Heather ONeal is a Certified Nurse-Midwife and Internationally Board Certified Lactation Consultant. She has dedicated her career to helping busy parents breastfeed with confidence. Read more about Heather.

Supplementing While Breastfeeding- 6 Tips

Breastfeeding for Busy Moms

If you are pregnant or have recently had a baby, you might be thinking about going back to work after maternity leave. Breastfeeding parents, in particular, sometimes have increased anxiety about returning to work. Expressing milk, preparing bottles, cleaning all those supplies — it can feel overwhelming.

Maybe even so daunting that you think:

I guess I’ll try to breastfeed.”

I’ll see how it goes.”

I don’t know if I can do it for a year.”

I am here to tell you that breastfeeding does not have to be all or nothing. You can nurse your baby, pump when you’re away, offer expressed milk, and supplement with formula. Any combination of these is OK. Really! You don’t have to feel guilty.

Yes, I am a lactation consultant. I support breastfeeding parents and their families, and I recognize the benefits of breastmilk. However, I am a midwife first. The word midwife means “with woman,” so I am “with woman” first. Get to know me better, HERE.

If we focus only on the baby, the parent gets completely lost. I don’t want parents to feel like they’re losing their minds. A happy mom who feeds her baby some breastmilk is better than a miserable mom who exclusively breastfeeds and/or pumps.

As the parent, you get to decide what a successful breastfeeding relationship looks like. And if you find that exclusively nursing and/or pumping is not working for you, it is OK to adjust your expectations.

Redefine your goals. Let go of the guilt. Feed your baby.

If you are stressed by your breastfeeding relationship, here are my 6 smart supplementation tips.

Tip 1- Establish your supply for the first six weeks.

After your baby is born, it takes about six weeks for your supply to become established. Try to not supplement during that period. Those early weeks are a really important time when your nursing baby is helping your brain and body know how much milk to produce.

If you’re going back to work, start pumping when your baby is about four weeks old and give one bottle every 24 hours. Use a nipple that’s similar to the breast, such as MAM or Comotomo.

Tip 2- Put baby to the breast first.

If you’d like to continue nursing when you’re able, always put your baby to the breast first when it’s time for a feeding. Then you can top off with formula or expressed milk if you need to.

This contact between the baby and the breast is important, especially if you’re having supply issues. Your brain has to be in on this situation. Having baby at the breast cues the brain and says, “We’re still breastfeeding.” We’re just not stressing about it.

Tip 3- Know which feedings to keep at the breast (if you can).

If you’re going to replace a feeding by supplementing with formula or expressed milk, remember it’s totally OK. However, there are two feeding times when it is best to keep baby at the breast if possible.

The first is the early morning feeding, usually between 4 and 7 am. This is super important! This feeding sets the tone for the day, and the breast is as expanded as it’s going to be. If your baby completely drains that breast, a sensor in the brain goes off: “We need to make more milk.” If you skip that early morning feeding, your milk-making hormones will decrease.

The second most important feeding is the one right before bed. This is when your body produces the fattiest milk, and the hormones in it help set the circadian rhythm. They help your baby sleep. And BONUS! They help you sleep, too.

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Tip 4- Do not measure success by how many ounces you pump (if you’re pumping).

Even if your baby is getting two or four ounces of breastmilk, that is a win! If that’s all you have, that’s great. As long as your baby’s mouth has touched your nipple, you are creating milk that has amazing immune properties. It’s like one giant vitamin.

As babies get older, volume goes down on purpose. The fat content and calories go up, and your baby’s not eating every 90 minutes. Four ounces for a 6-month-old is different than four ounces for a 6-week-old. It’s like a bowl of mac and cheese versus a bowl of chicken broth.

A lot of people quit because they’re “only getting four ounces.” Don’t stop because you’re feeling inadequate. (But if you want to stop, then stop! Remember — whatever works!) To learn more about feeding older babies, check out episode 10 of the Milk Minute Podcast.

Tip 5- Feed pumped breastmilk first without mixing with formula.

If you have expressed milk, make sure your baby gets that first. This means that, ideally, you shouldn’t combine pumped milk with formula.

I know, it’s appealing to mix the two to get the number of ounces you need for the next day, especially if your baby goes to a daycare center. A lot of daycare providers won’t mix formula, so you have to prepare both expressed milk and formula ahead of time.

My experience as a mom and a nurse has taught me that it’s best to keep expressed breastmilk and formula separate. Think of it this way: If you combine pumped milk and formula to get a 6-ounce bottle and the baby drinks only four ounces, you’re wasting some of that precious breastmilk.

Tip 6- Rally your supporters.

Your partner and daycare provider should be on the same page as you. Having a supportive partner helps with any breastfeeding issue.

When it comes to partners, I suggest giving them specific tasks that will make your life easier. For example, you can say, “It would really help me if you’d wash my pumping equipment.” Let them know how to be involved. Check out my post on why partner support is so important for breastfeeding success HERE.

As far as daycare providers go, if you have both pumped milk and formula, it can be extra work for them. They might find it annoying, but you have to stand your ground. The daycare providers will figure it out and your baby will be fine.

Takeaways on smart supplementation

I want you to know that my baby is almost 10 months old. I nurse her in the morning and at night. I pump when I can, so she gets some expressed milk and some formula. It’s working for us, and my milk supply is fine. I’ve adjusted accordingly, and we’re happy.

Supplementation is OK, and it doesn’t mean that your breastfeeding relationship is over. If you’re nursing sometimes and supplementing with formula, you’re still breastfeeding. There’s no “yes, but…” You own what works for you!

If you feel like you are in over your head, please schedule a consult with me! I can’t stand the thought of anyone stressing and crying over supplemented milk. Schedule HERE.

You can also take my more advanced breastfeeding class called, Feed Your Baby University, to learn more about pumping, managing a NICU stay, nipple injuries, and feeding older babies. Learning with my entertaining videos is WAY better than going to school for 6 years to be a CNM, IBCLC… trust me 😂.


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