Put baby to breast often
Aim for 10 breastfeeding sessons per day. If baby is not breastfeeding well, work with your lactation consultant.
Method for weaning from supplements
Do not drop supplements suddenly – this should be a gradual process.
Have you seen
- Prepare: Talk to baby’s health care provider and get his/her input. Record supplement amounts for a few days to determine how much supplement baby is getting per day. Use expressed milk for supplements if available. If you don’t have enough expressed milk, add banked milk or formula.
- Days 1-3: Take the current supplement amount (#1) and reduce by 1 oz (30 mL). Note that you’re not reducing 1 oz at every feeding, but 1 oz over the entire day. Monitor baby’s wet & dirty diapers. If diaper count is good, then do not exceed this amount of supplement each day – keep putting baby back to the breast if he wants to eat more.
- Days 4-6: Take the current supplement amount (#2) and reduce by 1 oz (30 mL). Monitor baby’s wet & dirty diapers. If diaper count is good, then do not exceed this amount of supplement each day – keep putting baby back to the breast if he wants to eat more.
- Days 7-9: Take the current supplement amount (#3) and reduce by 1-2 oz (30-60 mL) – try 2 oz if things are going well. Monitor baby’s wet & dirty diapers. If diaper count is good, then do not exceed this amount of supplement each day – keep putting baby back to the breast if he wants to eat more.
- Continue the above method, slowly reducing the amount of supplement every 2-3 days as long as baby’s diaper count and weight gain indicate that he’s getting enough milk. Once you get to the point that the supplements are only expressed milk (no formula), then you can usually proceed at a faster pace–at this point you are making enough milk for baby and just need to transition baby to getting milk only at the breast (when not separated from mom).
- If baby’s weight gain or diaper count are borderline or inappropriate, then spend several more days at the same supplement level, or return to the previous supplement level and proceed at a slower pace.
- Monitor baby’s growth. Weigh baby at least once a week to ensure that he is gaining appropriately. Get another weight check a week after baby is completely back to the breast, to reassure yourself that things are going well. Keep in touch with baby’s health care provider throughout this process.
Pump to increase supply
- Pumping will help you to increase supply faster, plus you will be able to use your milk instead of formula for any needed supplements. Your aim in pumping is to remove more milk from the breasts and/or to empty the breasts more often. The more milk you remove, the more milk you will produce.
- A hospital-grade double pump will save time and maximize your pumping efforts.
- Until supply is well established, it is important to get at least eight good nursing and/or pumping sessions per 24 hours. Ten sessions per day is better.
- If baby does not breastfeed at a feeding, pump for 20-30 minutes, or for 2-5 minutes after the last drops of milk. If baby breastfeeds, but does not soften the breast well, pump for 10-15 minutes after nursing. If baby softens the breast well, then adding pumping sessions between breastfeeding sessions is most helpful.
- Empty the breast as thoroughly as possible at each session. To ensure that the pump removes an optimum amount of milk from the breast, keep pumping for 2-5 minutes after the last drops of milk. Use breast massage prior to pumping, and massage and compressions during pumping to better empty the breasts and increase pumping output.
This method of reducing supplements was adapted from the methods used by Kathy Kuhn — Thanks, Kathy!
Go to professional handouts to view handouts on weaning from supplements
More information on transitioning baby back to breastfeeding
@ other websites
- The “Finish at the Breast” Method of Supplementation – Christina Smillie, MD, IBCLC, suggests an alternative way to use bottles for supplementation that she believes results in less supplementation, improved feeding at breast, less need for pumping, and an ultimately greater milk supply as a result of improved milk removal.
- Info from by Kathy Kuhn, IBCLC on reducing supplements: Weaning from Supplements, In: Supplementing the Breastfed Baby by Paula Yount