Can I Supplement with Formula and Still Breastfeed?

Just like a birth plan, sometimes, breastfeeding does not go to plan and some moms may need to supplement.  This does not have to mean the beginning of the end of breastfeeding if caution is used in how you supplement.

Supplementing Baby at the Breast

Often supplementation is only necessary for a short term while mom is regaining her milk supply or baby is having a frenotomy to release a tethered tongue to facilitate milk transfer. And the best method for supplementing formula is doing so while keeping the baby at the breast.  However, Supplemental Nutrition Systems are often expensive and difficult to clean so short-term feeding tubes are the preferred method in these cases.  In the case of supplementing a newborn, the best option is a 5FR feeding tube that is 36" long.  Don't opt for a shorter tube such as 15" because the shorter the tube, the faster the flow of milk and babies need to latch and use their tongue and jaw just as they would when exclusively breastfeeding. The act of the baby sucking at the breast while being supplemented also increased mom's milk supply.  

Lactation Aid Feeding Tube

You can use the feeding tube by placing the large end in a container and taping the other end of the tubing to the breast with the tube slightly past the nipple since the nipple will elongate during the feeding. You can use a 50ml cap as shown above or just a bottle and nipple by enlarging the hole in the nipple for this use only.  

Positioning Tubing on Nipple

Use medical grade tape such as transpore tape or micropore tape. Micropore tape has been found to be slightly more gentle on dry skin.  Image above shows tape on the areola, but you may prefer to start the tape the an inch behind the nipple to keep it secure and out of the infant's mouth. Either way it is best to run the tape in the same direction as the feeding tube 

Micropore Medical Tape

Lactation Aid Feeding Tube Sets can be purchased with tubing, containers, caps and syringes for flushing the tube as well. As I mentioned earlier, this is a short term feeding system so discontinue using the tube if it becomes rigid on the end or after two weeks of use, whichever comes first.

Lactation Aid Feeding Tube Set

Remember that your goal in short-term supplementing formula is to provide any shortage of nutrition to your baby.  So don't supplement the full amount of a feed if your body is making milk.  Only supplement the difference in formula.  This amount should be decreasing as your body begins to increase in milk supply.  In addition to keeping the baby at the breast to further hinder your supply, you will want to take a galactagogue lactation supplement to help you increase supply more quickly.  This way the time necessary for supplement is shortened.  

Best wishes for short-term supplementation and long-term breastfeeding!

Tanya

Supplementing the Breastfed Baby: Lactation Aid Feeding Tubes vs Supplemental Nursing System & Lact-Aid Nursing Trainer

     In my practice as a board certified lactation consultant, there were times when it was medically necessary to supplement.  Whether it was due to a poor suck or mismanaged milk supply, we need options when recovering from these issues and getting back to breastfeeding.  Many times, I would recommend finger-feeding with a syringe to keep moms from using a bottle nipple.  I would have rather recommended a Supplemental Nursing System which has a container with tubes that runs to the breast; but I didn't want to see mom spending the extra money when her budget was so tight.  At that time, the only options were the Supplemental Nursing System (SNS) by Medela and the Lact-Aid Nursing Trainer.   These cost mom $50 or more and had small tubes to be cleaned which were cumbersome.   Now, with more options available, Moms can use a short-term feeding tube which accomplishes the same thing and can be cleaned for a few days before disposing of it.  It is a small investment in comparison to the commercial systems.  While moms who are adopting babies and inducing lactation, rather than just building milk supply may still want a commercial unit; the Lactation Aid Feeding Tubes are the best course for the short term situation.  Thanks to IBCLC, physician and lactivist, Dr Jack Newman videos and instructions are available for using these feeding tubes.  You simply cut a slightly larger hole into a bottle nipple.  Insert the adapter end into the bottle and feed the tube into the babies mouth while he is latched on.  You may also use medical tape if you prefer to have the tube in place prior to latch.  These can be purchased from the International Breastfeeding Center in Canada, but due to the long ship time of up to three weeks, we have added them to our selections at Lactation Connection.  Sold in a two pack for under $10, these will last up to two weeks while mom is re-establishing milk supply or training a baby with a weak suck.  Each tube is in an individual sterile pack ready to use.  Instructions are included with the feeding tubes when purchased here:  https://www.lactationconnection.com/Jack-Newman-s-Lactation-Aid-Feeding-Tube-p/54-5036-2.htm
     Dr. Jack Newman also has a helpful instructional video on YouTube.  I encourage you to view it and encourage lactation consultants and breastfeeding counselors to recommend and use these feeding tubes for short term situations of supplementation. 
http://www.youtube.com/watch?v=ezGIkIkhC_o&feature
     It is also important to recognize the appropriate amount of supplementation.  Always assess milk supply first, then only give the difference of what mom is producing and the actual need of the baby.  This is to say that you supplement not how much the baby will drink, but the need of a baby of that weight.  Here is a link to a chart for appropriate milk intake to show how much to feed per pound of body weight:  https://www.lactationconnection.com/Feeding_s/1907.htm  For example, a 7lb baby who is older than 6 days needs 2.25oz eight times per day.  If mom is making 1.25, then the appropriate amount of supplementation is 1 oz. per feeding.  Contact you local lactation consultant for further instructions on supplementation or give us a call at 800-216-8151 9-5 M-F CST. 


Lactation Aid Images: 

Note:  Most lactation aid feeding tubes sold are slow flow.  They are 36" in length so that the flow is regulated.  Shorter tubes change the flow to a faster rate.  If you do need a faster flow for an older baby, medium flow lactation aid feeding tubes are now available at: https://www.lactationconnection.com/Jack-Newman-s-Lactation-Aid-Feeding-Tube-p/54-6036r.htm 

Happy Nourishing!

Tanya