Is it necessary to supplement the formula with breastfeeding and how to do it correctly. When you need supplementary feeding for babies: rules for mixed feeding

When we say that a baby needs supplementation, it means that in addition to breastfeeding, the baby needs to be supplemented with expressed breast milk, donor milk or artificial formula.

Does the baby need supplementary feeding?

Supplement theory

Before giving your baby food, make sure that it is really necessary. Complementary feeding for no good reason is a surefire way to reduce milk supply. The baby will be satiated with supplementary food, so it will suck less milk from the breast. If the baby is truly malnourished, and the cause of the malnutrition cannot be quickly eliminated, supplementation is needed so that the baby can grow, develop and, ultimately, suckle. Yes, yes, it is difficult for a hungry baby to extract milk from the breast. As you remember, babies breastfeed well when they are calm and happy, rather than screaming with hunger, so supplementation helps to establish breastfeeding while you address the cause of malnutrition.

Before introducing supplements, seek help from the La Leche League leader, support group or breastfeeding counselor. You may be helped to avoid supplementing or teach you how to feed in order to preserve.

As we mentioned above, it is preferable to supplement the baby with expressed. If you do not have enough of your milk, try to find a donor one. And only if breast milk is not available in any form, consult your doctor for advice on what formula to feed your baby with.

Let's look at three different situations.

• In the first case, the family is preparing for the move or the holidays. For several days my mother was busy more than usual, so she fed less often. The baby became more anxious and asked for breasts more often. In this case, more frequent applications will solve the problem without pumping and bottles.
• In the second case, the baby sucks and grows, but does not gain weight. It may be difficult for him to suck. In this case, the mother expresses the milk and feeds the baby until he is strong enough to empty the breast well on his own.
• In the third case, the baby does not gain weight for a long time. During this time, the mother's milk supply decreased. In this case, the mother continues to breastfeed, begins expressing to increase the amount of milk, and supplements the baby with donor milk or formula in addition to her expressed milk.

How much supplement does the baby need? Only he knows the answer to this question. If for some time he was content with little, then at first he can do with small portions. After some time, a wolfish appetite may attack him, and he will eat much more. The baby's stomach is used to a small volume of milk, so it will take a few days before it can hold more food. Regular bottle feeding gives your baby the ability to stop eating when he is full. In a week, you will understand how much supplement your baby needs at different times of the day. Offer supplements first, then breasts. Some babies suckle better on a full stomach.

If the baby is not gaining weight well, he needs not only to grow, but also to catch up. Growth requires more food to grow faster, so it's no surprise that your little one eats so much first. Rapid growth during this time will also be noticeable along a steeper growth curve. When the baby regains weight, he may start to eat less.

How to give supplements? Supplementation should be given the way you think is right.

Supplementary feeding devices

One option is to supplement with a breastfeeding tube, sometimes referred to as a breastfeeding system. Don't be intimidated by the lengthy description, it's actually quite simple. In general terms, the idea is that a tube is inserted into the bottle that goes to your nipple. The baby suckles by sucking the extra milk through a tube from the bottle.

You can buy a supplementary feeding system, or you can make it yourself. To do this, we need a regular feeding bottle, a bottle teat, and a thin tube or probe measuring 5 on the Charière scale. You can also use a commercially available feeding tube. Cut a hole in the nipple slightly larger than usual. Insert the tube there. Place the pacifier over the bottle. Make sure the end of the tube is dipped into the milk. Stick the other end of the tube to your chest with tape. Many people like to fix the tube in the place where the baby's tongue will be, but, in general, where the tip of the tube will be is not important. It is important that it is in the baby's mouth between the upper lip and tongue. By trial, you will find a position that is comfortable for you. If you are having trouble making a breastfeeding system or are not sure how to breastfeed with it, seek help.

Infant feeding devices

Supplementary feeding method	pros	Minuses	Remarks
Spoon		Time consuming and inconvenient for a large amount of supplementary feeding.	A good way to supplement colostrum.
Pipette, disposable syringe, or periodontal curled-end syringe (useful for breastfeeding)	An easy and fast way for small amounts of feeding.	Time consuming for a large amount of supplementary feed.	Place your baby on your lap so that his head is raised. Place your feet on a coffee table, etc. Give your baby thumb sucking while feeding. Make sure that the tip of the syringe or pipette does not touch the sky or the baby's cheek.
Small cup	A simple method for feeding small amounts of milk.	Milk spills. It is difficult to understand how much milk the baby drank.	Ask someone to drink you from a cup. Try to feed someone from a cup. In both cases, the person being fed eats with his eyes closed. This will teach you how to cup feed your baby.
Finger feeding	Easy to learn.	Can lead to nipple confusion.	Ready-to-use finger feeding systems are on sale. The breastfeeding system can be used for the same purpose.
Breast feeding system	The baby is sucking on the breast!	It takes a little time to learn how to feed this way.	Ask someone to teach you how to feed with the supplement system.
Bottle	The most common feeding method.	May harm breastfeeding.	Regular feeding and completing breastfeeding help support breastfeeding.

They say a lot about bottles. This is the most famous way to feed babies. Unfortunately, babies who taste the bottle often refuse to breastfeed. It's a shame when, despite your efforts, the baby peacefully falls asleep with a bottle, and not at your breast. Someone says that babies get confused between different ways of sucking - the mechanism of sucking at the breast is different from sucking a bottle. Someone thinks that the baby prefers to eat from the bottle. Many sin on the fact that milk flows more easily from the bottle. One thing is clear, bottle feeding threatens breastfeeding. Fortunately, today we have accumulated a little experience on how to bottle feed in a way that does not interfere with, but supports breastfeeding.

Supplementation before or after breastfeeding? There is no consensus on this, so rely on your observations and experience. One way is to feed your baby before breastfeeding. This method works well for supplementation in any way, and especially with a bottle. A calm baby breastfeeds better, sucks longer and more patiently, and eventually falls asleep at the breast. As a result, your milk supply will increase.

There is a fear that the baby will be full of supplementary food, so he will not have any interest and motivation to suckle. With this in mind, feed him supplementary food, but not too densely. Then, while breastfeeding, watch him suckle. If you don't notice that your baby is sucking well, try giving him a little less supplement next time. If the baby is hungry, having emptied one breast, offer him the other. If he's still not full, give him a supplement, and then attach it to the breast again for a snack. This method is not universal, although it helps some babies to breastfeed better. There is a voucher at the end of the book on how to supplement to avoid interfering with breastfeeding.

When you have more milk, and the baby has gained the missing weight, you will notice that the baby himself refuses to feed. This is a sure sign that you will soon be able to breastfeed only. If there is more milk, but the baby is in no hurry to give up the supplement, try gradually, over several days, to reduce the amount of supplement. In rare cases, when the mother has a partial volume of milk, you will have to feed until the baby starts eating from an adult table.

Measured bottle feeding

You can help your baby cope with bottle-sucking and avoid overeating by taking periodic breaks during feeding. When you notice that the baby's forehead wrinkles, the eyes open wide, wide, the fingers tense, and swallowing turns into choking, without removing the bottle from the mouth, tilt the baby forward slightly so that the milk flows from the nipple. Once he has mastered the milk flow, continue to feed. If it is more convenient for you to pull the bottle out of your baby's mouth, place the nipple on his lips as if you were saying “shhhh” (“Quiet!”) So that he does not get upset and knows that the food is not going anywhere. After a pause, offer the bottle again, but if the baby refuses to eat, do not insist. This means that he is full.

Bottle feeding to support breastfeeding

In the same way that your baby decides when, how, and how much to breastfeed, you can do your best to control the bottle feeding process.

• Choose a nipple that is even remotely similar to your nipples. For example, if you have short nipples, look for a short nipple. This will help reduce the competition between a live breast and a nipple (interesting activity, right? Artificial nipples don't look like your nipples at all, whatever the ad tells us). Don't buy "orthodontic" nipples. It is not by chance that we put this word in quotation marks. Research shows that orthodontic nipples lead to crooked teeth just like normal nipples. In addition, a nipple in the mouth looks very different from an orthodontic nipple, so babies tuck in their tongue instead of sticking it forward. This makes it difficult to breastfeed properly.
• Pick up a slow-flow teat or a newborn pacifier and feed it while your toddler eats from bottles. The flow of milk from the breast does not increase with the growth of the baby, therefore the flow of milk from the nipple must remain constant. Please note that there are no universal standards for milk flow rate, neither between producers nor between batches of teats of the same brand, so even two teats in the same package can flow faster or slower. See what is right for you.
• Feed your baby not according to the regime, but when he asks for food himself.
• When giving the bottle, simulate latching on to the breast. Run the bottle over your baby's lips to open his mouth wider. Place the base of the nipple on your lower lip so that your baby grabs not only the narrow end, but also the wide base of the nipple.
• Keep your baby almost seated with the bottle in a horizontal position. Do not worry that he swallows air - the air immediately exits through the nose. Air enters the stomach when milk flows too fast and the baby gags. This does not happen with measured feeding. Even if the baby has swallowed air, he will regurgitate it without any problems. Upright feeding reduces the effects of bottle feeding, such as tooth decay and ear infections (otitis media). When feeding lying or reclining, milk accumulates in the mouth and enters the ear cavity. This contributes to the development of tooth decay and the growth of bacteria in the ear. Upright feeding allows the baby to stop sucking when he is full.
• Change the position of the baby, as you would transfer it from one breast to the other. This stimulates an even development of the eyes and facial muscles, and also prevents the preference of only one side during breastfeeding.
• Wrap the bottle with paper, a towel, or a homemade cover so you don't get obsessed with the amount of milk remaining in the bottle. Do not force your toddler to finish the bottle. Let him decide when he is full.

Teresa Pitman
Diane Wissinger
Diana West

Discussion

Another problem is not highlighted here - insufficient nutritional value of mother's milk. After the flu, there was milk left, but the baby was no longer satisfied and ended up giving up breastfeeding! I had to give the body a transfer, 2 bottle feedings and sleep off, calmed down and the GW process started again. True .. I left 2-3 feedings a day, sleeping at night for 4 hours in a row is chic, after which my mother feels calmer and stronger. At the same time, milk is produced and we continue our normal life, grow and make us happy. What we wish everyone!

11/27/2018 06:23:40 AM, mother Yaga

Well, I don’t know, a child is different from a child. My daughter sucked in two days, if she was not enough. My chest was bursting. And the son, on the contrary, will suck and quit, never sucked it to the end. I fought with him for a long time. She didn’t give water, his chest was on demand, but he didn’t want to be empty. Then they stopped recruiting and decided to supplement. And she did everything exactly the same. So it depends on the situation and on the character of the child. Supplemented with a mixture of goat milk. We were allergic to cows. I bought MD cute Kozochka, tried several brands, but only she came up. In addition, goat's milk is nevertheless closer in composition to that of the mother's. Well, she fed until she gave up the feed. It turns out that we are mixed since 4 months. And I won't say that he gets sick more often than his daughter is purely on GV. Even less often.

thanks for the article and comments, everything is accessible and understandable!

What nonsense! Firstly, if it is difficult for a child to suck, then not complementary foods should be introduced, but the cause should be eliminated. A short bridle, for example. Introducing complementary foods in this case, we earn a lazy sucker. Then there can be no question of further GW.
And if the child is growing, then at whose expense? At the expense of my mother's milk. It will not grow from scratch for sure. Growth will stop a little - weight gain will go. It was like that with my daughter.
Why pump when you can breastfeed? A baby is better at stimulating than a breast pump. And to pump just to increase lactation - why? The baby will not eat as much as the breast will develop. Well, if you like lactostasis, then you are always welcome.
Yes, and supplementary food. What are they needed for? Not enough milk - suckle the breast - there will be more. Suck a little? Maybe you're not hungry? When you get hungry, eat. At this age, probably, hardly anyone will torment themselves with hunger. Sluggish with hunger. This state must be preceded by a brutal appetite. Sucks a lot - pisses little - that's already a problem. But she, too, may not require complementary foods. Seek advice from a consultant or a nursing mom - maybe things will get better.
And, in general, Professor Arshavsky believed that IW = SV = environmental disaster for a child.
If a baby pees 6 - 8 times, then up to 4 months, I think, he will not die without supplementary feeding.
And a nipple is a nipple, no matter how good it is, it is not a breast. She's sucked differently! It is very lucky if the baby does not confuse the nipples. In my case, I had to struggle with the nipple. And this is not very easy.
Yes, and that everyone is obsessed with hunger? The baby has 1000 more reasons to scream. And all children grow up in different ways. And no one thought that the reason for the underweight may not be in milk, but in the child? Sometimes even children on IW do not gain much. But for some reason, no one blames the mixture. And I know a bunch of cases when even after the introduction of complementary foods, the situation with food and weight did not change.

Not a bad article, the only thing that does not agree with the author is that if you feed from a bottle, the child will definitely give up breastfeeding. You just need to buy a special bottle. I was bottle feeding Dr. Brown, their nipples mimic the mother's breast and the sucking process is similar to breastfeeding. As a result, we successfully combined breastfeeding and artificial feeding. There was no rejection of the breast.

Comment on the article "Supplementation: in what cases it is worth additionally feeding the child"

How often should I feed my newborn? Intrauterine nutrients were delivered to the baby through the placenta continuously, and this did not require any effort from him. Now, getting food for a newborn is not easy. During the first days after childbirth, the child can rest after childbirth, so he will not be very active in relation to the breast. The next day, the child begins to ask for breast more often, every 1.5-2 hours. It is very important to feed your baby on demand. And keep it at your chest ...

Supplementary feeding rules If, despite the use of all methods of increasing lactation, the child does not receive enough milk and is starving, it becomes necessary to supplement with milk formulas or expressed breast milk. In order not to harm the child and not to provoke a rejection of the breast, it is necessary to adhere to the rules of supplementary feeding. Try to keep breastfeeding as much as possible, if possible - use breast milk for supplementation. Feed your baby ...

Going to work and breastfeeding Going to work or school of a nursing mother often becomes the reason for the termination of breastfeeding and the transfer of the baby to artificial formula, since there is a belief that it is very difficult to feed the baby with breast milk in such a situation. However, if you wish, you can continue to lactate and successfully combine breastfeeding and work or school. A few tips to help prolong breastfeeding: Exclusively breastfeeding ...

Discussion

I am still more impressed by the idea that it is better to avoid going to work early, because the child not only needs mother's milk, but the mother is at her side. By the time he went to work, his son was 2.5 years old, and we had long since turned off GV. Nevertheless, situations are different, I do not promise for the future, and I know for sure what I would fight for.

And now he (to be more precise) is 2 months old. Soon the kid will return and be very surprised at the size of her sister :) We were in the clinic today. The doctor is again not ours, but at least the examination was carried out as it should, and even the growth was measured without my requests :) But they are still strange anyway. They told me today that the child's weight is at the lower limit of the norm (this is a little over 5 kilograms, according to our development calendar, it is quite an average child :)) and that if so it will be in the next. month, then it's time to introduce complementary foods ...

The birth of a child makes a young mother experience a whole gamut of positive emotions - from pride in her child, from whom it is impossible to take her eyes off, to the realization of the honor of the role entrusted to her in raising a new person. But, unfortunately, after returning from the maternity hospital, the excellent mood quickly replaces the feeling of depression and fatigue, which cannot be eliminated. The reason for this phenomenon is hormonal changes in the body and quite natural fatigue after childbirth, as well as ...

Methods for weaning a baby from breast It is very rare that the baby refuses to breastfeed independently and completely painlessly. For most mothers, the question of how to wean a child from the breast is very, very relevant. Over the years, women have tried many different ways to wean a baby. Some of them are very effective, others do not bring any result, and still others openly harm the psyche of the child. A young mother may be confused, standing ...

And it flew ... 4:30 They shake me by the leg, spread their hands with the word "Everything." I still don’t understand anything, because I want to sleep deadly after a sleepless night of wallpapering. Somehow I wake up. Alenka explains to me that the mucous plug is completely gone and she has contractions. In general, the fact that the cork has finally receded is a harbinger, but it may still be quiet for a few days before giving birth. And the fights may well be trial (by the way, we already sat with such trial in the country for an hour with ...

Discussion

have you ever heard of bleeding with blood loss of up to 3 liters or more?

Good story. Childbirth is rather quick, successful, although a moment with bleeding would have greatly strained me. It's good that the midwife was not taken aback.

For the second birth, I recommend not to leave the house, and to start and finish all repairs early :). Because if the first was given birth in 4 hours, then with the second, it would be good if the midwife had time to come to the attempts. Well, immediately after the birth of the child, before the placenta leaves, hemostatic collection + breast for the child / or intensive nipple massage.

Discussion

there is not enough data a little. what is the lower weight? weight gain since when did it start? eg if the bottom weight is approx. 3600, the set began from the second week, then the increase will be 550 grams in three weeks, and this is already the norm. for the last week 50 grams - and for the previous one? what is the weight now? hmm ... the battery hasn't run out in the scales? in principle, large children can add less, but there are, of course, limits of reason.
I would still do an ultrasound - heart, kidneys. to calm down (nevertheless, I think, if the pediatrician suggested anything of this kind, she would have already sent you to the ultrasound scan).
8 times a day - not enough, in theory. What happens if you offer a second breast in one feeding? how many times pissing-pooping? how active? Have you tried weighing the feeding? (not to be horrified and immediately feed on something, but simply if there is 150 grams at a time, then the point is in supplementary feeding? if there is 50 grams at a time and so all day and only 8 times a day, then the direct meaning is to call consultant and discuss the situation at least by phone). also: don't you add water?
in general, I would first think about the numbers, do the examinations, talk to a consultant, get tested, and then, in a couple of weeks, I would look at the situation.

Maybe the bridle is short?

Supplementary feeding: in what cases it is worth additionally feeding the child. Bottle feeding to support breastfeeding. When we say that a baby needs supplementation ...

Discussion

Mine was born prematurely, the weight was 2640, now we are exactly 6 months old and the weight is exactly 7 kg, and the height of 64 is this normal?

07/01/2017 20:34:22, Suaybat

in general, it is considered from birth weight, BUT with a large loss, this addition must be taken into account. My eldest lost 500 grams for discharge, and ate 800 grams in the first month, i.e. actually 300 grams of birth weight. They tried to endure my brain, but not much. Moreover, often the main increase begins after 2-3 weeks of a child's life. So in almost 2 weeks, you can still eat sooo much. Try to feed more often, during sleep, or so. They will help you with this in the conference on GV

Discussion

I have nothing to do with chemistry, but from the media and from information about our favorite mixture to Humanu I know that if from native, it means not from powder, but from cow, natural. Agree, it's one thing to make a powder from natural, and then "chemize" the mixture, and quite another thing, when without all kinds of pomace ...
I don’t know about allergies ... We didn’t.

we are not candidates of chemical sciences, but I will definitely say that native milk as a raw material for infant formula is always a sign of quality. For example, only some manufacturers of baby food can boast that their processing plants are located near farms, and that they make the same porridge mixtures not from powder, but from liquid fresh milk. This is more complicated, and the quality control system must be different. I have a friend, she transferred the baby to the formula immediately - the milk disappeared on the 11th day after giving birth ... I used Remedia, but it is rare, Humana, - the pediatrician recommended it, since they are on native milk, not powdered, and the risk fluctuations in quality are minimal.
True, it is not recommended to include foods containing native (unadapted) cow's milk protein in the diet of children from families of patients with insulin-dependent diabetes mellitus. But this is for any GA food

Supplementary feeding: in what cases it is worth additionally feeding the child. If the baby is not gaining weight well, he needs not only to grow, but also to catch up. This means that he is full.

Discussion

I subscribe to what was said about the fact that weight is gained in jumps. Stop looking at the scales! I myself sometimes sin with this. And it turns out as you already wrote above: 2 weeks an increase of 0, and then in 3 days 500 g appears from somewhere.
At the 3rd month, we also had very profuse regurgitation, it seemed to me that half of it was regurgitating. They checked for intracranial pressure - everything turned out to be normal. At the 4th month, profuse regurgitation stopped just as suddenly as it began. The increase was then 500 g per month. We have a very good doctor, she said that this is all within the normal range, we continue to feed on demand and recruit well.
For God's sake, do not listen to your pediatrician: from an artificial break in feeding (3 hours) and the baby will suffer, and your milk will become less. So in a month you will be advised to supplement, and then generally transfer to a bottle. Mom's milk is digested very quickly! Recommendations to take a break in feeding for 3 hours are intended for artificial people, because the mixture takes a long time to digest and you can really overfeed it! (Of course, my advice does not apply to cases of physiological differences in the structure of organs, as in the example with the gallbladder).
If you still want the increase to be more, better, IMHO, take the child to your bed, let him sleep with you and suck as much as he wants. You will immediately notice the difference (although, of course, it will be worse to get enough sleep at first).

oh, I had the same problem with my daughter (I really hope that this will not happen again with the second baby). The first 2 months gained very well, and from the 3rd month the weight gain began to decrease significantly (for example, in the 3rd month we gained only 410 grams, and for 5 and 6 months together only 460 grams), it scared me very much, although the volume of daily feedings was normal. And from the third month all this began to be accompanied at first by profuse regurgitation, and then generally by vomiting. The older the more. In general, in the end (after the examination in Semashko, and before him we visited a dozen paid gastroenterologists in different clinics and the result of the prescribed treatments was zero), we found that the child had an irregular gallbladder from birth as a result of an irregular discharge of bile, which makes it difficult to digest food and hence the vomiting. The prescribed medications helped only while taking them, but when you finish everything over again. In general, this problem ended only after 2 years, when the baby herself was able to determine how much to eat, as soon as she turned away from food, I stopped feeding her and vomiting became extremely rare. And so almost every day. So most likely your doctor is right and this is from overeating (the child does not have time to digest it). Do not despair everything will be fine.

It is better to feed, I repeat, a sleepy child, or from a syringe (without a needle, of course). Breast or bottle? Several myths about breastfeeding. Supplementary feeding: in what cases it is worth additionally feeding the child.

Discussion

that is how we moved in 5 weeks from St. to Guards. also had 30-40 gr breast + 100 gr. supplementary feeding with a mixture and also 2300 were born, we just don't have a twin :))
at first, I fed from a spoon every 3 hours, 30-50 grams of the mixture because My daughter did not immediately begin to suck the required amount from the breast, but naturally gradually, the milk became more and after a month and a half I removed the supplements completely. the feeding regime at 5 weeks changed abruptly - on sv they fed every 3-4 hours, on gv every hour and a half. then it became 2-2.5. my main problem was the correct grip of the breast after the bottle, it was solved with the help of a consultant. parted with the bottle abruptly, this is also important. then at 8 months they learned to suck from the bottle again :)))
all IMHO, this was my experience.

I think yes. In general, control weighing before and after is a direct way to the bottle, because the child eats unevenly throughout the day and whether he is eating or not should be judged by weight gain. The main thing here is really to feed, even if 50 g, but on demand. As a result, the child will suck his own in a day. It is much easier to suck from a bottle !!! And the chest is work. Do as the doctor said, this way you will have enough milk, and the children will learn to breastfeed. I had the same experience with my daughter. We have overcome everything.

Check out other discussions: Supplementation: When is it worth supplementing your baby. Bottle feeding to support breastfeeding.

Discussion

my milk came on the 5th day. The first 4 days - on the mixture, then first for days on the chest and sometimes to sleep a little - the mixture ... - this is in the hospital. And at home I had to feed them, tk. there was not enough milk. After each feeding, she was decanting - at least 10-20 ml, but decanting. I drank a lot, ate a lot too, and with a calorie content. and milk gradually became more and more, and after 2 - 3 weeks from the mixed diet, we switched completely to GW!

I was discharged from the hospital - the milk was full. and then, it went somewhere: - (((3 weeks fed for 2-3 hours during the day and could suck from time to time falling asleep for 4 hours at night ... the supplement was never introduced. the child gained almost 800g in a month. we eat, but milk can disappear from time to time: - ((((no mammals, hippa apilaki, etc.) help ...

Supplementary feeding: in what cases it is worth additionally feeding the child. Bottle feeding to support breastfeeding. When we say that a baby needs supplementation, it means ...

Discussion

white threads, milky? Then it just starts to flow more fatty milk, after the first, more watery. When it gets into a bottle, into previously expressed milk, it dissolves in it. And that's all :)
On business:
1. Tear off skin is normal. The skin on the nipple should change. Normal - if it doesn't hurt. Cracks are often from improper attachment. By the fact that you are now pumping and feeding from a bottle, you even more confuse the attachment in the direction of the wrong one, most likely. You'd better refuse it. If it is completely impossible to breastfeed, use a syringe or spoon to pour. An electric breast pump, by the way, is not at all more gentle to the breast than a child. Vice versa. Therefore, well, it is very likely that the baby is not breastfeeding correctly.
2. Problems with the amount of milk can be associated with p..1. That is, be the result of improper attachment. On the other hand, you may not have a problem, and doubts about the amount of milk have been sown by the "kind" words of doctors or relatives. Why did you decide that there is not enough milk? Give the numbers: with what weight the child was born, what was the lowest weight, what was the gain. How much do you feed (duration and frequency of feedings)? How much does a child pee and poop per day?
3. If milk starts to seem small, you should not start feeding without trying all the ways to increase the amount of milk. Why: The body produces as much milk as the baby eats. Therefore, you fed - the baby ate less from the breast - less milk came on the trail. day - you add more feeding - ... voila! at 5 months milk is "running out". It is not too late to rectify the situation - if you, of course, have a desire (and since you write here, then most likely there is :)).
Write the numbers for now, without them nothing is clear. And you definitely don't need a doctor :)

Supplementary feeding: in what cases it is worth additionally feeding the child. If the baby is not gaining weight well, he needs not only to grow, but also to catch up. This means that he is full.

Discussion

Well so the child has the right to go on a diet :-)
One hundred koilo per month is actually a bit too much for most children.
Breastfeeding provides a more balanced gain. In general, mine added 500-700 a month. Nothing so sturdy has grown up.

I don't know what age the baby is. Your baby may not be sucking milk efficiently enough. This is not scary and goes away as the child grows up. Expressed milk can be added with a syringe while breastfeeding, rather than from a bottle. The child will then associate milk and all the pleasant sensations with the breast, he will not lose interest in the breast.
At night it helps not to wake up the child, and maybe turn him over or somehow disturb him a little. The child will not wake up, but if he turns around, then this is an easy stage of sleep. At this time, children suck well, and then, without waking up, they go into a deeper stage of sleep.

IMHO - you have to decide for yourself - if you feel or think what is needed / easier / want / you need to feed it so calmly - feed it. And don't waste your nerves.

Our baby was too lazy to suckle for the first weeks. First, don't give a pacifier at all. Second, feed more often, wake up every 2 hours. To suck more actively, he needs to be completely awakened (turn on the light at night, undress to a diaper so that he is cold).

Supplementation for a breastfed baby can be introduced for various reasons. Newborns are supplemented with expressed breast milk, donor milk, but more often, of course, they use it.

In which case to introduce supplementation, and in which not, can only be decided by the pediatrician, here an individual approach and weighing of all are necessary. "per" and "against".

Supplement, what is it?

Supplementary feeding- This is an additional food for the baby, which is introduced in order to compensate for the lack of breast milk. Do not confuse supplementary feeding and complementary feeding, supplementary feeding is prescribed if necessary according to indications, more often due to lack or lack of breast milk, and complementary feeding is an additional food that is introduced to all children from a certain age, when the mother has enough milk, but it is no longer can meet the nutritional needs of the child.

Supplementing newborns in the maternity hospital

In the first few days after childbirth, the mother excretes colostrum, its volume is only a few milliliters, but this small amount is enough to provide the newborn baby with the necessary nutrients, colostrum is quite high in calories and contains vitamins and antibodies valuable for the newborn. Due to the small amount of food, the child does not find it difficult to eat from the mother's breast, and his swallowing, sucking and breathing skills develop. On the third, fourth day, when milk appears, the child is able to eat well. But every young mother periodically thinks about whether the baby has enough milk or should resort to supplementary feeding. Here are the most common fears in which the introduction of supplementation is not required.

• The loss of 5-7% of birth weight by a child in the first days, disturbing the mother, this is the norm and does not occur because the child does not eat up, it is just that a small organism gets used to new "living conditions", very soon the toddler will again intensively add to weight. And by the time he leaves the hospital, his weight will be the same as at birth, this is one of the conditions for discharge.
• The newborn sleeps a lot. This is also absolutely normal, the child gets tired during childbirth no less than the mother, so he sleeps a lot. If the mother still thinks that the baby is sleeping too long, then it is better to try to wake him up and feed him, otherwise he will get very hungry, and the mother may not have enough milk. In the worst case, you will have to introduce supplementary feeding with a mixture while breastfeeding. And for the formation of lactation it is much better as often as possible.
• The child is restless. The baby does not always cry when hungry, later the mother will understand that there are many reasons for crying - (wet diaper, baby cold, hot, etc.)
• The baby cries and turns away from the breast, this fact does not necessarily indicate that the mother does not have milk, more often the baby simply does not yet know how to eat milk from the breast. Mom needs to be patient and teach him, you need to briefly attach the baby to the breast, the more often the better.
• The baby is breastfeeding too often. In fact, if a child is upset or sick, he can breastfeed up to 40 times a day and this does not mean at all that he is hungry every time and it is necessary to introduce supplementary feeding while breastfeeding. This is just a physiological need for a baby to be close to his mother, to feel her warmth and love.

Of course, a tired mother sometimes wants to feed the child with a mixture and rest, but this is not necessary. There are indications for the introduction of supplementary feeding, they can be symbolically divided into unconditional and conditional.

Unconditional indications for the introduction of supplementary feeding:

• The mother, for some reason, cannot be near the child;
• The baby has breast milk intolerance;
• The mother is taking medications that could harm the baby.

Conditional indications for supplementary feeding

Indications from the child's side:

• Low blood glucose levels in a newborn that do not rise even after breastfeeding;
• Severe dehydration with more than 10% weight loss and increased sodium levels, regardless of breastfeeding;
• Weight loss in a baby due to a lack of breast milk in the mother;
• Stool retention in a newborn;
• Milk is not sufficiently absorbed, despite its normal amount in the mother;
• There is a need for additional administration of vitamins and other nutrients.

Indications from the mother:

• Lack of milk, which remains even five days after removal of the placenta;
• Lack of milk due to Sheehan's syndrome, which can occur due to severe blood loss during childbirth;
• Underdevelopment of the mammary glands or violation of their function as a result of surgery or pathology;
• Unbearable pain during feeding, which doctors cannot stop despite their best efforts.

How to identify a lack of breast milk

If everything is clear with the unconditional indications for the introduction of supplementary feeding, then under the conditional indications, the question arises of how to determine that the child really does not have enough milk and needs supplementary feeding of the breastfed baby. For this purpose, pediatricians, together with young mothers, usually use the following methods:

• Counting the volume of urine.
• Counting the number of urinations.
• Expected weight gain method.
• Measuring baby's weight before and after feeding.
• Intuitive method.

How much milk a child should eat is calculated based on his age, weight and health status of the baby. The most generalized calculation method is the dependence of the amount of food on the body weight of the child. By the age of 2.5 months, the child should eat 1/5 of its weight, from 2.5 to 4 months - 1/6 and 1/7 from 4 to 6 months.

The amount of formula supplemented while breastfeeding will depend on the difference between the amount of milk the baby eats and the amount that he should consume.

Introduction of supplementary feeding with a lack of breast milk

The decision on the immediate introduction of supplementary feeding in case of a shortage of breast milk depends on what percentage of the daily ration the baby is missing. If the deficit is no more than 50%, then doctors first take all the necessary measures to stimulate lactation and introduce supplementary feeding of children with a mixture no earlier than a week later, only if the situation does not change. A deficit of more than 75% forces doctors to immediately decide on the introduction of supplementation, but at the same time, it is not worth leaving the mother trying. If the amount of breast milk increases, then the amount of supplementary feed decreases.

Supplementary feed selection

Here, all doctors give an unambiguous answer - breast milk. Theoretically, if possible, then it is necessary to use the expressed milk of the mother, if not, then feed the baby with donor milk. But in practice, in the maternity hospital, supplementary feeding of children with a mixture is more often used. The most hypoallergenic are mixtures based on protein hydrolysates. They are well tolerated by almost all newborns. Upon returning home, the mother, under the supervision of the pediatrician, can change the mixture or leave the one that was given to the child in the hospital.

Supplementary feeding methods

There are a lot of ways to feed with a mixture while breastfeeding, each of them has its own pros and cons. I propose to consider each of the methods in more detail.

Bottle


pros: One of the easiest ways, does not require special skills from both the mother and the child.

Minuses: If a bottle is used to supplement a breastfed baby, there is a danger of breastfeeding. The baby takes the bottle and the breast in various ways, the baby's tongue is involved in feeding from the breast, he presses the breast against his palate, feeding from the bottle mainly involves the cheeks, it is easier to eat from the bottle, and the baby subsequently chooses it.

To minimize this danger, several conditions must be met:

• Be sure to choose a bottle of the correct rectangular or oval shape, without narrowing in the center. The nipple should be small, not very firm and round, as close as possible to the shape of a woman's nipple. Large holes in the nipple do not need to be made; this interferes with the sucking reflex in the newborn. Milk should not flow too quickly, the baby should make little effort, the optimal bottle feeding process should be 15-20 minutes
• The correct feeding technique is that if the mother has milk, then you must first feed the baby with milk from the breast, and then give the bottle. Bottle feeding should be done in the same position as breastfeeding.

Syringe without a needle


pros: Cheap way, can be used as a one-off

Minuses: A small volume of the syringe, there is a risk of extinction of the sucking reflex when feeding a breastfed baby.

For supplementation, the largest syringes of 5-10 ml are used, the principle of feeding is similar to injections - milk flows out of the syringe when pressed.

Syringe supplementation options can be as follows:

• The baby sucks on a syringe through which milk flows slowly
• Milk enters the baby's mouth through the tube at the end of the syringe
• The baby sucks on the mother's finger or breast, and milk is injected into the corner of the mouth through a tube. This option is most preferable when supplementing infants with formula while partially breastfeeding.

Syringes with a tube can be bought at a pharmacy, dentists use these in their work, it is not difficult to build it yourself, putting a venous catheter on the end of the syringe. But here it must be remembered that the catheter must be changed after each feeding, because the mixture remains in the tube, which can deteriorate and harm the baby.

Tea spoon


pros: The method is simple and inexpensive, it can be used for a cold and in other cases when sucking is difficult. The spoon is easy to disinfect.

Minuses: At first, using a spoon when feeding babies with formula is quite difficult, because the baby will spit out most of the milk or formula. This method is least suitable for supplementary feeding of young children with formula while breastfeeding, since it does not develop the sucking reflex. It is best used when there is little time left for the introduction of complementary foods and accustoming the child to the "adult" diet.

To make your child learn to eat from a spoon faster, you can try:

• Quickly pour the contents of a spoon into the middle of the tongue;
• Pour milk over the cheek;

The next portion of milk should only be given when the baby has swallowed the previous one. You can understand that the child is full when he stops opening his mouth or starts spitting out the mixture.

Soft spoon


pros: More baby-friendly material, plus the spoon is inserted into the bottle, there is no need to constantly scoop up a new portion with danger of spilling.

Minuses: It is more expensive than the above devices.

It is easy to use a soft spoon, milk is poured out by pressing on the protrusions located on the sides of the spoon, you do not need to press hard so that the mixture enters the spoon in a small amount.

But here we cannot exclude the possibility that if the child does not eat from an ordinary spoon, then he may not eat from this spoon.

Cup

pros: The cup is very easy to clean between feedings, the baby eats from the cup even faster than from the bottle. Cup-feeding reduces the likelihood of air being swallowed, and therefore less regurgitation and colic.

Minuses: Cup feeding also requires skill. Not suitable for children with a weak sucking reflex.

You can use any cup to feed children with a mixture, but it is better to purchase a special one with thin walls and made of material that is easy to sanitize. But doctors recommend cup feeding if the baby is not breastfeeding at all. Supplementing babies with a cup of formula while breastfeeding can negatively affect their desire to feed from the breast. It is better to feed when the child is upright or half-sitting, you cannot pour milk into the child's mouth, he must drink himself. Premature babies mostly lap milk, and those born on time sip it. The cup must be tilted gently at all times so that the child does not stop eating or swallow air.

pros: Form and method of feeding are as close as possible to breastfeeding, low risk of air swallowing.

Minuses: High price. It is mainly used to feed babies with genetic abnormalities, due to which the baby does not have a sucking reflex.

Using a sippy cup is not difficult, the main thing is to pour the required portion of milk and release the air. The milk flow can be adjusted by turning the cup.

Finger feeding

pros: One of the most physiological of all formula feeding methods when breastfeeding, there is always tactile contact between the baby and the mother during feeding.

Minuses: May cause breastfeeding due to the fact that using this method does not require the baby to make an effort to "Get" milk.

Milk is fed through a syringe or tube into the baby's mouth, while he sucks his thumb, you can use a syringe with a straw.

Breast feeding

pros: The most natural method for breastfeeding baby. The baby gets used to eating from the breast, additionally stimulates the production of milk in the mother.

Minuses: Not suitable for babies who do not want to breastfeed. Difficulty sterilizing tubules.

The system of use is not simple, and usually consists of a bottle and a tube attached to it, the bottle being slightly raised so that the milk flows into the tube. The child is placed on the breast and a tube is inserted into his mouth, the child simultaneously sucks the breast and milk from the tube. Sometimes the baby is first fed simply from the breast, then a tube is inserted into the corner of the mouth.

Such a system can be purchased at the store, there are several options from different manufacturers, or you can make it yourself by attaching a tube to the feeding bottle. The tube must be washed, boiled, and it is better to change it after each feeding. Many mothers use this particular system for introducing supplements, because physical contact with the newborn is important for them, and because the baby is breastfeeding, milk arrives in it. The strength of the milk flow in the system can be adjusted.

Pipette


Pros: Can be used when other agents cannot be used, mainly for feeding premature or frail newborns

Minuses: very small volume, feeding even a very small child takes a long time.

For supplementation, you need to use a pipette with a blunt tip, before feeding, you can give the baby a clean finger, and inject milk into the corner of the mouth.

How to choose a feeding method

If possible, doctors advise choosing a method of feeding at the breast, this guarantees the development of the sucking reflex in the baby and gives a great chance of increasing the production of breast milk in the mother.

If the shortage of breast milk is small, or only periodic supplementary feeding is required for a breastfed baby, then a syringe or spoon can be used. Periodic supplementation may be required when "Crises" lactation, which often occurs from 3 to 6 weeks, at 3,4,7,8 months of lactation, such periods do not last long, only 3-5 days.

Negative consequences of the introduction of supplementary feeding

The negative consequences of supplementary feeding mainly arise from the refusal of breast milk.

• Supplementing children with formula can cause a lack of antibodies and microflora that is beneficial for the intestines of the newborn.
• Poisoning or infectious diseases if hygiene conditions are not followed.
• Decreased milk production with formula supplementation while breastfeeding.
• An improperly selected formula can cause a significant loss of body weight and an increase in the level of bilirubin in the child.
• Supplementing babies with a formula while breastfeeding can make it impossible to return to breastfeeding, since the formula saturates the baby for a longer period, and it is less often applied to the breast, as a result, the mother's milk becomes less.

Basic rules for feeding

Regardless of which option you choose for supplementation, you must follow the general rules.

• Breast before and after feeding. No matter how much milk the mother has, it is still the most valuable source of nutrition for the baby, therefore, it is necessary to breastfeed the baby, even if there is a little milk there.
• Don't force the child forcibly eat the whole mixture, let him decide when he is full. Reduce the mixture a little the next time.
• Feed only a calm baby. If the newborn is upset, you should first calm him down, and then offer him food.
• And the most important thing that young mothers should remember, even if they had to introduce supplementary feeding, there is still an opportunity to return to breastfeeding, often supplementary feeding with a mixture is introduced as a temporary measure and if you follow the advice of a pediatrician, you can return full lactation within 7-10 days.

Health to you and your children!

Supplementation of a breastfed baby can happen for a variety of reasons, but contrary to popular belief, it does not have to be bottle formula. In each specific case, the question of whether it needs to be introduced, how and how to implement it should be decided individually, taking into account the possible negative consequences.

What is supplementation

Supplementary feeding is expressed milk (mother's or donor's) and / or formula (), which are introduced in order to compensate for breast milk in the event of a shortage of it. Many people confuse supplementation with complementary foods, which are given to the child not as a forced measure, but to supplement breast milk with all the necessary substances in connection with the child's reaching a certain age. In other words, a child needs supplementary feeding if necessary, and complementary feeding is necessary for all children.

Supplementing a newborn in a maternity hospital

After the birth of the child, in the first three days, the mother excretes colostrum, the volume of which is only a few milliliters. Due to its high calorie content and valuable biological properties, it is that irreplaceable food that a newborn needs and to which he is physiologically most adapted in the first days of his life. A small amount of food helps the baby to properly master the technique of sucking, swallowing and breathing during breastfeeding. After 2-3 days, the newborn's weight loss occurs in the amount of 5.5-6.6% of the birth weight, but not due to lack of nutrition, but due to the child's adaptation to living conditions that differ from the conditions of the intrauterine period. All these features of the early days can confuse a young mother, making them doubt the ability to feed the child, and lead to the introduction of supplementary feeding. Therefore, it is important to figure out when supplementation in the hospital is necessary and when not. In any case, the doctor makes a decision on supplementation, evaluating each case individually after observing breastfeeding.

Supplementation is not required.

1. The child is sleepy. This is normal after a child is awake for the first time in his life. The next 10 hours include 1-2 waking periods with or without feeding. If the baby's sleep is long, it is better to wake him up by trying to breastfeed. Longer pauses between feedings require more food for the baby, and this is problematic in the initial period of formation. Therefore, it is better to try to feed more often than to feed the baby after a long sleep. The main rule for the first seven days is: "A child is awake if hungry."
2. The child is healthy. Healthy, full-term infants less than 18 mol / L after 72 hours of life, breastfeeding well, bowel movements regularly, and weight loss of less than 7%.
3. Restless child. Even in the case of very strong anxiety at night or many hours of wakefulness.
4. The mother is tired or wants to sleep.

Absolute indications for supplementary feeding.

1. Separation of the child and the mother due to the mother's illness.
2. The baby has a disease associated with the assimilation of breast milk.
3. The baby has developmental defects that prevent breastfeeding.
4. The mother is taking medications that are contraindicated for breastfeeding.

Relative indications when prescribing supplements

Child's testimony	Maternal indications
A decrease in blood glucose levels without obvious symptoms (hypoglycemia), confirmed by tests and remaining unchanged after breastfeeding	Insufficient amount of milk five days after childbirth, caused by residual placenta in the uterus, after the removal of which, lactation returns to normal.
Significant dehydration (weight loss over 10%, high blood sodium levels, lethargy) despite proper breastfeeding.	Insufficient milk supply due to Sheehan's syndrome.
Weight loss of 8-10% in an infant against the background of a delay in milk production in the mother after five days.	Insufficient milk production by the mammary glands due to their underdevelopment (primary hypoplasia).
Stool retention or excretion of meconium after five days.	Disorders of milk production due to previous breast surgery or breast abnormalities.
The baby receives little milk, despite its sufficient amount from the mother.	Sharp pain during feeding does not disappear after attempts to eliminate it.
Jaundice of newborns associated with insufficient breast milk production or jaundice of breast milk (bilirubin level 20-25 mol / l).
If necessary, additional introduction of micronutrients (vitamins, minerals, amino acids).

How to identify a lack of breast milk

If, in the case of absolute contraindications to supplementary feeding, everything is clear, then with relative ones, the question arises about the amount of breast milk or colostrum that the child does not get. The first thing to do is to make sure there is really not enough food. Several methods are used for this:

• counting the amount of urine;
• counting the number of urinations;
• method of expected gains;
• weighing before and after feeding;
• method of increments per week;
• "Intuitive" method.

The calculation of the amount of milk that a child should eat in one feeding can also be carried out by several methods that can take into account not only the age, but also the weight, state of health of the child. The difference between the norm and the milk actually consumed by the child will be the amount of supplementary feeding that the child needs.

Introduction of supplementary feeding in case of insufficient breast milk

Depending on the amount of milk that the child does not receive, supplementation can be prescribed immediately or after.

Lack of milk 25-50% of the norm. Supplementation is prescribed only after additional measures to increase lactation. To do this, within 3-4 days, a more frequent attachment to the baby's breast is carried out, and if this does not help, the baby is fed with one feeding alternately from two breasts. Only after exhausting all the possibilities for restoring lactation, after 7 days, supplementation is prescribed.

Milk deficiency is up to 75% or more. Supplementation is prescribed immediately, but measures are taken to restore lactation.

Thus, in all cases, supplementary feeding is only a temporary measure, which makes it possible in the future to return to breastfeeding.

The amount of supplementation should compensate for the lack of breast milk. At the same time, intermediate control is periodically carried out, since once a certain amount of supplementary feeding gradually changes up or down. More if measures to restore breastfeeding give a negative result and less if positive. Accordingly, if control is not carried out, then over time, overfeeding or underfeeding of the child may occur.

Supplementary feed selection

The best solution is to use expressed breast milk. At the beginning of lactation, it is better to pump by hand as it is more efficient and can increase milk production. To additionally enrich breast milk with useful components for premature and low birth weight babies will help

The situation is more complicated with colostrum, of which very little is excreted and it is problematic to collect it. In this case, the use of pasteurized donor milk is optimal.

Among artificial mixtures, they are the best for supplementation, as they reduce the risk of allergic reactions and the level of bilirubin.

Supplementary feeding methods

There are several methods of supplementation, each of which has its own advantages and disadvantages. The choice of this or that method depends on many factors, but in any case, the key to the success of their application is the mother's patience and determination.

Bottle

Advantages: requires a minimum of effort and training.

Disadvantages: there is a risk of breast rejection.

To reduce the risk of breastfeeding and improper grip of the breast, leading to cracked nipples, it is necessary to:

1. Choose the right bottle and nipple. The bottle should be straight without tapering in the middle. The nipple should not have a wide base, as this forces the baby to squeeze the gums. The shape of the nipple should be round, as it is closer to the shape of the mother's nipple, the material of the nipple is as soft as possible, otherwise orthodontic problems may arise. The hole in the nipple is made small so that the sucking process takes 15-20 minutes.
2. Correct feeding technique. If possible, give the baby a breast first, and then a bottle. They put the baby on their knees, holding them with their hand and raising the upper body. The bottle is held horizontally and the nipple is placed in the infant's wide-open mouth almost to the ring of the bottle. When everything is ready, the top edge of the bottle is raised to prevent air from trapping in the teat. As the bottle is emptied, the baby is tilted back to empty the bottle completely.

Syringe without needle or extended syringe

Advantages: inexpensive, can be used one-time.

Disadvantages: the volume of the syringe is not enough for older children, so it takes a lot of time to feed. There is a danger of getting used to sucking the syringe instead of the breast.

For feeding, it is better to take a 5-10 ml syringe. The principle of milk delivery is the same as for injections - with gentle pressure on the plunger, milk flows out of the syringe. The needle can be used to draw milk from a narrow-necked container.

The ways to use the syringe can be different:

1. The child sucks on a syringe through which milk is injected;
2. The milk flows through the tube at the end of the syringe into the corner of the baby's mouth.
3. The baby sucks on the mother's thumb, pad up, and milk is injected with a syringe into the corner of his mouth.
4. Milk enters the corner of the baby's mouth through a syringe with a tube right during breastfeeding.

You can buy a syringe with a straw at a pharmacy or make your own. The pharmacy sells a "long cannula" syringe that is used by dentists. You can make it yourself by attaching a nasogastric probe or a venous catheter purchased at a pharmacy to a regular syringe.

Tea spoon

Advantages: does not require material costs. No hindrance to breastfeeding as the spoon does not satisfy the need for sucking. A spoon can be used in case of a cold in an infant, since the sucking process is difficult at this time.

Disadvantages: using it requires skill, as at first most of the milk will be spilled by.

Usage. When the child opens his mouth, with a quick and confident movement, slightly tilt the spoon, pour its contents onto the middle part of the child's tongue. You can also try pouring milk over your cheek. According to mothers using this method of feeding, it takes only 2-3 days to learn how to use it effectively.

Medela Soft Spoon

Advantages: is more convenient to use than a teaspoon, since you do not have to scoop milk from the container every time. It is one of the simplest and most effective feeding methods.

Disadvantages: relatively high price of the device.

Usage. It is a soft silicone spoon combined with a bottle. When you press on the protrusions located in front of the spoon, milk begins to flow into it. So you can easily dose the amount of food. However, there is a possibility that if a child does not like a teaspoon, then a soft one will not work for him.

Cup

Advantages: easy handling between feedings (for convenience, Medela produces sterile cups with rounded edges and a scale). Feeding takes even less time than bottle feeding. Due to the fact that no air is swallowed during the use of the cup, the number of and is reduced. The weight gain is greater, and the tongue and jaws learn to work properly.

Disadvantages: can not be used in newborns with a weak swallowing reflex. As with using a spoon, it may take some time to adjust.

Any cup will do, but better with thin walls (coffee, pile). According to the WHO, all babies, even premature babies, can be cup fed. Premature babies lap up milk, and full-term babies sip.

Important! Cup feeding is optimal if the baby has not yet breastfed. Otherwise, it is better to use other feeding methods.

Usage.

1. Place the child upright or half-sitting on your lap, supporting the head with a hand that also supports the child's shoulders and neck.
2. Touching slightly, place the edge of the cup on the baby's lower lip.
3. Tilt the cup so the milk touches the baby's lips. The baby will start to lap or sip lightly on the milk.
4. The liquid level in the cup must remain the same so that the baby does not stop. To do this, you need to very smoothly gradually tilt the cup.

Attention! Never pour milk down the throat of a child! Let him control the sipping and swallowing himself.

Habermann's cup

Advantages: no breast rejection occurs after using the sippy cup. A special system allows the milk flow to be regulated, reducing the risk of air being swallowed.

Disadvantages: high price.

The main purpose of this sippy cup is feeding children who are unable to create a vacuum while sucking due to cleft lip and palate, Pierre-Robin syndrome and some neurological diseases.

Usage. Before feeding, milk is drawn into a bottle, air is released from the bottom of the teat and the cup is filled with milk after pressing the wide part of the tip using the pipette mechanism. When the tip is full, start feeding the baby. The milk flow is regulated by turning the drinking cup.

Finger feeding

Advantages: the child works with his tongue as when sucking on the breast. There is skin-to-skin contact between the baby and the mother. Suitable for sleepy newborns before breastfeeding and with cracked nipples to replace part of the feedings.

Disadvantages: personal hygiene rules are required. Not suitable for flat nipples, as the breast can be abandoned in favor of the toe.

Usage. You will need a probe dipped in a container of milk. The other end is attached to the finger. Alternatively, you can use a syringe with a tube at the end. When you suck a finger through a tube dipped in a container with milk, food is supplied to the child. If a syringe is used, milk is injected through a tube.

Breast feeding

The most commonly used for these purposes is the SNS (Supplementary Nursing System)
and the Lact-Aid system.

Advantages: the most convenient and physiological feeding method. The baby learns to suckle correctly and stimulates milk production in the breast. Breast abandonment is canceled out.

Disadvantages: not suitable for babies who refuse to breastfeed. Difficulties with the processing of tubules, since they cannot be boiled. The inconvenience associated with adding new portions of milk to the container. At the same time, excess milk will have to be discarded due to precautions. Some species clog the probes.

Consists of a container into which supplementary food is poured and from where a long thin tube comes out. An important feature of this method is that the baby receives supplementary food while sucking, even if there is no milk at all. This method is often used in the case of adoption of very young children, which allows a woman to feel like a full-fledged mother, and in some cases even start lactation.

Several use cases are possible.

You can first breastfeed your baby and then gently insert a tube into the corner of your mouth, or start breastfeeding with a tube right away. When the tube is inserted into the corner of the mouth, it is guided inward and slightly upward. Sometimes it needs to be supported while feeding, as some babies may gradually push it out of the mouth. The milk flow in the straw is regulated by raising or lowering the milk container. For 15 minutes of supplementation, the baby sucks out 30 ml of milk. For maintenance, it is advisable to use a breastfeeding system at each feeding.

The Medela breastfeeding system consists of a graduated bottle that is hung around the mother's neck and the probes coming out of her - one on the breast. The set includes several probes of different sizes and a patch for fixing them on the chest.

If it is impossible to buy a ready-made system, you can make it yourself by introducing a thin probe through the nipple into a bottle (5-10 ml syringe) with milk. A nasogastric tube or venous catheter is used as a tube. You cannot boil them, just wash and dry them, and after 24 hours use a new straw. If you do not have a thin probe, you can use a wide one, pre-tying a knot on it to reduce milk flow.

Pipette

Used as a last resort when others are not working or for feeding newborns. The main difficulty is obvious - the volume of the pipette is very small, and the process of feeding can take a long time.

Medela soft spoon supplement video

Haberman's cup video

How to drink from a glass video

Spoon feeding videos

Which feeding method to choose

The optimal solution is to choose a supplementary feeding system at the breast, as the baby will continue to suckle, and your milk supply will not decrease due to its constant stimulation. It is also the best solution in case of a large milk shortage or if you want to resume lactation. With a slight shortage of milk or the need for supplementary feeding for a short time, you can get by with a syringe, pipette, spoon, cup.

Potential negative consequences of supplementation

1. Changes in the intestinal microflora and an increase in the risk of allergic reactions when feeding with formula.
2. The risk of developing diarrhea and infectious diseases if hygiene standards are not sufficiently followed.
3. Decreased milk production due to inadequate emptying of the breast by the baby.
4. If the child receives additional water or glucose at the hospital, the risk of increased bilirubin levels and excess weight loss increases.
5. Formula feeding contributes to the formation of a longer feeling of satiety in the baby and less frequent latching on to the breast.
6. Supplementation can make it difficult to return to breastfeeding.
7. Before breastfeeding begins, supplementation has a negative effect on breastfeeding duration.
8. The introduction of supplementary feeding in the early postpartum period leads to excessive engorgement of the breast associated with rare attachments.

In contact with

Mixed feeding is a combination with supplementary feeding with artificial adapted mixtures. When the volume of received breast milk is more than 50%, mixed feeding in its effect on the health of the child approaches natural, with a decrease in the volume of received breast milk, mixed feeding approaches artificial.

Mixed feeding, that is, supplementing the baby with a mixture, is necessary if the baby does not have enough breast milk... It is possible to determine that the baby does not have enough milk by his behavior (the baby is crying and screaming from hunger all the time), by the lack of weight, by the number of wet diapers per day (a child older than 10 days should write at least 12-14 times a day). If you find that you do not have enough milk, then nevertheless, before running to the store for the formula, try to establish lactation for several days, because only 3% of women for health reasons are unable to breastfeed their baby, other mothers are deprived of this opportunity simply because of ignorance of the rules of successful breastfeeding.

If you want to continue breastfeeding and later refuse to feed, then remove all nipples and bottles, the baby should only suck on her mother's breast so that the grip of the nipple does not deteriorate, but supplementation can be given from a syringe or spoon. You need to feed the baby with a mixture only after he has received milk, and from both breasts. At the same time, remember that the baby can suck on the breast not only for 10-15 minutes, but also for an entire hour. As it is sucked out, milk will be constantly produced in the breast. Then you can. As soon as the child begins to gain normal weight or wet more than 14 diapers per day, the supplementary food should be removed and only the breast should be left. In the future, feed the baby only on demand, be sure to feed at night, do not limit the stay of the baby at the breast in time, follow the diet and drinking regimen for nursing mothers, and you will not experience any problems with lactation.

In addition, it is very important for a nursing mother to maintain peace of mind, not to worry and not overwork; to improve lactation, you can drink special herbal teas (fennel, nettle, basil), apilak tablets on royal jelly, vitamins for pregnant and lactating women.

There are also many reasons why a woman is forced to feed her baby with formula.... This can be an early exit to work, where it is impossible to express frequently and fully, and therefore lactation begins to fall. In this case, in your absence, the child is first fed with expressed milk, and then fed to a full portion with the formula. When you come home, then in the evening, at night and in the morning, breastfeed the baby. In this case, the baby will most likely receive supplements from the bottle. Choose it correctly, it must be anti-colic, have a nipple imitating the shape of a nipple, with one small hole so that it is difficult to suck from it, then the baby may not give up the breast.

It also happens that the mother does not manage to establish full-fledged lactation, and in order for the baby to receive at least some share of healthy milk, he is transferred not to artificial, but to mixed feeding. Such babies can be introduced to complementary foods 2 weeks earlier than infants, replacing them with supplementary feeding with a mixture. Then, after that, it will no longer differ from peers, babies, since it will receive only mother's milk and meals from complementary foods, but not milk formulas.

In the case of switching to mixed feeding, remember that the baby should still receive the baby on demand, and the supplementary formula should be fed according to the regimen, but only after both breasts have been sucked. To correctly determine the amount of formula needed for feeding, use weighing before and after breastfeeding. Taking into account the fact that the baby should drink milk per day at the rate of 1 / 5-1 / 6 of its own body weight, you can determine by weighing how much milk he drinks per day and calculate the amount of the required mixture. This is usually 20-50 grams per meal. With supplementary feeding in an amount of more than 200 grams per day, it becomes much more difficult to switch completely to natural feeding. Even with mixed feeding at night, try to breastfeed your baby only, it will be easier for you (you do not need to get up at night and prepare the mixture), and lactation will last longer thanks to prolactin, which is produced in the early morning hours (from 3.00 to 6.00). It is very good if you sleep with the baby, then the baby will receive both healing milk and bodily contact with the mother. Even if you do not have enough of your milk, while you have it, do not transfer the baby to full artificial feeding, as even in small quantities it gives the baby immune protection and even helps better assimilation of the mixture. Breast milk contains prebiotics and other unique beneficial substances that contribute to the formation of its own beneficial intestinal microflora, improve fermentation and good absorption of food.

We have already talked about supplementation and methods of determining the lack of milk. In a situation where the amount of milk is really reduced, it is necessary to determine the advisability of introducing supplementary feeding and then, if necessary, correctly introduce the mixture and quickly leave it, returning full breastfeeding again.

When should you think about supplementation?

If you conducted a test for wet diapers, and according to its results, there were 6-8 of them, or at the next appointment with a pediatrician, the baby gained little weight, less than 500 grams per month, then you should consult a pediatrician who supports breastfeeding, or invite a consultant on natural feeding at home. Sometimes it is enough to get advice on the Internet, sometimes by calling the hotline, but in most cases, a consultant must be invited to your home. The counselor will assess the correct attachment to the breast, watch the baby's activity and ask you about all the details of the feeding process. If, when eliminating all factors affecting sucking and the amount of milk - improper application, the introduction of more frequent applications and stimulation of lactation, there is no effect, the question of supplementary feeding is decided.

With the help of a consultant or doctor, you will decide which type of supplement is preferable in your situation - expressed milk or formula, and also determine which type of formula to choose.

Where to start if there is a milk problem?

First of all, a young mother needs to calm down and pull herself together, not scold herself and not get nervous - the milk in the breast is more difficult to separate from stress and your worries because of the blockage of oxytocin. Then even the milk that is available is difficult for the baby to get, and he begins to get nervous and cry, be capricious. Read online breastfeeding materials at trusted resources - the AKEV website, La Leche League, or regional breastfeeding support sites. There are many detailed and detailed recommendations, photos and valuable advice, there you can be contacted by experienced consultants.

Check the attachment to the breast, if you find mistakes, try to correct them, attach the baby more often, change the feeding position, try the nesting technique, carry the baby in a sling, let it literally "hang" on the chest.

Feed the baby as often as possible, at the first request, without waiting for the moment when the baby cries and because of the cry will not be able to kiss normally. Sometimes in the early days it may seem that the baby is hanging on the chest. In fact, babies are simply sucking on a volume of milk.

Feeding is mandatory when falling asleep, at night - at least once every two to three hours, upon waking, and during the day, do the maximum interval no more than one and a half to two hours. If the baby is awake, gently attach it to the chest, children have highly developed sucking reflexes - they can sleep and eat at the same time. If at night it is difficult for you to get up often and feed for a long time, it will be more convenient to organize a joint sleep, then you can rest, and the baby will always be able to eat as much as he needs.

Try to temporarily limit visiting crowded places with your child and frequent absences from the baby, limit the visits to your home by guests, dim the lights and give up noise stimuli - this is called "nesting", being with your baby all the time, constantly feeding and carrying him in your arms.

When carrying out all these activities, control the number of wet diapers per day, you can within a few days. But you don't need to weigh the child every day - weight control is carried out once a week. If the weight is worth it, it is necessary to decide with supplementary feeding, but if the weight arrives at the level of 100-120 g per week, activate actions to increase lactation. If the weight deficit is pronounced, and there is no weight gain at all, the introduction of supplementary feeding is indicated - ideally, it should be breast milk (expressed or donated), but usually supplementary feeding is given in the form of a mixture.

How to calculate the amount of milk you need?

How much milk or mixture should be given in one supplementary feeding, how much supplementary feeding is needed per day, how to stimulate lactation, how not to completely go to artificial feeding, but to return full GW - these questions immediately arise when prescribing supplementary feeding. So, it is necessary to carry out special calculations of nutrition in order to determine the amount of supplementation and its introduction. It is necessary to establish the exact lack of milk in order to supplement it with a mixture, but at the same time not to overfeed the baby with a mixture, not to reduce the amount of breast milk, but to stimulate lactation. Attention, it is impossible to give the mixture "by eye" by the mother herself without making calculations - this will lead to a quick withdrawal to artificial feeding.

Power calculations

For children over 10 days of age, three variants of calculations are used, which give very similar results. The first method is volumetric, according to it the daily volume of food:
- for a baby up to one and a half months, leaves 1/5 of the body weight,
- for a baby from one and a half to 4 months is 1/6 of the mass,
- from 4 to 6 months - is 1 \ 7 of body weight,
After six months, 1/8 of the mass,
but not more than 1000 ml for children under one year old. This is the maximum daily volume of milk for babies in the first year of life, you cannot give more of it - there will be overfeeding.

There is also a high-calorie way of calculating and calculating the amount of protein nutrition, but only doctors can carry them out. These methods are complex and require tables, and they are voluminous in practice most often because of their simplicity and clarity.

The volume of one feeding is calculated by dividing the daily volume by the number of feedings. Children up to six months should have at least 7-8 of them per day. In each feeding, fluctuations in the amount of feeding in each side by 10-20 ml are permissible, due to the difference in appetite during the day.

Methods for the correct administration of the mixture

Supplementation is prescribed in the first six months, when, due to age, it is impossible to introduce complementary foods to the baby in the form of porridge or mashed potatoes. After six months, the question of supplementary feeding is decided individually, according to the situation, usually it is no longer required, you can supplement with cereals. If they decide on supplementary feeding, they give preference to mixtures-hydrolyzates, they do not taste as pleasant as breast milk, and the baby will not give up breast in favor of a mixture.

The mixture is introduced strictly under the control of urination, and feedings are carried out strictly according to the clock. The entire volume of the mixture per day is divided into equal volumes, and given exclusively during the daytime - usually from six in the morning to 21-22 hours, every three hours. Breasts, unlike supplementary feeding, are given on demand, and before supplementary feeding, it is necessary to give the child both breasts at once, and only then the mixture is injected. At night, from at least midnight to six or nine in the morning, only the breast is given, even if the child will practically sleep on the breast. Thus, the stimulation of milk production in the mother is carried out, and the gradual withdrawal from supplementary feeding.

We begin to give the baby a minimum amount of the mixture, about 30 ml, if the baby urinates less than 8-10 times a day with this amount of the mixture, another 20-30 ml of the mixture is added. If the baby urinates on a given volume of the mixture, more than 15 times a day, at least 50-100 ml of the mixture can be removed from his food at once. On average, a sufficient amount of food is indicated by the number of urinations 12-15 times per day.

If, after breastfeeding, the baby does not eat up the entire volume of the mixture, it is poured out, the next portion of the supplement is given at the next prescribed time. If this time the baby again does not eat up the volume, the volume of the mixture is cut off completely by this amount. We give the baby the breast constantly, without time control. If the daily amount of supplementary feeding is small, up to 200 ml per day, you can safely remove about 50 ml of the mixture or one of the feedings with the mixture.

While the baby is receiving the formula, it is necessary to control the volume of urination and weight gain. As the weight stabilizes and active gains, as well as with a sufficient amount of urination, they switch to a smooth cancellation of the mixture according to the above methods.

Any supplementary feeding is given to a child only from a spoon, a cup or a special system, but not from a bottle with a nipple. Nipple sucking and breast sucking are very different in mechanism, and bottle sucking can lead to breast rejection. Supplementation and feeding are monitored by your pediatrician or lactation consultant to help you inject and withdraw the formula as your weight and urination return to normal.

Can full breastfeeding be returned?

Of course you can, moreover, this must be achieved in the end. Today, lactation consultants have ample practical experience with the transition from mixed feeding to full breastfeeding. But it is impossible to do this in one day, mom needs to be patient, be calm and confident in her abilities, then everything will work out. In any case, it is necessary to strive to minimize the amount of supplementary feeding in each case of mixed feeding, since each drop of breast milk is priceless for the baby's health. The timing of returning to full breastfeeding will directly depend on the amount of supplementary feeding, but you can return to full breastfeeding even with fully artificial feeding - the main thing is sincere desire and patience.

If the volume of supplementary feeding is about 100 ml, it can be removed in two to three days, and if the baby is actively sucking, then at the same time, simply abandoning the mixture in favor of frequent applications. With a daily volume of the mixture of 150-250 ml, you can gradually remove the mixture by 50 ml for about a week, or reduce the volume of each supplementary feed and, reaching 100 ml, gradually cancel them altogether.

The volume of the mixture more than 300 ml per day is canceled within two to three weeks with a gradual reduction in the volume of the mixture in favor of more frequent breastfeeding. The volume of the mixture is removed by half, and then, having fixed on this result, the mixture is gradually canceled altogether.

In parallel with the withdrawal from the mixture, it is necessary to make efforts to stimulate lactation - this is not only proper nutrition and special drinks, but also adequate sleep, calmness and frequent and full breastfeeding.