Supplementing milk

Your health care provider may recommend you give extra milk to your breastfed/chestfed baby. This may happen when:

• Mom/Birth parent is very sick.
• Mom/Birth parent and baby are separated.
• Baby has a medical condition requiring extra supplements.
• The baby has not regained his birth weight by two weeks or is not gaining enough with increased breastfeeding/chestfeeding.
• Mom/Birth parent has a low milk supply. The baby may need extra milk while mom’s/birth parent's milk supply is being built back up.

1. First choice is always parent's own expressed breast milk.
2. Second choice is pasteurized human donor milk. Donor milk is available at some hospitals in Fraser Health only with a doctor’s prescription. It is used in small amounts when medical supplementation is needed and when it is available.
3. Third choice is a non-human milk/ formula.

• Wait until you notice early hunger cues like rooting, sucking on fingers.
• Hold your baby close to your breast/chest and skin-to-skin whenever possible.
• Breastfeed/Chestfeed first whenever possible.
• Be sure to express or pump your milk each time you give your baby extra milk. This way your breasts/chest will continue to produce milk.
• Many mothers notice their babies will not go back to breastfeeding/chestfeeding after getting bottles. Try options that are less likely to interfere with breastfeeding/chestfeeding such as tube, spoon, dropper or cup feeding.

If you prefer to use a bottle, try to make it as close to breastfeeding/chestfeeding as possible.

• Use a slow-flow nipple which is soft, round and broad at the base. This is more like breastfeeding/chestfeeding.
• Hold your baby in an upright position. This decreases the risk of tooth decay and ear infections.
• Wait for a wide, open mouth. Brush baby's lips with the bottle nipple until her mouth opens widely. Don’t push or screw the nipple into the baby’s mouth.
• The nipple should be deep in the baby’s mouth with lips on the wide base of the nipple.
• Hold the bottle almost horizontally. The milk should just cover the nipple inside the bottle. This keeps the flow of milk slower. Avoid using bent bottles.
• Switch sides from one feed to the next. This may help develop both sides of the brain.
• Let your baby pace the feeding. Encourage frequent pauses. 
• Signs of fullness can include:
  • Sucking and swallowing slows or stops,
  • Mouth closes,
  • Baby pushes or turns away from the bottle,
  • Baby falls asleep
• Teach others. Everyone should give your baby a bottle in the same way to support breastfeeding/chestfeeding.
• Spend time skin-to-skin and continue to make breastfeeding/chestfeeding attempts. Bottle feeding is often just done for a short period of time until your baby can get back to the breast/chest.

Healthy Families BC: Supplementing