Your Complete Guide to Supplementing Your Newborn Baby

Let's clear the air right at the top here, I am NOT anti-formula. I am really glad formula exists as a safe option when it is truly needed because sometimes it is! My beef centers around three things...

• Lack of education.....I want you to be informed of what is normal and what is NOT so you can understand how to support your baby and milk supply if supplementation is needed or desired. 
• Lack of informed consent...If you are not given complete information by a medical provider or are not aware of all of your options and find yourself feeling forced or talked into using formula, you DESERVE better! I  am told stories relating to this way too often and they make me want to gnash my teeth. 
• Lack of options when common troubleshooting scenarios come up… this goes along with informed consent and I want to unpack scenarios below that I see all the time. It is not simply about information, you also need viable options to make your feeding goals work. 

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Click here for my free guide on baby-led latching.

What can you expect from your medical providers?

I wish I could tell you that all healthcare providers are fully educated on feeding options and how best to support breastfeeding families and goals, unfortunately, that is not the case. 

It typically rests with you to advocate for your feeding goals and know ahead of time some of the common scenarios when supplementation may be brought up by a well-meaning medical provider. 

A super sleepy newborn 

Should you wake a sleeping baby to eat? Wake baby? Never wake a baby? Only wake your baby when “_____.” Are you confused yet? When/, if to wake a baby for feeding, is a question I field from parents allllll the time. 

There is an idea floating around with newborns that you should never wake them to eat, period. Unfortunately, this can often lead to issues for both the baby and the milk supply. 

In early newborn days, until your baby is back at birth weight and is gaining weight well, (about an ounce a day,) then you need to be wake that baby up every 2-3 hours to eat.   

Why are newborns soooo sleepy?

The early postpartum hours/days and experiences during that time can impact the baby’s sleep and wake patterns. Often these early experiences will cause a baby to be extra, extra sleepy and have longer sleep windows than they would otherwise have, and feed less often. Here are some contributing factors…

• Birth: whether you had a vaginal or cesarean birth, both can contribute to fatigue for your new baby. 
• Circumcision
• Baby Assessments
• Medications
• Vaccinations

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Essentially, anything that adds a layer of stress for your baby can make them way sleepier and feed less often. So why not just let your baby sleep the stressors and events of birth off??? Great question.

Milk Supply + Infant Weight Loss

Two main factors come to play here. Milk supply is entering the chat + your baby losing weight. 

While it is completely normal for babies to lose some weight following birth, up to 10%, (this number can be further inflated if mama received a lot of fluids in labor,) we want to make sure that baby is feeding often and effectively to avoid losing too much weight. 

Milk supply is also impacted by the early postpartum hours and day, every time your baby latches and feeds at the breast it stimulates your body to make more milk and establish an adequate supply for your baby. Having long stretches of time between feeding sessions can have a negative impact on your overall supply.  The single biggest factor for long-term milk production is frequent removal or early milk. This is another reason I am a HUGE fan of hand expression! Did you know that moms who hand express in the first hour after birth end up with 130% more milk at 6 weeks?!  Learn more in our hand expression blog, here.  

So what SHOULD you do?

So we know you want to feed your baby often to help with weight gain and milk supply.

What is the window of time for most babies and how exactly do you wake a very, very sleepy baby?

• I recommend attempting to feed your baby every two to three hours. (It is okay if your baby wants to nurse more often, but this is the longest you would want to wait with a newborn between feeds.)
  

Steps to latching your sleepy baby

• Skin-to-skin: to start, you can begin to unsettle your baby by unwrapping them from blankets, and clothes and placing them on your chest skin to skin with only their diaper on. 

• These simple steps can help your baby’s natural feeding instincts to begin to fire up and are often enough to get babies ready to feed at the breast. It can also help get the oxytocin flowing for you.

• Get yourself comfortable in a deeper reclined position.
• Hand express a small amount of colostrum and rub it against your baby’s lips.

• Hand expression is the secret superpower you didn’t know you had and can help entice a sleepy baby to attempt to latch. Click here for a full guide on hand expression. 

• With your baby latched, add in breast compressions to help speed up your milk flow and keep your baby alert.

• This may be a two-person job in the beginning, which is very normal! It is great to get your partner or other caregivers in on the feeding action. They can help support the baby, help with breast compression, and even help with hand expression!

**Remember that latching takes A LOT of patience and practice. If you or your baby or both are feeling overwhelmed, it is okay to pause, bring your baby skin-to-skin, and resettle them before trying again. Click here for tips on landing your latch. 

Common Scenarios and Troubleshooting

Let's chat through some of those scenarios together, so that you can walk into your birthing space feeling knowledgeable and empowered to reach your goals...

• Provider: Your baby is getting a bit jaundiced so we need to start formula.

Jaundice is the buildup of bilirubin in a baby's body. All newborns experience some level of jaundice, but if high levels of bilirubin go untreated there are serious health consequences for the baby.  Elevated bilirubin in the baby is caused by: 

• Increased bilirubin from the breakdown of fetal red blood cells 
• An immature liver that has trouble processing all of the bilirubin 
• A slower digestive tract that causes the reabsorption of bilirubin

As your newborn becomes more jaundiced this makes them more and more sleepy and we all know super sleepy breastfeeders don’t always do a stellar job! We also want the baby to be pooping more frequently to help them excrete the excess bilirubin. 

You can ask the following questions:

• What is the volume requirement needed for my baby?
• Can I hand express or pump and supplement with your own milk?

Remember, newborn babies in the first few days of life do NOT need huge volumes. 

Examples of baby needs 

• Day 1: 2-10 ml
• Day 2 5-15 ml 
• Day 3 15-30 ml 

This is a very small amount and collecting your colostrum with my favorite superpower hand expression can help you get these volumes for your babe.

• Provider: Hi, mom, your baby lost too much weight -- you need to give your baby this formula.

You (ready to advocate for your goals): Ok, do you have any syringes so I can supplement at the breast? 

This is two birds, one-stone approach that can ensure your baby is getting needed nutrition all while stimulating your breasts to keep making milk and giving them colostrum at the same time. This is a great step to keep on track with your breastfeeding goals. 

I love curved tip syringes for supplementing small volumes of milk at the breast. Check out this reel on how to use a curved-tip syringe. 

• Provider: I would like you to provide formula after every feeding at the breast.

You (ready to come in with your secret superpower): Ok, could I get a pump and hand express? I want to supplement with my own colostrum and milk first. 

Click here, for our hand expression blog. Sometimes providers just assume you will need to use formula and don’t offer your own breast milk as an option! If you have milk in there USE IT! This will help your milk supply increase sooner and decrease the need for formula. Remember  it's PERFECTLY fine to mix formula and breastmilk together. 

Does supplementation ALWAYS mean formula?

Did you know you can supplement feeds at the breast with your own milk? Supplementation does NOT mean a formula is always needed! Before bringing formula to the table, it is a great choice to try to supplement your baby’s feeds at the breast with your own expressed colostrum and milk. 

What questions ARE great to ask

I hope these three scenarios give you an idea of common troubleshooting issues that may come up and an option to navigate them. You should always feel informed about the why of supplementation.

• You are allowed to ask for clarification!
• You are allowed to ask for alternative feeding methods other than a bottle. (I can't emphasize this one enough...there are several options before the bottle!). Finger feeding, supplemental nursing systems, cup feeding, etc. Click here for product recommendations.
• You are allowed to ask to give your own colostrum instead!
• You are allowed to ask for specific volume recommendations and length of time.

•  Example: 10 ccs every 3 hours for 24 hours

‍Want to prepare even more? 

Go into your birth knowing the following... Check out my freebie, all about baby-led latching, here.

1. Suggested volume recommendation for each day of life through the first 5 days and beyond. I gave a few above and go into more detail in the courses. Shoot, couldn't make it through without another boob school mention. Knowledge is power, my friend!
2. Alternatives to bottle...examples include: using a spoon, medicine cup, silverettes, and syringe at the breast (one of the best options to both supplement and stimulate your breasts at the same time.)
3. How to pace feed a bottle....click here to read our post on paced bottle feeding. 

4. ‍How to hand express....have we even met if you don't know this is my favorite all-time tool for you??? Click here for my hand expression guide.

Check out Boob School, to get more knowledge, support, and empowerment for your breastfeeding journey! Here’s what you get….14+ modules to take you from your very first latch to weaning your baby. 11 bonus PDFs so you never have to do a 2 am Google spiral. We also offer a free membership to Natural Breastfeeding where you can watch 60+ videos of other moms latching their babies. Get access to our private Facebook group and weekly support group calls. Get the support you deserve, today!

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Cheering you on, always!!

XOXO

Kelly

Boob School Founder and CEO

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