How Much Formula to Give When Supplementing?

By Markita Lewis, MS, RD

Markita is a clinical dietitian with a passion for the biological, social, and cultural aspects of eating. She enjoys writing about nutrition and wellness, food justice and policy, cultural foodways, and the psychology of nutrition.

 

Moms know that breastfeeding isn’t easy work. 

Although it’s a special time to bond with your child, feeding sessions can take up to an hour, and for some women, latching can be painful. And then there’s the seemingly endless amount of breastmilk a growing baby demands. This is why many moms choose (or are professionally recommended) to supplement their breastfeeding with baby formula, especially as the child ages into a toddler.

But weaning your baby off breastfeeding isn’t an overnight process. You have to supplement the right way. Below, we’ll outline the safest and smartest approach for you and your little one. 


What is Supplementing? 

Supplementing is a process that combines the nutritional powers of breast milk with precisely-formulated nutritional baby formulas and then toddler formulas when they’re older. Formula supplementation is a safe way to relieve mothers stuck in the constant feeding cycle while ensuring that a baby or toddler is receiving all of the nutrients they need to grow. 

The American Academy of Pediatrics (AAP) recommends that mothers breastfeed for the first six months post pregnancy and then slowly introduce solid foods or supplements over the next year. However, some mothers formula feed or add supplements within the first few weeks post pregnancy! If you're wondering how to transition a baby from breastmilk to formula, we are here to help!


How Much Formula To Supplement? 

Generally speaking, babies eat when they’re hungry and stop when they’re full. According to Dr. Julie  Ware: “No matter what your breastfeeding goal, making sure that your baby is being fed properly is one that is cited first by health care practitioners and doctors trained in breastfeeding. Many moms are surprised by how often a baby eats—generally, eight to 12 times every 24 hours.” 

In the initial infant months, babies should be fed whenever they get fussy. 

If you’re supplementing your breastfed infant early on, it’s important that you don’t introduce more than a bottle or two (per day) in the early weeks unless it is required. IF your goal is to breastfeed, you should try not to supplement. Women’s breast milk functions on a supply and demand basis. 

Thus, introducing infant formula can impact how much milk you naturally produce. As you supplement more and more with formula feeding, your natural milk  production wanes. So, it’s best to start slow and let your and your child’s body adapt to this dietary change. For more information on when to start supplementing with formula, check out our blog article!

For a baby that’s using formula in lieu of breastfeeding, the proper supplement schedule looks like this: 

  • First few weeks – Baby will require 2 to 3 oz of formula every meal, with a feeding schedule of once every 3 to 4 hours. 
  • Month 1 – The baby will require at least 4 oz of formula every meal, with a feeding schedule of once every 4 hours. 
  • Month 6 – The baby will likely eat 6 to 8 oz at every meal, with four to five feedings every 24 hours. 

Afterwards, your baby should consume 2.5 oz of formula a day for every pound of body weight. Typically, your baby will signal to you when they’re hungry or satiated , and you can feed accordingly. Once the baby reaches 12 months, you can begin supplementing the baby’s solid food with toddler formula.

At this stage, how you supplement with formula is up to you. It can be a daily addition or occasional supplement to breast milk, dairy milk, or solid food. 


Reasons to Supplement 

When it comes to the reasons why a mom starts to supplement, their reasons are varied. They include but are not limited to:

  • The breastfed baby has medical issues – If a baby is born prematurely or has certain medical conditions, they may need more than just breast milk to gain weight.
  • The toddler has milk allergies – One of the most common allergies for toddlers is a cow’s milk allergy. Sometimes, formula can be a substitute for supplemental dairy products. 
  • You can’t produce enough milk – Some moms are unable to keep up with their baby’s demand for breast milk. If your baby’s doctor feels like you aren’t producing enough milk, they will likely recommend supplementing with extra milk such as donor milk or powdered formula.
  • Your partner wants to help feed – Sometimes, your partner wants to help handle a feeding session or two. With this, you could either pump into a bottle or supplement with baby formula.  
  • You plan on returning to work – It may be too demanding to pump enough milk while at work. Additionally, returning to work can change the feeding schedule, which could reduce your breast milk supply. In either case, you may need to supplement your child’s diet with formula. 
  • You have multiple mouths to feed – If you have twins, exclusive breastfeeding could pose a significant challenge with breast milk production. Not only do you need enough breastmilk, but you’re also feeding for two! Formulas can help you better manage feeding two hungry babies. 

What Are Signs that Your Baby may Need a Supplemental Formula? 

Typically, doctors highlight certain “signals” that prove your baby is receiving an adequate amount of breast milk. These include but are not limited to: 

  1. Safe, steady weight gain – Babies lose around 10% of their birth weight in their first week of life. After, the baby should gain a half an ounce to an ounce per day for the following three months. 
  1. Lots of wet and dirty diapers – After a few days have passed, the baby should be producing at least 6 wet diapers and 3 stools within a 24-hour period. 
  1. Productive nursing – A baby should nurse at least 8 to 12 times every 24 hours during the first month. Sessions should stay between 15 and 45 minutes, and you need to ensure you can hear the baby swallow. 

If you notice that your baby has lost more weight than normal, they aren’t producing enough diapers, or their nursing sessions are either overly long or short, it may be a sign that your baby needs supplemental formula to help aid their growth. 

Consult with your doctor immediately to determine the proper course of action. 

After you’ve added formula to the feeding routine, be sure to monitor signs of your baby’s growth and constitution. If the baby is happy, growing steadily, and producing wet diapers, you should be on the right track. However, keep an eye out for signs of vomiting or tummy pain, which could indicate that your baby is ingesting too much formula. 


How Adding Formula Can Affect Your Baby 

If you’ve only been breastfeeding, slowly adding supplements to their feeding sessions will likely have some noticeable impacts on your baby. 


To that end, a few natural adjustments may include: 

  • Longer breaks between feedings – It’s much easier for a baby belly to digest breast milk than an infant or toddler formula. This makes them feel fuller for longer. As a result, once you start supplementing, your baby may not seem to gain an appetite as quickly after a meal. 
  • Refusing the bottle – Some babies take a while to transition from the breast to bottle. Others flat out refuse. A baby may need some coaxing to make the switch.
  • Refusing the breast – On the flip side, some babies and infants take a liking to formula—so much so that they no longer want to nurse. For many young ones, drinking formula is easier and more satisfying than breastfeeding.
  • Bowel movement changes – If you add formula to your baby’s diet, you can expect to notice changes in the color, consistency, and pattern of your baby’s stool. Bowel movements may occur less frequently, have a stronger odor, and become darker and firmer.   

Selecting a Baby Formula 

Today, there are dozens of baby formula supplements available. The sheer volume of options can make it difficult to identify the right formula for your child. With that being said, there are four key qualities that a baby formula should have: 

  • Proper nutritional balance – The FDA has created specific regulations for the necessary concentrations of fat, protein, and carbohydrates. Your baby’s food should contain the ideal combination of nutritional elements to support healthy growth. 
  • Organic – A large percentage of baby formula is made using synthetic or genetically modified ingredients. When searching for an organic baby formula, look for a label that says “certified organic” so that you know your child’s nutritional source is safe and natural.
  • Whole food ingredients – An adequate nutritional supply is more likely to come from whole food ingredients as opposed to isolated components. Your child’s baby formula should contain mostly whole food ingredients with zero synthetic ingredients. 
  • Vitamins A & D –  There are dozens of vitamins that a baby needs to grow healthy and strong. Few are more important in the early stages of development than vitamins D and A.  

On the other hand, be wary of products that contain GMOs, vegetable oils, and heavy metals—all of which can have negative effects on a baby’s health. 


ELSE — The Ideal Plant-Based, Non-Soy Toddler Formula 

Supplementing is an important process that many mothers utilize to ensure that their baby is receiving adequate nutrition. But when first beginning, it’s important that you consult your doctor. Once you’ve introduced a supplement, make your child’s transition a gradual one. Let your baby and body adjust to the new routine before making any big adjustments. Check out our blog article on how to switch formulas, so that if your child is over 12 months you can make a healthy switch to Else today. 

And when it comes to finding the best formula for your toddler , you’re already here. 

At Else, we provide complete nutrition using a plant-based organic supplement formulated with three main ingredients: organic almonds, tapioca, and buckwheat. We’re the natural, doctor-recommended alternative to a dairy-based formula. 



 

Sources 

AAP. Breastfeeding and the Use of Human Milk. https://pediatrics.aappublications.org/content/129/3/e827


What to Expect. Why Don’t We Tell Moms How Hard Breastfeeding Is? https://www.whattoexpect.com/news/first-year/why-dont-we-tell-moms-how-hard-breastfeeding-is/


Stanford Medicine. Infant with Loss of 10% Birth Weight. https://med.stanford.edu/newborns/professional-education/breastfeeding/babies-at-risk/infant-with-loss-of-10--birth-weight.html

 

The content and advice provided in this article is for informational purposes only and is not a substitute for medical diagnosis, treatment, advice for specific medical conditions. Always consult a pediatrician to understand the individual needs of your child. 


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