Top 6 reasons why you SHOULD supplement with formula

Women who are certain they want to breastfeed are often devastated if they need to temporarily supplement with formula.

The key point to remember: you are not a failure. And it isn’t the end of the world. There are some key medical reasons why it’s necessary. And offering formula for a short time won’t sabotage breastfeeding success.

1. Premature newborn. If your baby is born between 24 to 34 weeks gestation, they probably won’t be able to breastfeed initially. You’ll need to start pumping to stimulate your milk production. 

2. Late preterm newborn. Babies born between 34 to 36 6/7 weeks gestation tend to be very sleepy, lazy, and inept at efficient suckling at the breast. You can nurse exclusively once baby's skill and energy level improves, baby's weight is gained appropriately, and you are making at least 3 oz. of milk combined from both breasts for each feeding. 

3. Low blood sugar (hypoglycemia). Some newborns have trouble maintaining an adequate blood sugar level. Babies with low blood sugars lack the energy to eat, which leads to persistently low blood sugar. Besides its negative impact on feeding, sustained low blood sugars can lead to brain injury and seizures. The temporary solution is to offer supplemental formula in addition to nursing.

4. Excessive weight loss. Newborns that lose more than 10% of their birth weight are dehydrated. They lack energy to eat (another vicious cycle) and so they lose more weight, end up with low blood sugar, and develop jaundice. If your baby is dehydrated and your mature milk hasn't arrrived yet, supplement with formula.

5. Significant jaundice. Humans clear out a waste product (called bilirubin) in their poop. Bilirubin has a yellow pigment to it. In the first few days of life, a newborn doesn’t clear out much bilirubin because the liver (which breaks it down) doesn’t function at 100%. For a variety of reasons, some newborns get significantly jaundiced. If there is more bilirubin than the skin can handle, it collects in the brain and can cause permanent brain damage (called kernicterus). There are several ways to prevent kernicterus, but the first and simplest thing to do is to get a newborn to eat and poop more. For a breastfed baby, that means supplementing with formula for a few days.

6. Maternal reason. Sometimes a mom intends to nurse, but encounters a medical problem of her own that prevents her from doing so at first. Those problems include: postpartum bleeding, high blood pressure, etc. If this happens to you, don’t let it get you down. Nurse as much as your OB doctor allows and let your baby have some formula until you have recuperated.