Breastfeeding and Bottlefeeding: Mix with Caution

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Breastfeeding babies are often given supplemental feedings.  In most cases, the additional food is given by bottles.  What seems to be forgotten is that this practice can negatively impact the long-term success of breastfeeding.

Feedings not done directly at the breast are the first steps toward weaning.

Babies will do their time on the breast and wait patiently for the chaser of milk that they have come to expect via a bottle after breastfeeding.  They will often get fussy when this pattern is changed. Their mothers, who have become accustomed to measuring volumes of milk being given via the bottle, then lose confidence in direct breastfeeding; they worry that they don’t have enough milk in their breasts if their baby does not act happy when a supplement is not offered.

Knowlege is power.  All supplements are not equal.  During the start-up period of breastfeeding, strategic supplementation is advised so that you do not compromise your breastfeeding goals.

Breastfeeding with Expressed Milk Supplements:

The lighter, species specific nature of human milk causes much less digestive upset in the baby.  Expressed milk given by a bottle is a pooled sample of milk and the ratio of water, fats, proteins, etc. may vary from one serving to the next.  Nonetheless, it will be clear that all growth is taking place solely due to the nutritional value and calorie content of human milk whether taken directly from the breast or via the bottle.

However, it should be noted that the additional air in a bottle of expressed breast milk may make the baby feel more full than when it feeds directly at the breast.  This is one possible reason that premature babies only given human milk in a bottle, for days or even weeks prior to discharge from the hospital, seem unsatisfied initially when switched to exclusive breastfeeding

Breastfeeding with Formula Supplements:

Several variables are in play with this approach.  The breast milk and formula are inherently different as has already been discussed. ((See Bukisa article:  Got Enough Milk? ) Caregivers tend to be very generous with the readily available, heavier formula when feeding with bottles.  There is a belief that the baby will sleep longer if more is taken at a feeding. When formula is given there is usually an unlimited supply compared to the output that results from the mother’s pumping efforts.

Since formula is harder to digest, breastfeeding more frequently will not be as productive.  The baby needs to be alert and truly hungry to breastfeed well.   Otherwise, it will snack on the breast and wait for the bottle.  The mom will think she is breastfeeding, but she is quickly becoming the aperitif rather than the main course.

Babies react differently when breastfed only or breastfed and given bottles of breast milk and/or formula.  For this reason it is essential that the utmost effort be made to optimize the baseline of direct breastfeeding.  Judicious use of supplements, preferably of human milk whenever possible, will foster a less complicated analysis and more enjoyable breastfeeding experience.


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