How to breastfeed and formula feed correctly. How to supplement breastfeeding if there is not enough milk and which formula to choose

Supplemental feeding with formula during breastfeeding or, scientifically speaking, mixed feeding is a technique that is relevant when a baby, for certain reasons, cannot satisfy its own physiological needs for food by feeding on mother’s breast milk. It is worth understanding that colostrum and breast milk are the best food for a newborn, and if you have the opportunity to breastfeed your baby, then you should not miss this opportunity.

However, there are situations when breast milk is not enough for the baby. Many inexperienced mothers often ask why babies need to be weighed weekly in the first months after birth. Weighing babies is necessary, first of all, in order to monitor the dynamics of changes in the child’s weight, since it is weight gain or loss that is a diagnostic sign of the normal physiological and anatomical development of the child. The child should be weighed weekly and the results recorded so that the dynamics of weight changes can be seen. The baby's weight should increase according to the following pattern:

• in the first month the increase should be 90-150 grams;
• in 2-4 months – 140-200 grams;
• after 4 months – 100-160 grams.

This is approximately how the weight of a child under one year of age should change, but these indicators are very arbitrary. One way or another, the child should be shown to your pediatrician every month, and only a specialist can assess the baby’s development, the effectiveness of feeding and whether there are indications for supplementary feeding with formula milk.

Indications for mixed feeding

Supplementary feeding during breastfeeding, as we have already noted, is not a whim, but a necessary measure. There are a number of medical indications for the use of this method of feeding. Conventionally, they can be divided into two groups: some are directly related to the mother and her state of health, and others are related to the baby’s health state or other reasons why breastfeeding is not enough for him.

On the mother's side, the indications for supplementary feeding are as follows:

• reversible or irreversible hypogalactia is a pathological condition of the mammary glands, in which the formation and secretion of milk is disrupted and lactation time is significantly reduced;
• defects in breast milk (insufficient fructose or fat);
• chronic diseases of a woman that do not allow her to feed the baby as many times as required;
• the need to take certain medications during lactation.

Supplemental feeding with formula is also necessary according to the baby’s indications if he has:

• severe manifestations of exudative diathesis;
• severe anemia;
• increased need for certain nutritional components in premature newborns and children with chronic nutritional disorders.

Also, one should not discount the social reasons for the need for mixed nutrition for an infant, such as the mother’s work or the baby being in a closed institution for newborns, when the amount of expressed breast milk is not enough for proper feeding. Thus, if your baby is not gaining adequate weight, is constantly capricious or, on the contrary, lethargic and inactive, and the “wet diaper test” shows that the baby “relieves” less than 10 times a day - this is a reason to consult a pediatrician regarding mixed feeding.

Correctly selected products for supplementary feeding of the baby ensure its rational physical development. If the time for complementary feeding with “adult food” has not yet come, then as supplementary feeding you can introduce milk formulas specially designed for this into the baby’s diet, which are divided into three large groups:

• highly adapted;
• adapted;
• poorly adapted.

A highly adapted formula is considered to be the closest in composition to breast milk, but this does not mean that it is better or worse than other formulas that are less adapted. When choosing a formula, you should focus on the baby’s age and the correspondence of this indicator to what is indicated on the packaging by the manufacturer, as well as the recommendations of the pediatrician, who will help the mother choose the formula that is ideal for the baby.

The process of choosing formula can be difficult, as your baby may refuse to eat a particular formula or it may cause an allergic reaction. It is difficult to give advice on this issue, since each baby is a distinct individual, and it is not possible to predict many of the reactions of his body. For this reason, it is often necessary to choose a mixture by trial and error.

The only recommendation concerns what you definitely shouldn’t supplement your baby with – diluted cow’s milk, which is often recommended by “popular experts” as a supplement. This product is poorly absorbed by the baby’s body and does not contain the necessary nutrients in the required quantities. Moreover, it can cause digestive disorders, allergies and other unpleasant things. At the age of 6-7 months, you can use fermented milk products and special mixtures based on them as supplementary food. Dairy products of this category should be introduced only after consultation with a pediatrician or breastfeeding specialist. If you are in doubt about which formula to choose for supplementary feeding, it is better to ask a specialist for advice!

How much supplementary food does a baby need?

An important point when introducing supplementary feeding into a baby’s diet is to determine the exact amount of formula that the baby is missing. There are two ways to do this: take into account the calorie content of food and its volume. The latter method is more popular due to its accessibility. To understand how much milk the baby consumed while breastfeeding, he must be weighed before and after feeding, and then fed with the amount of formula that is not enough to meet the age norm. When calculating the amount of formula, it is also worth taking into account the weight of the baby.

Regarding age restrictions, you must follow the following rules:

• up to the age of one and a half months, the child should eat a volume of food equal to 1/5 of his own weight;
• at four months - 1/6 of its weight;
• up to six months - 1/7 part;
• after 6 months - 1/8 part.

At the same time, the total volume of food should not exceed 1,100 ml, taking into account both the milk obtained during breastfeeding and “additional nutrition”. The entire amount of supplementary feeding can be divided by the number of feedings and supplementary feeding can be given at each breastfeeding, or one feeding can be completely replaced with formula milk. To monitor the effectiveness of mixed feeding, it is worth constantly weighing the baby before and after feeding.

There are some general rules for introducing supplementary feeding, following which you will be able to achieve better results:

1. The first rule is that it is better to supplement the baby’s feeding after putting him to the breast, since, having eaten, many babies are reluctant to suckle, and this can lead to early cessation of lactation, which is extremely undesirable.
2. The temperature of the mixture should not exceed 37-38 degrees.
3. The mixture is prepared immediately before feeding and only for one time.
4. You should feed them with the same mixture; you should not experiment.
5. Supplement your baby only after he has drunk completely from both breasts.

By following these rules, you can effectively feed your baby with health benefits, and not vice versa. If there are any changes in condition or any reactions of the body, inform your doctor about them.

Effective supplementary feeding tools, or how to maintain lactation

We have already answered all the main questions that concern young parents, but the most important of them remains unresolved - how exactly and with what “tools” it is customary to introduce supplementary feeding. There are many different techniques, but we will focus only on the most effective and relevant:

1. Bottle with nipple. The most accessible and simple, but not the most correct way of supplementary feeding. Our main goal is to maintain lactation, and therefore bottle feeding is dangerous because the baby will completely refuse to breastfeed.
2. Disposable Spitz. A fairly affordable and hygienic method of supplementary feeding, in which there is no risk of breast abandonment. But it is not suitable if the volume of complementary foods is large enough.
3. Tea spoon. It is convenient and can help accustom your baby to a spoon, but it has one drawback - there is no mobility, and you will not be able to feed the baby on the road or on the street.
4. Miniature cup. A convenient and hygienic way to supplement feeding, but handling the cup requires remarkable skill. If there is none, then the milk will constantly spill, and it will be very difficult to control exactly how much formula the baby received.
5. Supplementary feeding system at the breast. This technique is the most popular and effective. This method allows mother and baby to receive skin-to-skin contact and not violate the sacrament of breastfeeding. Such systems are less accessible, they are not easy to wash and clean, and it is impossible to use them during a forced break in feeding.

Learn more about the breastfeeding system

The breastfeeding system is a simple design consisting of a supplementary feeding container and long but thin tubes that are attached directly to the nursing mother’s nipple. Thus, by taking the nipple into his mouth, the baby will make the necessary sucking movements and receive food, even if the mother’s breast is already empty.

Supplementary feeding at the breast is recommended by many breastfeeding experts, since this type of supplementary feeding, according to Medela sociologists and leading pediatricians, stimulates lactation even in girls who have never given birth. The main thing is that the baby correctly takes both the nipple and the tube into his mouth. If he doesn’t succeed the first time, you can help him with your hands by inserting a tube into the corner of his mouth.

Thus, supplementary feeding at the breast is preferable for children, especially under six months of age. This is the most physiological way of supplementary feeding, although not the most accessible. However, the money and effort spent pays off with interest. In many cases, women who used supplementary feeding systems noted that the quantity and quality of their own milk increased significantly.

Let's sum it up

Based on the fact that our main goal is to do our best to promote breastfeeding, we can summarize that supplementary feeding of a child is not a way to make life easier for the mother, but a necessary measure. Only if doctors consider that this is the only way out of a certain situation can supplementary feeding be given preference over breast milk.

Only a doctor can decide on the advisability of introducing complementary foods, since although the baby’s stomach is ready for small amounts of “foreign food,” it absorbs colostrum and breast milk better. If the baby really “doesn’t finish eating”, any doctor himself will suggest you introduce supplementary feeding. At the same time, the doctor will certainly write out all the recommendations, calculate the amount of necessary supplementary feeding based on the child’s anthropometric data and give other necessary recommendations. Only a correct and professional approach to supplementary feeding is the key to its effectiveness.

Look at a specialist’s opinion on mixed feeding of a baby:

If a child receives both mother's milk and formula at the same time, such feeding is called mixed. With this type of feeding, the share of formula in the baby’s diet ranges from 20% to 50%.

In the case of this type of feeding, feeding can be organized in two ways:

1. The breast is given first, and then supplemented with formula.
2. Completely replace any formula feeding.

Since there is nothing better than breast milk for a baby, choose a feeding method that will give him more of your milk.

Causes

• Most often, people switch to mixed feeding when there is insufficient breast milk production. Often, a lack of milk is a far-fetched problem caused either by a mother’s subconscious reluctance to breastfeed, or by a woman’s low awareness of the processes of lactation. However, there are also objective reasons for hypogalactia that force the mother to resort to supplementary feeding.
• The second reason for combining breast and bottle feeding when feeding a baby is when the mother goes to work or school. Often, a mother leaves expressed milk while she is away, but more often, while the mother is working, the baby is fed formula milk.
• The doctor recommends a mixed type of feeding when the baby is not gaining enough weight or was born premature. In this case, this type of feeding is a temporary measure - gradually feeding becomes completely breastfeeding.
• Mom can also start bottle-feeding the baby to free up some time for herself. In this case, you can leave the child with your husband or another adult for a short time without worrying that the baby will remain hungry.
• Another important reason for supplementing the baby with formula is the presence of compensated diseases in the mother.

Breastfeeding provides the opportunity for close contact with the baby and provides the substances it needs for development. Even if there is an acute shortage of milk, do not refuse partial breastfeeding

pros

• With this type of feeding, the mother can be temporarily replaced by another adult, but at the same time she will have the opportunity to maintain closeness with the baby during breastfeeding.
• The baby retains all the benefits of breastfeeding.
• The mother may be away from the child for some time.
• Mixed feeding can help dad establish a closer connection with the baby.

Minuses

First of all, due to skipping feedings, the mother may experience problems with the breasts (congestion, milk rushes, chest pain and even mastitis) and with lactation. Also, the mother may suffer psychologically from the fact that the time of breastfeeding has been reduced.

At the same time, it may be difficult for a child to adapt to two types of feeding at once:

• He may refuse bottle feeds and be capricious. This may decrease his appetite.
• Having started to easily receive formula from a bottle, the baby will not want to “work” getting milk from his mother’s breast. This happens with a very early transition to mixed feeding (in the first 6 weeks of the baby’s life).
• Often not receiving enough breast during the day, the baby begins to demand more breast milk in the evening and at night.

What is better: supplementing with formula or completely switching to it?

The baby's digestive system is tuned to breast milk, and when formula enters it, various unexpected reactions are possible. Therefore, you need to especially carefully monitor the baby’s reaction.

It is important to understand that formula, even if it is expensive and of the best quality, is not equal to breast milk. Therefore, there is no need to give up breastfeeding under any circumstances. Supplemental feeding with formula should not be taken lightly; you should not choose formula without consulting a doctor. Also, a mother’s decision to supplement the baby with goat’s milk or kefir can only harm the baby’s health.

Mixed feeding is much better than artificial feeding. If milk is not enough, try increasing lactation

Rules

• If formula and breast milk are given at the same feeding, then first the baby is applied to the breast (even if the mother has very little milk), and when the baby has completely emptied it, the formula is given. The reason for this approach is that the baby has a greater appetite at the beginning of feeding. If you give formula first, it will be difficult for the mother to calculate the required amount, and the baby will not want to suckle at the breast to get milk, since he has already satisfied his first hunger.
• In situations where the mother will be temporarily absent during the day, the child is transferred to a mixed feeding regimen in which the baby will receive only formula two or three times a day, and at other feedings only mother’s milk.
• If the amount of supplementary feeding is small, it is recommended to give the formula from a spoon, since due to the easier intake of the product from the nipple, there is a risk that the child will refuse to suckle at the breast. If a large volume of formula is being given, it is important to choose a nipple that is firm and has small holes so that the baby will have to exert effort to get the formula out of the bottle.
• The diet with this type of feeding can be free, but if the mother decides to feed the baby on a schedule, then the number of feedings can be reduced by one.
• It is important to carefully monitor the sterility of bottles and nipples.
• If the mother goes to work, the first attempts to bottle-feed the baby should not be put off until the last few days. In most cases, infants do not immediately accept bottle feeding. It is optimal to start feeding the baby with formula 2-3 weeks before the mother begins to leave home for a long time.
• With mixed feeding, you can start feeding a baby two to three weeks earlier than a baby who receives only breast milk.

When mixed feeding, it is necessary to follow many rules and monitor the baby’s reaction when introducing the formula.

Requirement calculation

If you have the opportunity to provide your baby with the required amount of milk at one feeding (while reducing the total amount), use this opportunity and give the formula only at one of the feedings. In this case, you can only calculate the amount of formula required for the current feeding of the baby with formula.

To determine the baby's needs for additional nutrition, you should take into account the age of the baby and the type of formula used.

First, calculate the baby’s total daily nutritional needs:

• for a baby under 10 days old weighing less than 3200 g, to calculate the required amount of nutrition, you should multiply 70 by age in days (if weighing over 3200, multiply 80 by age in days);
• a child under 2 months is given food in the amount of 20% of his body weight;
• children from two to four months require food in the amount of 1/6 of their weight;
• babies older than 4 months to 6 months of age need food in the amount of 1/7 of their body weight;
• Children aged six months to one year require a daily food intake of 1/8 to 1/9 of their body weight.

We divide the total volume by the number of feedings and find out the approximate amount of nutrition the baby needs in one feeding.

The amount of milk sucked can be measured by control weighing: weigh the baby before feeding and then after. After subtracting these values, you will know the amount of milk you drink. Now all that remains is to subtract the volume of breast milk the baby receives from the total volume - this way the mother will know how much formula the baby will need.

Through simple calculations you will find out how much formula you need to give your child.

To make sure that the baby has enough all nutrients for growth and full development, you need to calculate how much protein, carbohydrates and fats the child receives daily. The calculation is based on the intake rates of basic nutrients into the child’s body, as well as the approximate content of these substances in human milk.

First, they calculate how much the baby receives in total breast milk per day, and then how much protein, carbohydrates, and fats he receives with this food. Next, the nutrient content in the resulting volume of milk mixture is also calculated. Having calculated the baby's needs depending on age, it is determined whether the food received is enough for the baby.

It should be taken into account that the protein requirements of the baby increase when switching to mixed feeding. A baby under 4 months of age requires 3 grams of protein per kilogram of weight if supplementary feeding is carried out with an adapted formula, and 3.5 grams if the formula is not adapted. A child over 4 months of age needs 3.5-4 grams of protein.

What do they supplement with?

For supplementary feeding, the same mixtures are chosen that are recommended to be fed to bottle-fed infants. Preference is given to an adapted mixture.

The formula must be exclusively adapted and selected by the pediatrician based on the needs of your child

What can't you supplement with?

The baby should not be given a medicinal mixture unless it is recommended by the pediatrician. There are strict indications for the use of mixtures with a therapeutic effect, for example, soy mixture is given for allergies to milk protein, and lactose-free is used for babies with lactase deficiency. Kefir, cow's or goat's milk can significantly harm the baby's body.

If your baby doesn't like the bottle

Many babies are reluctant to switch from breastfeeding to bottle feeding. To make this transition more successful, mothers are advised to:

• Try putting different types of nipples on the bottle so that the baby can choose “his own.”
• At first, bottle-feed expressed breast milk.
• Bottle feed when your baby is hungry but not too hungry.
• Let someone else, not the mother, offer the baby a bottle of formula for the first time.
• When the baby is fed with formula, let the baby not be in the position in which he is accustomed to receiving his mother's breast.
• The liquid given to the baby should be warm, since the baby is accustomed to receiving warm milk from the mother’s breast.
• You should not expect your baby to immediately drink all the formula from the bottle.
• In extreme cases, the mother will have to not breastfeed the baby for a whole day so that the baby still agrees to try the formula from the bottle.
• If the baby persists and is already 6 months old, it makes sense to plan to feed the baby with complementary foods during the mother’s absence.

In this article:

Sometimes situations arise when supplementary feeding with formula becomes necessary. Unstable lactation, illness of the mother and insufficient weight gain by the child are common reasons for mixed feeding. Supplementary feeding is the introduction of an artificial formula into the baby’s diet, which should supplement the mother’s lactation on a temporary or permanent basis.

When is supplementation needed?

There are a number of reasons justifying mixed feeding. As practice shows, there are plenty of them against the backdrop of the modern rhythm of life.

Situations when supplementary feeding with formula is needed while breastfeeding:

• Unstable or disrupted lactation . Sometimes a baby simply does not have enough breast milk, which affects his body weight.
• Mom's illness . If a woman is forced to take medications that are not approved for breastfeeding, pediatricians recommend giving up breastfeeding and switching the baby to an adapted milk formula. This step will protect the baby from pathogenic microflora and drug metabolites that penetrate into mother's milk.
• Rhesus conflict . Incompatibility of the blood of mother and newborn is an indication for artificial nutrition.
• Time trouble . Not all women manage to take maternity leave for several years. Is it possible to supplement a breastfed baby with formula in this case? Yes, this is better than completely switching to artificial nutrition.

What products are used for supplementary feeding?

The composition for supplementary feeding of newborns should be as close as possible to breast milk. It is not difficult to purchase a high-quality product adapted to the needs of a baby - on store shelves there is a sufficient assortment of domestic and foreign baby food that can be offered to the baby from birth.

Milk from domestic animals - cows or goats - is not currently used in pediatrics. These foods have been proven to negatively affect a child’s immune system, digestive tract, and kidneys. There is also a risk of the baby becoming infected with Brucella and other pathogenic flora, which can be transmitted from sick animals. Supplementing a newborn with formula eliminates this possibility.

Mixture volume

If a baby does not have enough milk while breastfeeding, he must be supplemented with an artificial formula, the volume of which must be calculated correctly, but how to do this? There are two ways.

To find out how much breast milk the baby receives during the day, he is weighed before and after feeding. Based on the difference obtained and the child’s age needs in terms of food volume, an appropriate conclusion is made. This method helps to quickly and easily determine whether supplementary feeding is necessary and how much formula the child needs.

You can also find out whether the mother has a lack of milk by counting wet diapers. To this end, you need to give up disposable diapers for one day and swaddle your newborn the old fashioned way. On average, an infant urinates 12 times a day. If this happens less often, you should add 30 ml of the mixture to each feeding until the number of wet diapers corresponds to the norm.

There is no need to calculate the required amount of supplementary feeding “by eye”. Such actions can lead to digestive problems, increased stomach volume and excess body weight of the child if you make a mistake and overfeed the baby.

Choosing a mixture

After deciding on the need to introduce supplementary feeding for a newborn, a young mother is faced with the task of choosing suitable products. Modern adapted formulas are close in composition to mother's milk, so choosing high-quality baby food these days is not at all difficult.

How and what mixture to choose to avoid allergies and digestive problems? A good mixture contains unsaturated fats necessary for the full development of the nervous system and brain. Most products contain pro- and prebiotic additives, which eliminate the possibility of digestive problems in the baby. Nucleotides have a positive effect on the formation of immunity, and lutein is beneficial for the visual organs. It is also important that the infant formula includes iodine, taurine and other trace elements.

The child’s age and well-being also play a role when deciding which formula is best to supplement a newborn’s feeding. The composition of baby food changes in accordance with the increasing needs of the baby, so you need to pay attention to the product labeling. Usually, infants under 6 months of age are labeled with the number “1,” and older children with the number “2” and “3.”

If a child has digestive problems, such as colic or colic, it is better to choose fermented milk formula. For lactase deficiency, pediatricians recommend lactose-free products.

The tendency to frequent regurgitation can be eliminated by feeding an anti-reflux formula with increased viscosity. For babies with allergies, a hypoallergenic product is better suited, while a nursing mother should not forget about compliance.

Before purchasing the mixture, you need to read the instructions. It is important not only to purchase a quality product, but also to learn how to prepare and store it correctly. So, which formula should you choose for supplementary feeding? It depends on the age and needs of the baby.

How to introduce supplementary food?

Proper introduction of artificial nutrition into the baby's diet guarantees the success of mixed feeding.

• Breast milk is the only true source of nutrition for a baby . It contains the entire necessary list of microelements, vitamins and salts that the baby needs during the period of growth and development. Therefore, supplementary feeding with formula during breastfeeding is possible only if the newborn has first emptied the mother’s mammary glands in full.
• If the child does not finish the offered mixture, there is no need to force him . You can determine whether a baby is full by his behavior: he does not make sucking movements, turns away from the bottle or pushes it away with his hand. A breastfed baby should be supplemented with the same amount of the selected formula, without decreasing or increasing this volume, including before bedtime.
• Babies eat better when they're in a good mood . If the baby is overexcited, cold or in pain, constant crying will interfere with normal eating. Therefore, first the mother must eliminate all unfavorable factors, and only when the child calms down should she be fed with formula.
• The hole in the bottle should not be too large . Quick and easy saturation with artificial formula leads to the fact that the child will soon completely abandon the breast. If possible, it is recommended to replace the bottle with a dessert spoon.
• Temperature The finished mixture should be comfortable for the baby - no higher than 38°C.

If you follow these simple rules, supplementary feeding with formula while maintaining breastfeeding will allow you to avoid a quick transition to artificial nutrition for your baby.

What to supplement with?

A bottle equipped with a nipple is a familiar attribute for every young mother. But pediatricians advise using it only under extreme circumstances. This method of supplementing newborns with formula is a direct threat to lactation.

Long-term observations indicate that children who try a pacifier for the first time begin to be reluctant to take the breast and soon categorically refuse mother's milk.

So, how to properly supplement formula feeding to a newborn with the help of simple devices?

A young mother can choose which method is most optimal for her:

• Dessert spoon or teaspoon . This is the easiest option to feed a baby without threatening lactation. The child is supplemented with formula using a spoon, provided the volume of food is modest.
• Pipette or syringe . This option is also suitable for supplementary feeding with a small amount of formula, that is, you should not feed your baby this way at night. In addition, the process itself takes a lot of time and effort from both mother and baby, but does not affect the process of producing breast milk.
• Small cup . Another simple, but not very convenient method that allows you to supplement your baby with formula. In the absence of experience and skills, milk may partially spill out of the container, so it is quite difficult to determine how much the baby has eaten and whether he has eaten enough. But this method best demonstrates how to properly supplement your baby with formula at night.
• Mom's finger . Feeding in this way is safe for lactation, but it is rarely used due to the length of the process. It is better to use a finger to awaken the sucking reflex in a baby.

If there is a need to introduce supplementary feeding while breastfeeding, the mother should make as much effort as possible to maintain lactation.

How to return to natural feeding?

With mother's milk, the child receives a maximum of useful microelements, hormones, protective antibodies and nutrients. If there is not enough breast milk, you can supplement the baby with formula, but at the same time the woman should think about whether she is doing everything to maintain lactation.

Frequently putting the baby to the breast, no matter how full it is, will help solve the problem. In this case, the woman receives stimulation of the mammary glands, and the baby realizes the sucking reflex in full. You should not limit the time he stays at the breast. Co-sleeping and giving up the habit of supplementing your baby with formula while breastfeeding can solve the problem of a lack of breast milk in 7 days.

Additionally, a woman can take herbal and homeopathic remedies aimed at improving lactation. We also must not forget about proper nutrition, maintaining a drinking regime and eliminating stress factors. Sometimes these simple recommendations free a young mother from worries and worries about how to feed the baby.

The relevance of the problem of mixed feeding does not lose popularity at any time. It can only be solved through an integrated approach, which necessarily takes into account such indicators as the state of his health, the presence and number of urinations.

How to choose a formula and introduce it into a child’s diet? A product suitable for age and individual needs should be administered carefully, preferably not from a bottle and without exceeding the norm. But even after the introduction of supplementary feeding, the young mother needs to make efforts to eliminate mistakes made during breastfeeding until lactation is restored.

Useful video about feeding a baby with formula

Mixed feeding of newborns is a reasonable alternative when mother's milk is not enough. It allows you to maintain lactation and provide the baby with at least partially natural nutrition. If you feed your baby correctly, mixed feeding will only benefit him. Over time, many women manage to completely restore lactation and transfer the baby to breast milk.

Mixed feeding is a feeding method in which an infant receives infant formula at the same time as breast milk. The amount of additional food should not exceed 50% of the infant’s daily food intake. If formula milk makes up the majority of the diet, feeding is considered artificial.

Properly organized mixed feeding of a newborn helps to maintain breastfeeding and increase milk production. Baby food cannot completely replace mother's milk. It contains many valuable substances that are not found in artificial analogues. Natural food is ideal for the development of the baby and protects it from diseases. Of no small importance is the psychological contact between mother and child, which is established during breastfeeding. The process of sucking mother's milk calms the newborn, giving him a feeling of security and comfort.

The baby’s diet should be dictated only by objective necessity. As obstacles to natural feeding are eliminated, the amount of supplementary feeding should be reduced.

Mixed nutrition is prescribed to newborn children who, due to their health or the health of their mother, did not receive mother's milk immediately after birth. Once breastfeeding becomes possible, the baby is gradually transferred to breast milk.

Women suffering from hypogalactia need to supplement their child's feeding. Hypogalactia is called insufficiency of the mammary glands, in which too little milk is produced. Without receiving the required amount of food, the baby goes hungry.

A baby may be malnourished when its mother's milk is not nutritious enough, although it is produced in excess.

Women who work or study and cannot provide the child with the required amount of expressed breast milk are forced to switch their baby to mixed nutrition.

Mixed feeding includes babies who, for health reasons, have been prescribed medicinal or special formulas by their pediatrician.

How to determine that mixed nutrition is necessary

Many women are afraid that they will not cope with the role of a mother and will not be able to breastfeed their baby. In the vast majority of cases, their fears are unfounded. The female body regulates the amount and composition of milk produced, focusing on the requirements of the newborn. Therefore, the growing baby is saturated with breast milk and receives all the nutrients necessary for development.

It is impossible to transfer a child to mixed feeding based on the appearance of the breast or milk. If the mammary glands are poorly filled and the milk looks watery, this does not mean that the baby is not getting enough.

The decision to introduce additional nutrition should be made by the pediatrician. Without his permission, it is impossible to feed a newborn with infant formula.

If supplementary feeding occurs without reason, the baby will overeat. Excess food can upset the digestive system and lead to weight gain. Systematic overeating in childhood often causes obesity in adulthood.

If mixed feeding is not organized correctly, infant formula can displace breast milk, and the baby will be deprived of natural food.

Signs of malnutrition in a newborn

To determine it, you need to observe it and evaluate the dynamics of its development.

Rare urination indicates a lack of mother's milk. If a newborn's diapers become wet less than 6-8 times a day, he is not getting enough food. Tracking urination is not difficult if you use gauze diapers. It is easier to assess the type of urine on a fabric surface. If it is dark in color and smells bad, this is a sign of dehydration. It occurs in a newborn against the background of intense vomiting, diarrhea or prolonged malnutrition.

An important indicator of a child’s adequate nutrition during the nursing period is his weight. The newborn should return to its birth weight within 2 weeks of delivery. During the first 6 months of life, a well-nourished baby increases its weight by no less than 500 g every month. There is no need to weigh your baby every day. It is enough to evaluate his weight every 2 weeks. If there are doubts that the baby is malnourished, you can do control weighings before and immediately after feeding. This will allow you to determine how much milk the baby drank. A one-month-old baby sucks about 90-100 g of milk per feeding. A baby aged 3-4 months drinks 150 g of milk, and a six-month-old baby drinks 180-210 g. The daily amount of food eaten should be 1/5 of the baby’s weight. If after control weighing the baby’s weight changes slightly, he does not have enough food.

A malnourished baby cannot withstand 1.5-2 hours between feedings. He starts crying a lot an hour after eating and sucks greedily at the breast.

A sign that a child is starving is a change in the nature of bowel movements. The baby's stool darkens and becomes denser, greenish or brown in color.

How to properly organize mixed feeding

When you decide to switch to mixed feeding, you need to consult with your pediatrician about how to feed your baby correctly:

• You need to start eating with breast milk. The baby should be allowed to empty both breasts before formula is offered. Allowing your baby to suck all the milk from the breast can significantly increase milk production. Before breastfeeding, the baby can only be offered certain medicinal mixtures prescribed by the pediatrician.
• You should not offer your baby food in a bottle with a nipple. Satisfying his need for sucking, the baby may lose interest in mother's milk. If there is a large hole in the nipple of the bottle, it will be much easier to suck on it than on the breast. In this case, the baby may completely refuse to suck mother's milk. It is best to spoon feed your baby formula. This method is the most inconvenient for babies. Therefore, he will tend to suckle more.
• To maintain lactation and increase the amount of milk produced, it is imperative to breastfeed the baby at night. During this period, the largest amount of the hormone prolactin, which is responsible for lactation, is produced.
• You can give only baby formula at one feeding. This scheme is convenient for women who need to leave for several hours every day.
• It is recommended to breastfeed your baby on demand. You can offer breast milk when your baby is upset, can't sleep, or doesn't feel well. The more a newborn breastfeeds, the more milk the mammary glands will produce.
• If you carefully follow all the recommendations, the amount of milk will gradually increase. As lactation increases, it is necessary to reduce the volume of infant formula. In this way, it is possible to transfer the child to full breastfeeding.

How to calculate the required amount of baby formula

The amount of additional nutrition is calculated depending on the child’s body weight deficiency. If a newborn at 3 weeks weighs 3100 g (birth weight 3000 g) and has all the signs of malnutrition, he needs additional nutrition. The body weight deficit is 3400 g - 3100 g = 300 g. To calculate the required daily amount of food, you need 3100 g: 5 = 620 ml. With seven meals a day, the baby should eat about 90 ml of milk per feeding.

Control weighing allows you to determine the amount of milk that the baby sucks from the mother during one feeding. If its quantity fluctuates between 60-70 ml, it is necessary to prepare a one-time serving of baby food of 40-30 ml.

If one feeding is completely replaced with infant formula, the serving volume should be increased to 90 ml.

Your pediatrician will help you calculate the optimal amount of baby formula. He will take into account the individual characteristics of the child, his state of health and the maturity of the digestive system.

What mixtures can be used for supplementary feeding?

When mixed feeding, your doctor will tell you how to choose the right milk formula. If the baby is completely healthy and has no problems with the digestive system, you can give him Nutrilon, Humana, Nan, Hipp.

When a baby suffers from constipation, regurgitation and colic, it is better to include fermented milk infant formulas Nan, Nutrilon, Nutrilak or Agusha in his diet. They contain lactic acid bacteria and bifidobacteria, which help restore a healthy balance of microflora in the child's intestines.

If your baby has an intolerance to cow's milk, you can feed him infant formula based on goat's milk (Cabrita, Nanny) or soy (Nan-soy, Frisosoy, Enfamil-soy, Similak isomil). In most cases, such products are well tolerated by children.

For babies with protein intolerance, products with split proteins are made. Such mixtures do not cause a negative reaction in the child, but have an unpleasant taste and low nutritional value. They can only be used as prescribed by a doctor.

If you are mixed-feeding your baby, you should not try to feed him the entire prepared portion of baby formula at any cost. If he refuses to eat, the feeding should be stopped.

For the next meal, there is no need to prepare an increased portion of the formula, trying to compensate for the volume that the baby refused during the previous feeding. You should always prepare the portion of baby food recommended by your doctor.

After the baby has eaten the offered mixture, you can offer him the breast again. If the baby is not full, he will suckle with pleasure.

Infant formula takes longer to digest than mother's milk. The number of feedings with mixed feeding will be 1 less than with breastfeeding.

To prevent your baby from weaning off the breast, you can use a special device for feeding newborns. It is a container for baby food with a straw attached to it. The tube is fixed near the mother's nipple. The baby grabs it along with the nipple and receives additional nutrition in the most favorable conditions for him.

Babies who are on mixed feeding need to be introduced to their first complementary foods 2-3 weeks earlier than those who are on a breastfeeding diet.

There is no need to be upset about having to supplement your baby with formula. Critical periods occur in all breastfeeding women. As the baby grows, his food needs also increase. The mammary glands need time to ensure the baby’s increased appetite. For some women, adaptation takes a little longer.

We need to think about how to properly organize mixed feeding and restore lactation faster. You need to drink more fluids, eat well, get enough rest, get enough sleep and regularly be in the fresh air.

Supplementing with formula while breastfeeding seems to be common when feeding infants. Every mother has heard about this. Let’s take a closer look at what it is and whether it should be avoided.

Complex Concepts of an Easy Process

Pediatrics contains many terms that are not clear to mothers. To avoid ambiguous conclusions, let’s look at the names of the processes:

• Breastfeeding (BF) is feeding the baby at the breast;
• Mixed feeding of newborns (MF) - feeding with mother's plus artificial nutrition;
• Artificial (IV) – cultivation with artificial mixtures;
• Supplementary feeding - additional feeding to the main one before the introduction of complementary foods;
• Complementary feeding is the gradual introduction of adult food into the baby’s diet.

Very simple, but mistakes have consequences. After all, formula for feeding newborns is not the same as formula for supplementing newborns.

Let's consider supplementing baby food with a mixed diet. In this article we will not describe what formula to feed a newborn if there is no milk. After all, if there is no milk at all, then this is artificial cultivation.

If you are interested in the choice of formulas for feeding, then we talk about it in the article at the link, in the next one - about the options, and a general overview of the mixtures -.

Describing all processes in detail and preventing possible complications is a task at the state level. Rather, it is a global issue.

Global strategy

The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) created the Global Strategy for Infant and Young Child Feeding in 2003.

Based on scientific facts, it has been substantiated that only breastfeeding is necessary for the first 6 months of life, because the introduction of any other food during these months is an important risk factor for illness and death in children. 45% of all child deaths are from poor nutrition.

This suggests that by thoughtlessly supplementing with artificial formula for the first 6 months, the mother is endangering her child. Yes, of course it sounds cruel, but it's true.

After all, only 35% of children on the planet receive only breast milk until 6 months of age. Increasing this figure means reducing the mortality rate of children on the planet. Every mother in any city, all over the world can do this.

My milk is not enough

When the baby cries, the first thing the mother thinks about is that he is not full. When he lingers on the arms for a long time, doubts creep in that there is probably nothing there anymore.

If the scale in the pediatrician's office shows a small increase in weight, then the mother is ready to immediately run to the pharmacy for a jar of food.

Why does this happen, and is it really necessary to supplement?

Almost any mother can feed her baby exclusively with her breasts. The only important thing is to want it. Don't be lazy or panic, and there will be enough milk.

What to do

If a mother feels like she doesn’t have enough colostrum or milk in her breasts, she needs to do the following:

1. Calm down;
2. Put everything aside;
3. Analyze weight gain;
4. Place the baby frequently on the nipple;
5. Express after each feeding and supplement with a spoon;
6. Use the services of breastfeeding consultants or a pediatrician if these steps do not help. They will analyze the situation and be able to tell you what exactly the problem is and how to solve it.

The options may be different:

• Increased tactile contact;
• Drinking lactation teas and/or medications;
• Breast massage, etc.

Indications for mixed feeding

Mixed feeding is prescribed only for medical reasons. There are few such indications, but only a doctor can establish it for specific reasons.

Supplementary feeding during breastfeeding - treatment, and self-medication can cause irreparable harm to your baby’s health.

If you still need it

Supplementary feeding with formula during breastfeeding Komarovsky E.O. considers it a normal thing, but only because he is a doctor. If the doctor prescribed supplementary feeding with formula, gave recommendations on which formula is best to supplement the newborn baby, in what quantities, the mother should use her common sense.

3 questions about artificial baby food

To understand how to supplement with formula while breastfeeding, you need to have a good understanding of this issue. We will not describe in detail the brands and composition of artificial nutrition, since this contradicts the International Code of Practice for the Marketing of Mother's Milk Substitutes, let's look at the overall picture.

Which formula is best to feed a newborn?

For this age, the use of highly adapted milk nutrition is a prerequisite. Its composition is as close as possible to mother's milk.

Which formula is best to feed a newborn baby depends on each specific situation. You must clearly know why the substitute is prescribed. Manufacturers are required to clearly state on the label the purpose of this food.

Glagolova S.A. family doctor, Kyiv

If a child gains 150 g per week, then there is no talk of any supplementary feeding.

How to calculate volume

In the maternity hospital, the average colostrum consumption rates are used:

• 1st day of life – 2-10 ml per feeding;
• 2nd – 5-15 ml;
• 3rd day – 15-30 ml;
• 4th – 30-60 ml.

Also, to calculate the first week use:

Zaitseva formula

Amount of daily milk = 2% of birth weight * number of days to live;

For example: you need to find out how much to give on the first day after discharge from the hospital.

2%(3200)*4 = 3200*2/100*4 = 64*4 = 256 ml for the 4th day of the baby’s life;

If the baby eats every 3 hours, then it turns out:

• 24/3 = 8 feedings per day;
• 256/8 = 32 ml per feeding.

These calculations do not work after 7-10 days of life. From now on, use the following formula:

Shkarin's formula

A child aged 2 months should receive 800 ml of food per day. For every week that is not enough until this age, 50 ml is subtracted from this volume.

And for each month above this period, 50 ml is added.

For example: baby is 1.5 months old = 6 weeks = 800-100 = 700 ml daily.

If he is 5 months old = 800+150 = 950 ml per day.

How much artificial nutrition is needed?

Not everyone understands how to feed correctly when mixed feeding, if it is not known how much was drunk from the mother’s breast. You can try to figure it out in the following ways:

1. Weighing the diaper. It is known that in children under 3 months the urine volume is 175-590 ml per day. This is approximately 50% of total food intake. By weighing the diaper before and after, the weight of the urine is calculated. The percentage determines how much milk the child drank. This method is not official and is rarely used.
2. Control weighing of the child. The baby is weighed before and after feeding, and the amount of food consumed is calculated.
3. Give as much as the baby wants.

When mixed feeding, feed children on demand, first on one breast, then on the other, then give artificial nutrition until completely saturated.

What to give from

If supplementing your baby is a temporary forced action, then try with all your might to maintain breastfeeding.

For additional feeding, use a cup, spoon or syringe (without a needle). This will allow you to follow all the doctor's instructions, but will not allow your baby to stop breastfeeding because of the bottle.

The breastfeeding system will make this task easier. The idea is very simple - a bag of food is hung on the mother's neck and, through a tube attached to the chest, enters the baby's mouth during breastfeeding. This system can be purchased or made independently. The main thing is not to forget about hygiene. Take proper care of it.

What to do if the baby doesn't want to

If you follow all the recommendations and there is no other way out, then you need to get together and help your baby during this difficult time. Children always feel their mother’s mood; if their mother gives him a cup with confidence and a smile, he will definitely eat if he is hungry.

If the little one refuses, you can change the method, try feeding at the breast or using a bottle with a pacifier.

Krovets E.O. pediatrician, Moscow

Supplementing your baby with artificial baby food indicates that the mother does not know about the risks and problems that may arise.

Helping and guiding is the task of every doctor.

The norms of breastfeeding and artificial feeding are described.

conclusions

Only a doctor should decide whether to give artificial baby food. The mother, under any circumstances, is obliged to take responsibility for establishing breastfeeding. And it is better to avoid giving formula for supplementary feeding of newborns, because mother's milk is the best that a child can receive in infancy, and it is also completely free.