Temporary Supplementation – What is it, and how do I do it ?
Part 1. What is Temporary SupplementationTemporary supplementation simply means a baby is fed by either formula or safe donor breastmilk for a short period of time. The difference between this and combination feeding lies in the fact that combi feeding is usually a long term choice made by parents who are happy using both formula and breastmilk. Whereas temporary supplementation is exactly as the name implies…it’s a stop gap to get you and your baby through a difficult time, most often used by parents who would prefer to breastfeed long term. Such supplementation is not a modern invention, it is perfectly normal in all cultures, with babies being fed throughout our history by other mothers/wet nurses (often family members or friends), with whatever milk substitutes they had access to, often milk, goats, sheep, horses, camels etc. The Roman, of course, gave honey and wine, not great for the baby ! Luckily for us we have access to safe, highly regulated formula designed especially for our human babies. Supplementation is mostly used in the first few days of the babies life to help keep them fed and healthy until the mothers milk supply comes in. The milk supply can arrive from day 3 onwards, but can sometimes take much longer than that, 11 days is the longest that one of my clients has experienced, but 4, 5 or 6 days is not uncommon.
ColostrumIn the first 2 to 3 days babies rely on their own body reserves, and on colostrum produced by the mother. If all goes well mum produces enough colostrum to keep the baby healthy and satisfied until her milk comes in. But it doesn’t always work like that. • Sometimes mum doesn’t produce enough colostrum, or she has a very hungry baby, or she is too weak/exhausted/ill after the birth to breastfeed. • Sometimes mums milk is slow to come in, or there isn’t enough to keep baby satisfied. • Sometimes baby is ill, or weak, or has problems latching on to the breast. These factors can come right with time, effort and support, but in the meantime baby MUST be fed. In the UK there is a supply of safe donor breastmilk that has been tested and stored properly, but this is usually kept for premature babies, so in reality, temporary supplementation involves using formula, which is a perfectly safe and healthy alternative.
Is My Baby Hungry ?I hear so many parents worry that they wont know if their baby is getting enough milk in the first few days, but it really is easy to tell. If your baby latches on, sucks for a while, and then they either stop sucking and seem relaxed and happy (they can look drunk, with milk dribbling out of their mouths so are often described as milk drunk) or fall asleep and are happy to be put down to sleep after some winding, then you can be pretty sure your baby is well fed. In my experience a new born baby with a full tummy, once winded, can be wrapped up and put down in their bassinet, and will sleep for 2 to 3 hrs. They don’t waste any effort crying for no reason
Signs your baby may need temporary supplementation (in the first few days)• Your baby latches on, seems to be sucking, but never gets to that milk drunk or sleepy stage. • Your baby feeds, falls asleep, but then wakes again after a short time. • Your baby latches on and feeds for hours at a time. • Your baby doesn’t latch on but cries at the breast. • Your baby only sleeps in your arms and can’t be put down. • Your baby cries a lot, often for hours. If your baby is showing any of these behaviours try supplementing and see how they react. If they drink then seem happier and more relaxed you did the right thing.
Warning SignsI hate to worry you, but there are also danger signs that indicate your baby is in urgent need of supplementation. This is known as Accidental Starvation which is not your fault, and can happen to anyone. The graphic below, from The Fed Is Best Foundation, shows symptoms to keep an eye out for if you think your baby might not be getting enough milk. If you are in hospital and you are worried about your baby being hungry or being at risk you should not hesitate to ask one of the medical staff. It may turn out to be nothing, but you should always raise your concerns. The 3 main risks for your baby at this point are dehydration, low blood sugar, and jaundice, all of which are very serious and can be fatal if not addressed so they should take your concerns seriously. Unfortunately in some hospitals that are more focused on promoting breastfeeding, there can be some resistance to supplemental feeding. In these hospitals they may tell you that babies stomachs are tiny and they don’t need much colostrum/milk, that its ok and normal for them to cry a lot, or that a baby feeding for hours at a time is just ‘cluster feeding’ and is perfectly normal. Believe me…it is not normal and is not ok, not in the first few days.
Trust Your InstinctsIf you think that your baby might be hungry, then go with that and offer them formula. If they take a couple of mouthfuls then stop, they weren’t really hungry and no harm was done ( contrary to social media hysteria, formula will not harm your baby in any way !) If they gobble down the milk then quite happily pass out and go to sleep, then your baby was hungry and you did the right thing.
Again, hospitals promoting breastfeeding can be very resistant to giving you formula so rather than put yourself in the stressful situation of having to ask, my advice would be to take in your own emergency supply of Ready Made Formula and bottles and teats so you have what you need, when you need it. You don’t need their permission to feed your baby ! If they continue to try and persuade you not to supplement, simply ask them to leave.