A Breastfeeding Mom’s Guide to Supplementing with Formula

Formula is not commonly talked about amongst breastfeeding moms because most moms set out with the intention to provide exclusive breastmilk for their baby. As a lactation consultant I will always support mom with her breastfeeding goals, however, there may be times when exclusive breastmilk/breastfeeding is not possible. We will start out by pumping to be able to use mom's milk but there are scenarios when mom is not able to produce enough milk, mom and baby are separated, baby is losing weight, baby is not able to transfer the milk or is not tolerating the milk. Thankfully, all of these scenarios are rare! 

The number one rule is to always FEED THE BABY! The goal is to use breastmilk, but if that is not possible then formula is the back up. It is important to be educated about how to prepare it so here are the basics about what you need to know.

1. Check the expiration date and the directions on the formula container for specific instructions.
2. Powered formula and liquid concentrate formula will need to be mixed with water.
3. Check with your pediatrician whether you will need to boil the water. City tap water is generally fine but it is important to have your water checked prior to using for safety reasons. Let the cold water run for several seconds and then measure out the amount of water that you need. Many parents will choose to mix formula using bottled water (do not use distilled).
4. Using a clean and sanitized bottle, measure out the exact amount of formula with the exact amount of water. If using powdered formula, use the scoop that comes with the formula and when scooping the formula is should be an unpacked and level scoop of powdered formula.
5. Add the water to the bottle first and then add the formula. Shake or quickly move in the shape of an "8" until it is thoroughly mixed and there are no visible clumps of formula. If you are preparing formula in bulk, then you can use a larger pitcher to make bigger quantities. You would then pour the amount you need into each bottle.
6. If you are using breastmilk and prepared formula then it is safe to mix them together. If your baby is not finishing all of his bottles you may want to consider offering the breastmilk first.
7. Many babies like the milk warmed, but some like it at room temperature. Warm the bottle in a large mug or bowel of warm tap water (~1-2 min), run it under warm tap water (~1-2 min) or use a bottle warmer. Check the temperature on your inner wrist before giving it to your baby. It just needs to be luke warm. Never microwave.
8. Prepared formula can be stored in the refrigerator and should be used within 24 hours of mixing.
9. Once the baby has started sucking on the bottle for both breastmilk and formula it must be used in 1-2 hours. Babies have bacteria in their mouth and that can potentially get into the bottle of milk. 

What is paced bottle feeding?

Paced bottle feeding is a way to bottle feed your baby so the feeding is slowed. Even the slowest flowing bottle can flow quicker than what a baby would do at breast so paced feeding helps to mimic breastfeeding. The bottle is held horizontonally and when the baby starts to drink quickly, then you either tip the bottle down or take it completely out of their mouth. Frequent burping is necessary with bottle feeding. Check out the Paced Bottle feeding video on the Baby's Best Beginning YouTube channel to learn more.