Breastfeeding FAQs: Solids and Supplementing_KH_Parent

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) says babies should 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.

Although experts believe breast milk is the best nutritional choice for infants, breastfeeding (or exclusive breastfeeding) may not be possible for all women.  For many, the decision to breastfeed and/or formula feed is based on their comfort level, lifestyle, and specific medical considerations that they might have.

Most babies do not need to have formula as well as breast milk (this is called supplementing). But for women who are having a hard time with breastfeeding or pumping or need to go back to work, supplementing breast milk with formula may be the only option. Of course, the more breast milk you can give your little one, the better.

Babies who require supplementation may do well with a nursing system in which formula or pumped milk goes through a small tube that attaches to the mother's nipple.

Some experts feel that if you give bottles too early — before your baby is used to breastfeeding — your little one might have "nipple confusion" and may decide that the bottle is a quicker, better option than the breast. While some babies experience this confusion, others have no problem transitioning between a bottle and the breast.

Most lactation professionals recommend that parents wait at least a month 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 or even go to 100% formula, your baby will be fine and healthy, especially if it creates less stress for you.

If I want to give my baby formula, how do I start?

Depending on how much formula you'd like to give your baby (whether it's one bottle a day, one bottle a week, or several bottles throughout the day), you can begin to replace the desired amount of breastfeeding or pumping sessions with bottle feeds.

Of course, 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. To reduce uncomfortable engorgement from skipping regular feedings, you may want to gradually decrease feedings over time.

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 the 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 formula 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 4 to 6 months old before introducing any solid foods at all. Why? Because feeding solids earlier than this can increase the chances of your baby developing food allergies.

Water and juice should not be given during a baby's first 6 months unless recommended by a doctor. Breast milk usually 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 (rice cereal is usually the best one to introduce first) on a spoon before advancing to fruits and vegetables. But do not add cereal to your baby's bottle unless your doctor instructs you to do so. Adding cereal to bottles can make babies overweight and can be difficult for young babies to swallow.

Also, fruit juices should not be given to babies younger than 6 months. Even when your baby is older, keep fruit juices to a minimum (no more than 4 to 6 ounces per day) and only offer it from a cup, not a bottle. Too much juice can fill a baby up (leaving little room for more nutritious foods), promote obesity, cause diarrhea, and can put a baby at an increased risk for cavities when teeth start coming in. When you do give your baby juice, make sure it's pasteurized and try diluting it with water.

And remember to never put your baby to bed with a bottle or capped cup of juice, formula, or breast milk because the sugar in them can cause dental cavities.

Reviewed by: Larissa Hirsch, MD
Date reviewed: May 2008

Related Sites

American Dietetic Association
Women, Infants, and Children (WIC)
American Academy of Pediatrics (AAP)
La Leche League
American Academy of Family Physicians

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