeding moms and formula-feeding moms? 

Does a can of free formula really benefit anyone?