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

In this article, we discuss 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 its weight.

Does supplementing always have to be done with artificial milk?

Although most people imply that artificial milk should be offered when supplementing, it really shouldn’t be that way. The recommendations included in UNICEF’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, artificial milk is the third option.

When is supplementing needed?

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

• Premature babies who have difficulty suckling or their mother does not achieve adequate milk production.
• Babies with pathologies, who lose weight or with growth failure.
• Babies losing 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 mother becomes pregnant before they are one year old.
• Other

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

In the case of babies who have supplemental breast milk, once they have regained weight, the supplements can be removed at once as the baby will find the milk she needs in the breast.

And how much supplementing?

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 her needs. It is crucial that the baby is 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: syringe-finger 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 in the event that 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.