You’ve probably heard the phrase “breast is best” tossed around in the news or in your own mommy circle.

The truth is, what works for some women isn’t necessarily what will work for all moms. You may find yourself wanting or needing to supplement breast-feeding with formula.

Here are five reasons why moms choose supplementation, some formula basics, and a few tips to make combination-feeding work.

Reasons to try supplement breast-feeding

Supplementing breast-feeding with formula is also called combination feeding, mixed feeding, or complementary feeding.

There are a variety of reasons women may choose to feed their babies this way.

1. Serious illness in mother or baby

Pregnancy and childbirth don’t always go according to plan. The textbook scenario may not be your reality.

After delivery, you may be very ill, or have a baby who needs special medical attention. Whatever the case, your baby may need to eat formula for some time. If you do wish to continue breast-feeding, you can consider pumping milk to offer your infant at some or all feeds.

Many medications also aren’t safe for breast-feeding. If you’re put on one that isn’t, you can offer formula feeds while maintaining your milk supply through pumping.

2. Baby isn’t gaining weight

Babies are monitored closely in the first year for growth and development. Though the charts doctors use to assess growth rates are only taken from a sample of infants, you may find that your baby isn’t gaining enough weight. This isn’t always a reason for concern.

If your baby significantly falls off their own growth curve, some pediatricians will recommend supplementation for extra nutrition and calories.

3. Primary lactation failure

Not producing enough milk for baby? Friends and family may try offering suggestions to improve your supply. But you may not be able to produce enough if you’ve had a previous breast surgery, experience hormonal issues, or thyroid abnormalities.

Some women also have a condition called hypoplasia or insufficient glandular tissue, meaning their breasts do not have enough of the glands responsible for producing enough milk.

If you suspect you may have this condition, speak with your doctor.

4. Separation from baby

Moms who work outside the home face unique challenges with the idea of exclusive breast-feeding. You may not have a schedule that makes pumping milk easy, or you may simply not wish to pump at work.

In these cases, you may choose to nurse your child when you’re together (not at work) and to supplement with formula when you’re separated.

As time goes on, some mothers may even try to have their babies “reverse cycle,” which means that they nurse more often in the time when mom and baby are together. This way, fewer supplemented feedings are needed overall.

5. Higher order multiples

You may have twins, triplets, or other higher order multiples. Feeding more than one hungry mouth may drain you physically and mentally. You may also want help from your partner or another caregiver.

There are a number of ways you can approach combination feeding with multiples. Some women choose to rotate feeds.

In this scenario, you would breast-feed one baby while the other gets a bottle. Then at the next feed, offer the bottle to the baby you had just breast-fed and nurse the baby who last had formula.

Formula basics

If you’ve visited the baby aisle at your local grocery store, you’ve probably seen a million formula options.

Formula comes in three basic forms, including:

  • powders that mix with water
  • concentrates that dilute in water
  • ready-to-use formulas that can be served directly to baby

The actual ingredients differ from formula to formula, too. You’ll find the following.

  • Cow’s milk: It typically has added iron, which is recommended for babies in most cases.
  • Soy-based formulas: These are also fortified with iron. They provide a good option to babies who are allergic to lactose or for parents who don’t want them to eat animal products. It’s important to note that many babies who are allergic to cow’s milk are also allergic to soy-based formulas.
  • Hypoallergenic formulas: These are some of the easiest to digest. They are a solid choice if baby is allergic to milk and soy.

Specialized formulas are also available for premature and low birth weight babies.

With so many options, the process of choosing which formula to use may seem daunting. Try to go with what meets your family’s lifestyle, budget, and your baby’s needs. If it doesn’t work, you can always try something else.

Your pediatrician may be able to help guide your choice while taking your child’s specific medical history into consideration.

How to make supplementation work for your baby

Supplementing breast-feeding with formula comes with its own challenges. It’s a delicate balance to feed your baby without shortening or interfering with lactation and the breast-feeding relationship.

It’s best to begin any supplementation with formula after baby is “thriving” on their mother’s breast milk.

In other words: Try to avoid frequent supplementation in the early days if you can. If possible, try exclusively breast-feeding for at least the first three to four weeks before offering formula.

From there, your baby may not want to take a bottle from you. Many babies do better if they receive supplemental feedings from another caregiver.

If you’re having considerable trouble getting your little one to drink formula from a bottle, try changing the scenery. Offering formula in the same setting where baby breast-feeds may not be the best option. The baby may expect the breast.

As with many situations, some babies will likely do better with transitioning from bottle to breast than others. Try to be consistent with your new routine. Ask for help when you need it.

Next steps

While you may have heard “breast is best,” there’s a new phrase making the rounds these days. It states that “fed is best.”

As a parent, you’re doing the best you can for your baby. If supplementation is something that you feel will work for your situation or lifestyle, do your research and try it out. Your doctor and a lactation consultant can help with any issues you face along the way. Make an appointment today to discuss your plans.