Formula vs Breastmilk
“With the formula shortage, I’ve been getting a lot of questions about how to build your milk supply if you are supplementing with formula. This is for moms like me, whose kids get both breastmilk and formula. So, here are some facts about supply.
So first of all, I always like to remind parents that likely you do have enough milk.
Part of the issue is the idea we should be able to feed our babies and pump and have a large ‘freezer stash.’ As a mom preparing to return to work, I often felt I didn’t have enough milk because my freezer wasn’t overflowing with frozen milk. I had some, but not the 100s of OZ some of the moms I know had. But I always had enough to feed my baby.
In a perfect world, your body will make enough milk to feed your baby, no more and no less. Most babies need about 24-27 OZ in 24 hours. Given that we encourage nursing moms to feed 10-12 times per day, this means your baby is getting somewhere between 2 and 3 OZ per feed. When you pump 2 OZ AFTER feeding your baby (who is satisfied), this means you have an EXTRA 2 OZ! That is awesome!
Your baby is gaining weight, content between feeds, peeing and pooping, developing appropriately, and you get very little when you pump after a feed? That is okay! It means you have an adequate supply to meet the needs of your baby. GOOD JOB!
Nursing babies, especially newborns, should eat 10 to 12 times per day (meaning every 2-3 hours). So, if your baby is feeding every 2 hours, this does not mean you don’t have enough milk. It means your baby is right on schedule.
Remember breast milk is digested in about 90 minutes, so it is not uncommon for a breastfed baby to want to nurse every 1.5 to 2 hours. If that is your baby, that is okay! It’s normal. Goes longer between feeds with formula? This is also normal. Formula takes longer to digest, so it is normal for a formula fed baby to feed less often.
This does not mean your milk isn’t enough, it is just the nature of breast milk vs formula. You are doing amazing, mama!
If you, like me, are inclusively feeding your baby (meaning you are doing breast milk and formula), the formula shortage news may be making you wonder how you can bump your supply up so you need less formula.
Before we start talking about this, I just want to say if you have chosen to fully or partially formula feed your baby, there is no shame in that, and you should not feel guilty. This formula crisis is due to many, many factors outside our control and never should have happened.
I know as a mom you want the best for your baby, and the best thing you can do for your baby is be a healthy mom. A lot of us choose to formula feed to protect our mental health and this is always the right choice.
So, while working to increase supply may be a solution if you are partially formula feeding, if the thought makes you anxious or stressed, skip it. I am not here to stress you out but simply offering some suggestions if you want them!
As a refresher, our milk supply is built on supply and demand. The more milk that is removed, the more milk our body makes. In contrast, the more milk left in our breasts, the less milk our body makes. This is why it is so important, especially in the early days, to remove milk often and effectively.
So how does this help us during these stressful times? Well, the principal is true no matter where you are in your breastfeeding journey. If you feed your baby more often, aiming for 10-12 times per day and no longer than 4-5 hours between feeds/pumps, you could increase your supply. In theory, the more milk you remove and the more often you do it, the more milk your body will make. We think this is why babies will cluster feed during growth spurts.
So, there it is. Easy enough. If you want to increase your supply, you’re going to have to nurse/pump more. If this is something you think you can do, then it is worth a try! If the thought of doing this adds stress to your life, then don’t do it!
What am I doing? Well, I exclusively pump. On a good day I get 5-6 pumps in. With that, my baby gets mostly breast milk, but she usually needs 1 bottle of formula at daycare. To eliminate this bottle, I would likely have to wake up overnight to pump. I know myself and I know 5-6 hours of uninterrupted sleep is necessary to maintain my mental health. So, I am choosing NOT to do this, to keep supplementing with formula if we need to, and get the sleep I need to protect my mental health.
Let’s talk about supply. First of all, to be totally clear, if your baby is thriving on just your milk then you do not have low supply! Good job!
Other things that do NOT mean low supply…
1. Frequent feeds. Breast milk is digested in about 90min, so it is not uncommon for babies, especially newborns and infants, to nurse every 2 hours.
2. Changes in feeding duration. As babies get older, they can become more efficient nursers and can take less time to feed.
3. Your baby is fussy after feeds. This can be due to many reasons, including gas, colic, reflux and hunger.
4. Your breasts don’t leak or feel soft(er). Leaking or the feel of your breasts has nothing to do with milk production.
5. You don’t feel let down. Some women don’t. It’s okay.
6. No milk when you pump. The pump is less efficient in transferring milk. Getting less milk when you pump does not reflect supply at all.
7. You don’t have a huge freezer stash. We should be producing what our baby needs and a freezer stash is actually a sign of overproduction, which isn’t always good.
So, what can cause low supply?
1. Supplementing or feeding on a schedule. Supply is established through supply and demand. The more often you nurse, the more your body knows to make milk. If you substitute a nursing session for a bottle or wait to nurse because it is not time, your body doesn’t know it is supposed to make milk, so you can have lower supply.
2. Using a bottle (it is easier to drink from than from the nipple), a pacifier (a baby will soothe itself with a pacifier even if hungry), or a nipple shield (which is a helpful tool but can decrease nipple stimulation and can interfere supply/demand cycle).
3. Feeding on one breast per session or ending sessions early. Again, supply is supply and demand, and if your body is stimulated often and as long as needed, it can lead to a supply issue.
4. Medical issues in baby (i.e. jaundice, tongue tie, congenital disorders) and mom (i.e. thyroid issue, medications, breast issues).
If your baby is having poor weight gain, a drop in number of wet/dirty, is excessively sleepy or have any other concerns, please call your provider.”
This story was submitted to Love What Matters by Elena Shea, MD, FAAP, IBCLC of Reston, VA. You can follow her journey on Instagram, Facebook, Twitter, and her website. Submit your own story here, and be sure to subscribe to our free email newsletter for our best stories, and YouTube for our best videos.
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