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Does Formula Affect Breast Milk Supply?

January 8, 2018 by  
Filed under Uncategorized

by Jennifer A. Gardner, MD

As a pediatrician, I’m frequently asked if formula affects breast milk supply. This is an important question, because nearly half of all mothers who plan to exclusively breast-feed end up supplementing with formula. Plus, a recent survey1 conducted by store brand formula found that three out of four moms use infant formula at some point during baby’s first year. Additionally, 17 percent of moms planned to wait until their baby was six months old to introduce infant-formula feeding; but only four percent made it that long.

So, does baby formula affect breast milk supply?

The answer, simply put, is yes and no.

The good news is that supplementing will not stop milk production, but it could decrease it. Fortunately, there are many approaches a family can take to minimize the risk of decreasing the mother’s breast milk supply.

First, whenever possible, introduce the bottle only after successful breastfeeding has been established. This avoids nipple confusion and helps ensure a healthy supply of breast milk. Since this strategy isn’t always possible, sometimes supplementing is considered earlier because of an inadequate milk supply.

In this case, supplement with formula only as needed. Your goal to maintain adequate milk supply is to empty the breast with each feed. This means breastfeeding as much as possible and pumping when you do bottle-feed. When you pump and add the breast milk to formula, your baby gets the volume and calories he needs, and you get the signal to keep producing milk!

A baby must work harder when breastfeeding versus bottle-feeding. You can use a special nipple that makes the baby work harder so she doesn’t associate bottle-feeding with easier feeding!

In the end, the decision to supplement or when to supplement is a very personal one. You must weigh the benefits of formula with the potential for decreased milk production. The survey also discovered that 35 percent of moms chose to feed their baby with infant formula so they could share the feeding responsibilities for baby with their spouse. While this decision may be difficult, there are no right or wrong decisions. What we know is that all babies do best when the mother is relaxed and confident with feedings. If supplementing with formula reduces your stress level, this may help with breast milk production.

Whether moms choose to breastfeed, formula-feed, or use some combination of both, parents should feel confident in their decision. In fact, did you know that all infant formulas sold in the United States must meet the same FDA standards and offer complete nutrition for baby? That means even cost-saving store brand formula is nutritionally comparable to nationally advertised brands.

And remember to give yourself credit. I tell my patients that any amount of breast milk is beneficial to your baby. There’s never room for guilt in the feeding relationship.

About the author: Jennifer A Gardner, MD, is a mom of a three-year-old son, a pediatrician, and the founder of an online child wellness and weight management company, HealthyKidsCompany.com, in Washington, DC.

My Feeding Prescription

January 5, 2018 by  
Filed under Uncategorized

by Jennifer A. Gardner, MD

One day, I entered an exam room to find a new mom quietly sobbing into a tissue as she held her newborn baby. I sat down next to the mom, and we began to talk about her difficulty breastfeeding. The new mom tearfully told me that latching on was a challenge, and her milk supply was suffering.

The mom had expected breast feeding to be natural and easy. But even after lactation consultants and multiple doctor visits, she felt frustrated, guilty, and pressured. She felt tons of pressure—from her family and even from her husband to make breastfeeding work and not to supplement.

As she cried, I knew that I was observing the culmination of so many tumultuous emotions and deeply entrenched expectations. Reality was not meeting expectations.

I offered the mom reassurance. I explained that we mothers are told that breast is best and natural. But it doesn’t always come easy!

After I could tell the mom felt a bit unconvinced, I moved on to finding a solution. I’ve learned in my practice that in cases like this, the best thing to do is what works.

I knew that if this mom needed to supplement with infant formula while we worked on increasing her supply then that’s what would be best for her and the baby.

I gently explained this to her. But still the mom was worried. She agreed that supplementing with infant formula was best for her baby—and for her. But she didn’t believe that her family would accept this advice.

So together, we hatched a plan. I wrote her a prescription to supplement with a bottle—filled with either breast milk or formula.

With relief, and a gentle smile, the mom agreed to give it a try. And out came my prescription pad!

I asked the mom to keep me posted on her progress. She told me that her milk supply steadily increased over the next few weeks. Plus, she said that she felt more confident and relaxed.

The new mom and I even laughed when I told her breast is best, but sometimes a bottle (breast milk or baby formula) can be a girl’s best friend!

Many new moms find breastfeeding to be a challenge. Store brand formula conducted Baby’s First Year[1] survey earlier this year and found more than half of moms experience issues when it comes to breastfeeding baby, with low breast milk supply being the top concern. The new trend of “fed is best” echoes that whether moms choose to breastfeed, formula-feed, or use some combination of both, parents should feel confident in their decision. In fact, did you know that all infant formulas sold in the United States must meet the same FDA standards and offer complete nutrition for baby? That means even cost-saving store brand formula is nutritionally comparable to nationally advertised brands.

The survey also found that sometimes the pressure for mom to breastfeed is too much. One out of three moms experienced situations where they felt the need to justify to others why they use infant formula to feed baby. Additionally, one out of 10 new moms lied about breastfeeding baby to avoid criticism from family and friends.

The fact is that nowadays three out of four moms use infant formula during their baby’s first year. And that is perfectly ok! Moms need to do what is right for their baby and for themselves.

About the author: Jennifer A Gardner, MD, is a mom of a three-year-old son, a pediatrician, and the founder of an online child wellness and weight management company, HealthyKidsCompany.com, in Washington, DC.

 

[1] Store brand formula Baby’s First Year survey was conducted between February 13-20, 2017, among 2,000 nationally representative Americans between the ages of 18 and 65 who currently have a child between the ages of one and three, using an email invitation and an online survey.  Margin of error is +/- 3 percent.

Unconfusing Nipple Confusion

December 4, 2017 by  
Filed under Uncategorized

by Michelle Davis-Dash, MD

Breastfeeding is not always beautiful, fun, and easy. To be honest, sometimes it can be downright ugly and hard. There’s one important thing to remember: You are not alone.

One of the frustrations that breastfeeding mothers encounter is method of feeding. In the beginning, there’s such a sense of accomplishment putting baby to breast and no longer feeling the pain and dread that was felt in the beginning. A new mom feels a sense of pride seeing her dear baby satiated by nursing at her breast and the sweet satisfied “milk coma” that comes after.

According to the Centers for Disease Control and Prevention’s breastfeeding report card (cdc.gov/brestfeedingreport), more than 80 percent of new moms try breastfeeding. Despite the many benefits of breastfeeding, most moms, for various professional and personal reasons, introduce a bottle at some point. Many babies resist this change. It’s a “no go.” The new moms panic, thinking, “My baby is going to starve. I’ll never be able to leave the house because I have to be here to feed my baby.”

Rest assured, there is hope. When a baby refuses to accept a bottle, it’s called “nipple confusion.” With some diligence, patience, time, and simple solutions, you can unconfuse your baby. Here are some ideas to try:

Before you try to give your baby a bottle, make sure she/he is hungry. Sometimes a baby wants to suckle for comfort, and that’s not the time to try to introduce the bottle. Instead, try switching to a bottle during a breastfeeding session. That way, if it doesn’t go well, you can put baby back on the breast and try switching to a bottle again later.

  • For infants from birth to two months old, a bottle may not be your best option to feed pumped breastmilk. Instead, you can use a plastic-tipped spoon, a medicine dropper, or a lipped cup.
  • A new breast milk bottle by nanobebe (link) is receiving some strong buzz (link to the bump article naming nanobebe the best bottle for breastfed babies). Unlike the uniform baby bottle shape, the nanobebe breastmilk bottle has a (breast like) ergonomic shape to which the baby is meant to instinctively connect. The concave shape was bio medically engineered to spreads the milk into a thin layer which warms at faster rates to protect nutrient damage while providing quick access to nutrition when baby is crying and hungry (a need fulfillment baby has grown accustomed to while breastfeeding).
  • Pump often. When you are first transitioning your baby to a bottle, you might have to do what is called “triple” feeding: a combination of nursing, bottle feeding, and pumping. You’ll have more than enough milk supply to experiment with different feeding techniques and know that you’re providing adequate nutrition.
  • If you’re concerned that your baby isn’t getting enough milk see your pediatrician immediately. Your baby’s doctor will monitor her developmental progress, tracking growth parameters and troubleshooting before things get serious, which, for an infant, can sometimes happen in a matter of hours to days. If your pediatrician is not well versed on breastfeeding, find one that is.
  • Last, but not least, relax. Don’t be so hard on yourself. Mothering is hard enough without piling more stress on yourself. You’re doing one of the most noble things imaginable—feeding your baby breast milk–and you are rocking it! Let yourself be proud of yourself!
About the author: Michelle Davis-Dash, MD is a mom of a son and a daughter, a board-certified pediatrician with more than 10 years of clinical experience, and a medical contributor to the Mommy MD Guides, in Baltimore, Maryland.

Breast or Formula? Do I really have to choose?

September 14, 2017 by  
Filed under R.McAllister

by Rallie McAllister, MD, MPH

Life is like a giant flow chart. Every minute of every day, you’re making decisions, whether you realize it or not – surprisingly it adds up to about 35,000 decisions a day!

Bath or shower?

Turn left or right?

Chicken or fish?

There are some things in life we feel so strongly about, we make a choice once and that’s it. For example, many decades ago you probably decided if you were a Republican or a Democrat, and you probably haven’t looked back.

Fortunately, other choices in life aren’t so definite. For example, no one minds if you bag your groceries in paper one day and use plastic the next.

In parenting, some moms feel tremendous pressure to choose between breastfeeding or formula feeding. My experience is a great example of how this doesn’t have to be a defining moment. It doesn’t have to be a limiting choice. It’s perfectly fine—better even—to choose both.

I got the best of both worlds by breastfeeding and formula feeding with all three of my sons, and I would not change that experience for the world! For all three of my kids, I started nursing. But early on, I supplemented with formula. I found this to be beneficial for two main reasons.

One, my husband could also feed our babies. This was incredibly valuable for me, and it was also a very positive experience for him and for our sons. And I’m not alone, in fact, 35 percent of moms chose to feed their baby with infant formula so they could share the feeding responsibilities for baby with their partner, per a survey conducted by Perrigo Nutritionals, the makers of store brand infant formula.

Two, adding formula helped me to transition back to work. Before my sons were born, I had bought a breast pump, and I worried a lot about how I was going to pump at work. Turns out I didn’t anticipate everything I could have. The first day I returned to work, I pumped—in the teeny supply closet they offered me. I put my pumped milk in a sealed container in the office refrigerator.

Imagine my surprise when the office administrator told me I had to move it to the biohazard refrigerator instead because milk was a body fluid. She wanted me to put my baby’s milk in with the throat cultures and stool samples!

I found that supplementing with formula meant that I no longer had to pump at work. That convenience factor helped simplify one aspect of my otherwise chaotic life. For many working moms, “convenience” is the number one factor for choosing to feed baby with infant formula. I nursed my sons at home before and after work, and then they drank formula during the day.

This flexibility helped me, and it also helped my babies as well. My sons thrived on the seamless combo of breastfeeding and formula feeding.

If you decide to combo feed and you receive formula samples at the hospital, rest easy knowing that you can switch from the nationally advertised brand to a less expensive, nutritionally comparable store brand formula when you return home with baby.  In fact, a clinical study by University of Virginia researchers found that switching from one brand of formula to another is safe and well tolerated in infants.

In the study, babies who switched from a big-name milk-based formula to a store brand milk-based formula didn’t experience an increase in spit up, burping, gas, crying or irritability compared to babies who stayed with the advertised brand. No matter what you decide – breastfeeding, formula feeding, or supplementing with formula – please know that all three or a combination of these options will support your baby’s healthy growth and development.

 

About the author: Rallie McAllister, MD, MPH, is a family physician and mom of three sons in Lexington, KY. She’s the co-author of the Mommy MD Guides books, including The Mommy MD Guide to Your Baby’s First Year.

About the survey: Perrigo Nutritionals, the makers of store brand formula, conducted the survey in February of 2017, among 2,000 nationally representative Americans between the ages of 18 and 65 who currently have a child between the ages of one and three.  Margin of error is +/- 3 percent. To learn more about store brand formula or to discover special promotions or offers, visit storebrandformula.com.


The information on MommyMDGuides.com is not intended to replace the diagnosis, treatment, and services of a physician. Always consult your physician or child care expert if you have any questions concerning your family's health. For severe or life-threatening conditions, seek immediate medical attention.