|SSM Cardinal Glennon Children's Medical Center|
Breastfeeding FAQs: Solids and Supplementing
Whether you're a new mom or a seasoned parenting pro, breastfeeding often comes with its fair share of questions. Here are answers to some common inquiries that mothers — new and veteran — may have.
Is it OK to give my baby breast milk and formula?
The American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommend that babies be breastfed exclusively for the first 6 months. Beyond that, the AAP encourages breastfeeding until at least 12 months, and longer if both the mother and baby are willing. The WHO recommends that babies be breastfed for at least 2 years or longer.
Experts know that breast milk is the best nutritional choice for infants. In some instances, breastfeeding (or exclusive breastfeeding) may not be possible or an option. The decision to breastfeed and/or formula feed should be based on comfort level, lifestyle, and specific medical considerations.
Breast milk is all that is needed for about 6 months, at which time complementary foods are introduced. Most babies can exclusively breastfeed without the need for any formula. A mom who cannot provide all the breast milk her baby needs might be able to meet with a lactation consultant for guidance to increase her supply.
Babies who need supplementation may do well with a supplemental nursing system in which pumped milk or formula goes through a small tube that attaches to the mother's nipple, or can be temporarily fed the pumped milk or formula by bottle.
Some experts feel that giving bottles too early can create "nipple confusion," leading a baby to decide that the bottle is a quicker, better option than the breast. To avoid this, be sure that your little one has gotten used to and is good at breastfeeding before you introduce a bottle. Lactation professionals recommend waiting until a baby is about 3 weeks old before offering artificial nipples of any kind (including pacifiers).
It's important to remember that your baby's health and happiness is, in large part, determined by what works for you as a family. So if you need to supplement, your baby will be fine and healthy, especially if it creates less stress for you.
If I need to give my baby formula, how do I start?
If you're using formula because you're not producing the amount of milk your baby needs, nurse first. Then, give any pumped milk you have and make up the difference with formula as needed.
If you are weaning from one feeding at the breast or from breastfeeding altogether, you can begin to replace the desired amount of breastfeeding or pumping sessions with bottle feeds. To eliminate a feeding at the breast or a pumping session, you should pump to reduce uncomfortable engorgement so you will not have problems with plugged ducts or mastitis.
As you eliminate breastfeeding sessions, your milk supply will decrease and your body will begin to adapt to produce enough milk to accommodate your new feeding schedule. Starting your breastfed baby on formula can cause some change in the frequency, color, and consistency of the stools (or poop). Be sure to talk your doctor, though, if your baby is having trouble pooping.
If your baby refuses formula alone, you can try mixing some of your pumped breast milk with formula to help the baby get used to the new taste.
Is it OK for me to give my baby the first bottle?
If possible, you should have someone else give your little one the bottle at first. Why? Because babies can smell their mothers and they're used to receiving breast milk from mom, not a bottle. So try to have someone else — such as a caregiver or partner — give a breastfed baby the first bottle.
Also consider either being out of the house or out of sight when your baby takes that first bottle, since your little one will wonder why you're not doing the feeding as usual. Depending on how your baby takes to the bottle, this arrangement may be necessary until he or she gets used to bottle feeding.
If your little one has a hard time adjusting to this new form of feeding, just be patient and keep trying.
When should I introduce solid foods and juice?
Although many women in the past started giving their babies solids early on, the AAP now recommends waiting until your baby is 6 months old before introducing any solid foods at all. Why? Because feeding solids earlier than that can increase the chances of your baby developing food allergies.
Breast milk provides everything babies need nutritionally until they start eating solid foods. Watch for signs of solid-food readiness, such as your baby's tongue-thrusting reflex subsiding and your baby having good head control and beginning to reach for other people's food.
Start with baby cereal on a spoon (rice cereal is usually the best to introduce first) before advancing to fruits and vegetables. But do not add cereal to your baby's bottle unless your doctor instructs you to do so. Cereal added to bottles can be difficult for young babies to swallow and can make them overweight.
Fruit juices shouldn't be given to babies. There is no benefit to offering juice, even to older babies. Juice can fill them up (leaving little room for more nutritious foods), promote obesity, cause diarrhea, and even put a baby at an increased risk for cavities when teeth start coming in.
And remember to never put your baby to bed with a bottle.
Reviewed by: Joseph DiSanto, MD, and Karin Y. DiSanto, IBCLC