You probably already know that the American Academy of Pediatrics recommends exclusive breastfeeding for at least your baby’s first 6 month of life, and continuing to use breastmilk as your baby’s main nutrition for their first year. But that isn’t always realistic for every family and there are a host of reasons that you may decide you need to supplement with formula.
Making the decision to supplement can often cause stress on a new mom - it is completely normal to feel that way! But, we encourage you to celebrate every drop of breastmilk your baby gets to have and remind you that both breastmilk and formula will give your baby the nutrition they need to be healthy and happy. It can be hard to know when it’s time to supplement with formula and how to effectively give your child both breastmilk and formula, so we’ve put together this guide to help you more easily navigate the process.
What does it mean to “supplement with formula?”
Many mothers only feed their little one breastmilk (either from the breast, pumped into a bottle, or both) when they are born. They may plan to exclusively give breastmilk indefinitely, or they may have a set timeframe in their mind for how long they want to give their baby only breastmilk. Whether the process goes according to plan or not, there may come a time in your baby’s first year of life that you decide to give your baby some formula in addition to the breastmilk they are receiving. This is called formula supplementation.
Supplementing gives your baby a combination of both breastmilk and formula. This is different from completely stopping breastfeeding, which we discuss how to do in our article, “How to Transition from Breastmilk to Formula.”
Reasons to Start Supplementing with Formula
Deciding to supplement with formula is a completely personal decision. There are different reasons you may decide that supplementing is the best choice for you and your baby, and sometimes it’s medically necessary to do so. It’s important to not let the the “advice” of your family and friends guide your decision.
Instead, we encourage you to weigh the pros and cons as well as talk to your baby’s pediatrician. There are times when supplementing is necessary to give your baby the nutrition they require to thrive. We know that sometimes it can be hard to let go of the guilt of not continuing to breastfeed exclusively (I know I felt this way - especially with my first baby), but just remember that a fed baby is best and your baby will be healthy and happy no matter when you decide it’s time for supplementing.
These are some of the top reasons why you may decide to supplement with formula:
Your baby isn’t gaining proper weight. Formula supplementation is often necessary for babies right after their birth. Sometimes it is the only way to get a baby the nutrition they require from the start. If this is being recommended to you in the hospital it can feel jarring if that’s not what you had planned on. But just remember that they are the experts and it’s their job to care for your baby in the best way possible and that includes making sure they have what they need to grow well.
This could also happen later on. Once I went back to work and started pumping, my body wasn’t producing as much milk. Around 6 months of age, my son started to only maintain his weight and not gain. Though my doctor didn’t require that I supplement yet, it was made clear that I either needed to supplement or start nursing much more frequently. This was really emotional for me, but I knew that supplementing was what was best to give my baby what he needed.
- Other medically necessary reasons. Besides not gaining proper weight, there may be other medical conditions that require formula supplementation. This could be something that you are experiencing or your baby. Your doctor will help you determine what is best so be sure to be up front with him or her and contact them if you ever have any concerns.
You feel overwhelmed with breastfeeding. Breastfeeding is hard work for a lot of moms. It can be painful at times and may not be the beautiful process you envisioned. If you feel overwhelmed with breastfeeding it is completely OK to start supplementing with formula to ease some of the burden or to quit breastfeeding altogether. Your well-being is important for you to be the best mom you can be.
You’re going back to work. Yes, there are plenty of moms who are able to continue giving their babies only breastmilk when they head back to work. If you make a commitment to pumping during your baby’s scheduled feeding times, supplementation may not be necessary. But this isn’t true for everyone. Balancing work, pumping and caring for your baby at home can be a lot, so there is nothing wrong with needing to supplement during these times.
Your partner wants to bottle-feed. Though you can pump a bottle and have your partner feed it to your baby, sometimes this isn’t the best or most convenient choice for families. Even supplementing with one formula bottle a day may give your partner an opportunity to bond with your little one while you are able to get a break that you’ve earned.
- You’re just ready! Honestly, this is a big one! Sometimes you don’t need the “perfect” reason other than it just feels like supplementing feels like the next best step. That is your choice and one you should feel 100% comfortable in making to carve out the best life for you and your baby.
How to Effectively Supplement with Formula
Once you make the decision to supplement your baby’s nutrition with formula, you’ll want to make sure you are going about it in the most effective way possible as well as creating a schedule that works best for you.
Here are our top recommendations for supplementation:
Use a formula that is recommended for breastfed babies. There are certain formulas that are more like breastmilk than others, and you’ll want to try to find one that mimics the taste, nutrition and texture of breastmilk as much as you can. Read our article, “Best Baby Formulas of 2021” for our top two recommendations in this category.
Use a bottle that’s designed for breastfed babies. Babies who have been breastfed may have a harder time taking a bottle since it’s different than what they are used to. In order to avoid nipple confusion, finding a bottle that was made with breastfed babies in mind can help a lot. Our recommendations in the article, “The Best Bottle for Breastfed Babies,” can help you find one that works well for your little one.
Use other strategies that make the bottle easier for your baby to take. Besides choosing the right formula and bottle, there are few other things you can do to help your baby take their new nutrition more easily. We suggest warming it to the exact temperature of breastmilk using the Baby’s Brew so that the warmth of it is the same as what they’re used to. It’s also best if someone else gives the initial bottles.
Start slowly. You may have an idea in your mind for how much you want to supplement, but it’s best to work up to that. For example, if you want to have half of your baby’s feedings be from formula - perhaps 4 of the 8 feedings she has per day - it’s best to start with one per day for a couple of days and work up to all four. Sometimes this may not be possible, but if you can plan ahead, the process will likely go more smoothly this way.
Decide if you will do full feedings with formula or do a bit of both. There isn’t just one way to supplement with formula. Some parents find it’s easier to just do full bottles of formula with the other feedings being complete breastfeeding/breastmilk bottle feeding, but it may work better for you to give both during one feed. If you want to do it that way, we suggest giving the breastmilk first and then topping off your baby with formula for the rest of the feed until they are full.
- Be prepared for digestion and stool changes. Once your baby starts getting even a bit of formula, their poops will look and smell different. Even one bottle of formula per day can make this change, so don’t be alarmed. Your baby may go through some digestion struggles as well as their body acclimates to the new nutrition or figures out how to properly drink from a bottle. This is not cause for alarm and will often work itself out in a few days as your baby gets used to it. If the issues do persist, we recommend checking in with your baby’s doctor.
If your goal is to continue to breastfeed as long as you can while supplementing, you'll also want to be sure that you are continuing to breastfeed enough times per day to keep your supply up. Maintaining a consistent schedule day-to-day in this regard is your best bet in being able to continue to breastfeed.
Moving Forward with Formula Supplementation
Formula has been giving babies around the world adequate nutrition since it was created in 1867. It has come a long way since then, and companies continue to improve the profile of their formulas to make them as close to breastmilk as possible. The most important thing to know is that all formulas sold in the U.S. must meet strict guidelines and are perfectly safe for your baby to drink.
Though you may struggle with the idea of your baby getting nutrition other than breastmilk initially, just know that your baby will continue to get everything they need from the formula while still getting the major benefits that breastmilk offers from any amount you can continue to give.
Formula Supplementation FAQ
These are some of the most common questions asked about supplementing your breastfeeding journey with formula.
Is it ok to breastfeed during the day and formula feed at night?
Breastfeeding during the day while formula feeding at night can definitely be done. Families may choose this route so that the mother is able to get more sleep at night and the partner is able to help with the feedings. Just know that your breastmilk supply will be affected if you are not pumping or breastfeeding at night. We suggest doing a late-night breastfeed before bed and one early in the morning to keep breastmilk supply up as much as possible.
Does supplementing with formula reduce the benefits of breastfeeding?
The more breastmilk a baby is given, the more nutritional components, immune-properties and antibodies they receive. But even one feed per day of breastmilk will give a baby some of these added benefits that only come from breastmilk. In short, breastfeed for as long as you can and giving as much as you can, but also remember that formula feeding is a perfectly healthy choice for your baby, too.
Can you combine breastmilk and formula in one bottle?
You can combine breastmilk and formula, but read our article “Mixing Breastmilk with Formula - Your Questions Answered,” to be sure you’re following the proper guidelines and recommended process.