Babies often receive supplementing milk during breastfeeding, sometimes with formula and sometimes with pumped breast milk. The introduction of supplemental milk, as a form of administration and its content, can affect the feeding of the infant, and therefore, it is very important to examine thoroughly its actual need.

This article discusses what supplementing means, when it is needed, and the best options for administering it.

What is supplementing?

Supplementing means giving variable amounts of milk to a baby once or several times a day after the usual breastfeeding sessions to help this baby gain or regain weight.

Does supplementing always have to be done with formula milk?

Although most people imply that artificial milk should be offered when supplementing, it really shouldn’t be that way. The recommendations included in WHO’s document “Infant and Young Child Nutrition, Global Strategy for Infant and Young Child Feeding” are very clear:

“The vast majority of mothers can and should breastfeed, just as the vast majority of infants can and should be breastfed. Only in exceptional circumstances can a mother’s milk be considered unsuitable for an infant. In those few health situations where infants cannot, or should not, be breastfed, the choice of the best alternative – breast milk expressed from the infant’s own mother, breast milk from a healthy wet nurse or human milk bank, or a breastmilk substitute offered in a cup, which is a safer method than a bottle and nipple – depends on each circumstance.”

Thus, the first option for supplementation is always to offer expressed breast milk to the baby and if the mother is unwilling or unable to pump, commercial formula milk is the third option.

When is supplementing needed?

Many babies receive additional milk even if they don’t need to be supplemented, but some infants need these small amounts of extra milk (either breast milk or artificial milk). The most common situations are:

• Premature babies with suckling difficulties or if their mother does not achieve adequate milk production.
• Babies with pathologies who lose weight or with growth failure.
• Babies who have lost more than 10% of their weight in the first few days of life.
• Babies who, after 15 days of life, have not regained their birth weight.
• Babies suffering from hypoglycemia.
• Babies whose mothers become pregnant before they are one year old.
• Other

In these cases, it is advisable to encourage the feeding of the baby to correct the situation as soon as possible. Once the situation has recovered or normalized, supplementing can be eliminated. In the case of formula milk, depending on the amount that the baby has, it will be necessary to relactate.

For babies who have supplemental breast milk, once they have regained weight, the supplements can be removed at once as the baby will find the quantity of milk they need from breastfeeding.

And how much to supplement?

The amount of milk offered to the baby is usually small amounts of 20 or 30ml (less than 1 oz) several times a day. It will depend on the baby’s situation and their needs. The baby must be able to achieve a normal weight.

Does supplemental milk always have to be given in a bottle?

Supplemental milk can be offered in a bottle, but there are always alternatives if the mother doesn’t want to use them. Depending on the situation and the age of the baby, the most suitable method can be found in each case: finger-syringe method, cup feeding, spoon feeding, or a supplemental nursing system, for example.

In short, it is just as important to plan the baby’s supplementing as it is to accompany the mother so that her milk production is maintained or increased if she needs it, as well as to bear in mind the importance of informing about the methods of supplementation and keeping a good follow-up for the relactation process.