"Hi Jess. I had to supplement with formula during the first few weeks of my baby's life, but I really want to exclusively breastfeed. How do I do this?"
👆🏼I get this question regularly, so I want to take the time to talk about what you can do if you're in a situation like this.
FYI: The information I provide should never be considered professional medical advice or be used to help determine a diagnosis or treatment. Always consult with a physician or medical professional if you have any concerns or questions about your or your baby's health.
First of all, let me say that there are MANY reasons why babies are given formula in the first couple of weeks. Sometimes babies need to be separated from their moms (if they're in the NICU, for example) and mom has a hard time expressing milk. We are thankful that formula is an option for families!
Sometimes, formula is given due to a fear that baby isn't getting enough milk (or baby isn't gaining enough weight). Please read this article for more information on this subject! In a nutshell, it's recommended by all major organizations that doctors use WHO's growth chart, as it takes into account the unique growth patterns of breastfed babies, unlike other outdated growth charts that were based upon formula-fed babies' weight gain. You can ask your doctor which growth chart they use.
Regardless of the reason, if you want to exclusively breastfeed - you can do it! There's still hope!
Also, it is 100% okay if you want to continue giving formula. I feel like sometimes moms want to exclusively breastfeed because "it's the right thing to do" (and yes, there are benefits to breastfeeding). If you read the tips I give below and think - I don't think I want to do that - THAT IS OKAY!
The benefits of breastfeeding, while they're there, are not the end-all-be-all of your decision making. YOU are important, too. Read Cribsheet by Emily Oster for more information about the actual data behind breastfeeding vs. formula feeding. I am sure it will help you feel less pressure about this decision.
How to Exclusively Breastfeed After Formula Supplementation
Before I go any further - I want to give you my #1 tip for being successful at the transition from formula to all breastmilk:
Please, oh please, find a local & well-respected lactation consultant (LC) to help you, especially if you supplemented with formula due to milk supply or baby weight gain issues. Often, these issues are due to latch or tongue/lip ties. The lactation consultant you likely saw in the hospital may or may not have been helpful (and they often have a very large case-load).
In most mid-to-large sized cities, there are amazing lactation consultants who take insurance, do home visits, offer free breastfeeding groups, can diagnose tongue/lip ties, and be your cheerleader. There are also many LCs who offer virtual consultations, too. Most insurances cover at least 1-2 visits with an LC. If you receive WIC, they (usually) have LCs in office who can help you. Local mom facebook groups are great places to get recommendations for LCs.
Breastfeeding Basics You Need to Know
Breastmilk is produced by the principle of supply and demand. There is not a "fixed" amount of breastmilk that your body can make. If baby is sucking & nursing more frequently, your body will make more milk. If baby nurses less frequently, your body will stop making so much milk. This is why sometimes, if you supplement with formula, it can take some time for your body to begin making more milk once you begin exclusively breastfeeding. Your body thinks: This baby only needs a little bit of milk because that's all that baby has been eating.
Typically, this process will only take a short time and your body will get the message.
Here are my other tips
If you are only giving bottles to baby
Decide whether or not you want to continue giving breastmilk in bottles, or transition to no bottles (or only bottles when you're away). If you want to transition from only bottles to mostly breast-fed, I will highly recommend that you see an LC, as that process may take some trial-and-error. Babies get used to a quicker flow with bottles, and can get frustrated at how slow milk comes out of your breast. This isn't a cause for concern, but will take some perseverance and the help of a trained professional to make that transition happen.
If you have been breastfeeding and supplementing with a bottle of formula & want to only breastfeed (with occasional bottle use)
Begin slowly weaning baby off of bottles. For example, let's say that you always give a bottle of formula after you breastfeed baby: Drop a bottle of formula one at a time. I would go at a pace of 1 bottle of formula every few days. You can go quicker if things are going well and baby seems to be increasingly satisfied after feedings.
As you drop a bottle of formula, that means that you will want to breastfeed baby again if he shows signs of hunger. Even if it's 30 minutes after you got done breastfeeding, keep offering your breast to your baby. By doing this, you're telling your body to make more breastmilk (see Supply & Demand above).
You may be thinking - OMG that sounds really intense. And I want to prepare you that yes - you will be nursing a TON for the first week or two. So go ahead and pick out a show (or three) to binge watch on Netflix. Create a breastfeeding station. Have your partner or family take care of the meals & chores. Breastfeeding on-demand is the only way to get your milk supply to the level it needs to be for you to exclusively breastfeed. There's just no way around it.
At the beginning, I don't recommend pumping & giving bottles. There's just no substitute for the suck-pattern of a baby - it's simply the best way to get your body to make more milk. That means that you'll need to be on-call day & night for a couple of weeks. Plan accordingly (and remember that if exclusively breastfeeding is your goal, this all will be worth it).
After a couple of weeks (and breastfeeding is well-established with baby pooping & peeing appropriately), it's fine to start giving baby bottles of breastmilk again. Be sure to choose the slowest flow nipple possible and do paced bottle feeding.
If you want to (still) give only bottles to baby, but want to give exclusively breastmilk
(This is assuming that you have been pumping at least some of the time. If you need to completely re-lactate, I recommend finding an LC who can help you)
Follow the general structure for dropping formula bottles as outlined above. Instead of a formula bottle, you'll give a bottle of breastmilk.
In order to give exclusively pumped breastmilk, you'll need to increase your supply by "power pumping." Here's an article about how to do this. This method basically mimics breastfeeding on demand, but with a pump.
You may not have a "stash" of breastmilk available. If that's the case, begin power pumping a few days before you start dropping formula bottles, that way you aren't stressed about not having enough milk handy.
Be sure all your pump parts are working well and your flanges fit correctly.
Final Thoughts
Be sure to stay hydrated and to eat well. Hydration is an often overlooked part of milk supply. Get yourself a nice water bottle & ask your partner to keep it full. Also, this is not the time to be intensely trying to lose weight. Your body requires calories to make more breastmilk!
I always say that the first 6-8 weeks of breastfeeding are the hardest. It really does get better, and all of the work pays off. I was always amazed at how easy it was to breastfeed once I got past the first two months. It became like second-nature for me to breastfeed no matter where I was (in Target, at church, in the backseat of our van...). You can do it!
BUT: If you try what I outlined above and you don't like it or don't want to exclusively breastfeed anymore, that's okay! It's totally fine to go back to supplementing with formula.
These tips are not all that I can give! If you want to exclusively breastfeed and feel like you need understanding about how to latch, good positions to try to breastfeed, how to use a pump...I highly recommend taking our Breastfeeding Made Simple online class. This is an inexpensive, on-demand video-based class that will set you up for success with breastfeeding.
I'll end with saying this: YOU ARE A GOOD MOM. Period.
With love,
Jessica