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.

Reasons

• 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 study. 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.

Cons

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 the baby is first 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 right 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 regime 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 has 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.

Breast milk is the best food for children under 1 year of age, so most young mothers prefer natural feeding. However, in some situations it becomes impossible to give the child the required amount of nutritional fluid, which is why the full development of the baby is at risk. Supplementary feeding during breastfeeding will help solve this problem.

Supplementary feeding, unlike complementary feeding, is not required for all children. Experts say that an infant does not need to be fed additionally if there is enough milk. However, not every young mother knows how to correctly determine whether her baby is getting enough to eat. Often women unreasonably introduce supplementary feeding out of false fears that they have little milk, and thereby provoke a deterioration in lactation. In the future, this may lead to a complete transition to artificial feeding.

The following signs indicate that your baby is not getting enough breast milk:

• the baby is not gaining weight well;
• while sucking the breast, the baby behaves restlessly, cries, throws the nipple;
• the child’s body is dehydrated (symptoms include lethargy, dryness and pale skin).

A reliable way to determine whether a baby is getting enough breast milk is the wet diaper test. To carry it out, you need to stop using diapers for a day and monitor how many times the child urinates within 24 hours. If your baby wets his diaper at least 12 times, it means he is getting enough breast milk.

To find out for sure that a child is not eating enough, you need to take into account all of the above signs at once. If a woman no longer feels hot flashes and a feeling of fullness in the chest, as at the beginning of the lactation period, and between feedings it is not possible to express milk, but the baby is gaining weight well and feels normal, the introduction of an artificial formula is not required.

Supplementary feeding methods

If there is a need to supplement with formula, it is not recommended to use it for this purpose, even despite all the convenience of this method of supplementary feeding. Sucking from a bottle is much easier for a child than feeding from the mother's breast, so after the introduction of supplementary feeding, the baby may refuse natural feeding. In addition, the use of bottles quickly leads to the formation of an incorrect latch on the nipple.

If a woman nevertheless chooses this method of feeding, she should give preference to anatomically shaped nipples with a small hole. Offer the baby a bottle only after breastfeeding.

There are also the following supplementary feeding methods:

1. Syringe. For this method, use a sterile 5-10 ml syringe without a needle. The tip of the product must be inserted into the corner of the child’s mouth and, slowly pressing the piston, supply food. The syringe may have a long and thin soft tube at the end; in this case, you can simultaneously place a clean finger in the baby’s mouth, pad up, so that the baby sucks on it like a mother’s breast. Unlike a bottle, a syringe does not contribute to the refusal of natural feeding and does not harm the correct latch on the nipple.
2. Spoon. In this case, a simple teaspoon is used: formula or milk is taken into it, and when the infant opens his mouth, the food is quickly poured onto the middle part of the tongue or behind the cheek. You can also use a soft silicone spoon with a built-in food container. It is produced by manufacturers of children's products specifically for the introduction of supplementary feeding during breastfeeding.
3. Cup. You can use any small cup with thin walls or a special plastic container for supplementary feeding. When giving milk or formula to an infant from such a cup, do not pour the food down the baby's throat. He must “lap” or sip the liquid himself. This method of supplementary feeding is suitable even for premature infants.
4. Supplementary feeding at the breast. This method uses the Medela breastfeeding system or its analogues, made with your own hands from a simple bottle. This device looks like a container with two small long tubes into which formula or breast milk is placed. During feeding and at the same time receives nutrition through a tube. With this system, women can easily coordinate their actions when attaching the baby and feeding supplements, since using the device does not present any difficulties.
5. Pipette. This is the most labor-intensive method, since the volume of the pipette does not allow giving a breastfeeding baby a lot of nutrition at one time. Therefore, feeding in this way is used only when the child does not require a large amount of formula and if other methods do not work.

Each woman chooses for herself how to give formula to her baby while breastfeeding. The main criteria should be the effectiveness of the method and the convenience of the method for the mother herself.

Which mixture to choose for supplementary feeding?

The formula for supplementary feeding should be chosen carefully, taking into account not only the age of the infant, but also the characteristics of his body. For babies under 6 months, the most suitable is highly adapted artificial nutrition, which is as close in composition to breast milk (Nan-1, Nutrilon-1, Hipp-1).

For children prone to developing allergies, a hypoallergenic mixture (Frisopep, Nestozhen, Nutrilak GA) is required; for tummy problems, preference should be given to fermented milk Nan-1 and Nan-2. If the baby suffers from lactase deficiency and cannot digest lactose (a protein found in all dairy products and breast milk), he can only be supplemented with a lactose-free formula (Nutrilon Lactose-Free, Nutrilak Premium Lactose-Free, Bellakt).

When choosing baby food, it is important to pay attention not only to the price and popularity of the product, but also to other characteristics - composition, expiration date. You also need to make sure that the mixture dissolves well: this largely determines how convenient it will be to give it to your baby.

When starting to supplement your baby with formula while breastfeeding, you should definitely consult with a pediatrician who will help you choose the most appropriate type of artificial nutrition.

Calculating the amount of supplementary feeding

When using formula, it is important to correctly calculate the amount of food so as not to overfeed the baby and not provoke a deterioration in lactation, leading to a premature end to breastfeeding. You can determine exactly how much formula your baby needs at a doctor's appointment.

To find out the required amount of supplementary feeding during breastfeeding yourself, you first need to calculate the amount of milk that the baby should eat per day. It is important to take into account the age of the baby. The simplest way to do this is considered to be the volumetric method. According to this formula, an infant eats a volume of food per day equal to 1/5-1/8 of body weight (see table).

So, at 3 months, a baby who weighs 5400 g should consume 900 ml of milk per day (5400:6=900).

The next step is to calculate the amount of food required per feeding. Here you should determine how many times a day the infant eats. A three-month-old baby is breastfed 6 times a day, which means that he normally eats 150 ml per feeding.

If you weigh a baby before and immediately after a meal, you can see how much milk the baby was able to suck. Based on this, it is calculated how many grams of formula should be given additionally to the child during the current feeding.

There are also others when breastfeeding. A popular method among young mothers is related to the results of the wet diaper test. If the child urinated only 8 times instead of the required 12 times, then the mixture he receives should be enough to “wet” the diapers 4 more times.

For infants up to 3 months, each act of emptying the bladder requires 30 ml of food, i.e., the missing daily volume of the formula in this case will be 120 ml. The norm for infants over 3 months increases to 40-60 ml per urination.

When making calculations, it should be taken into account that the total amount of artificial formula during mixed feeding should not exceed half the daily amount of nutrition.

How to properly introduce supplementary food

Taking into account the developmental characteristics of the infant, the rules of mixed feeding state that supplementary feeding must be introduced gradually so that the child’s body can adapt to unusual food. In the first days, you can give the baby a mixture in the amount of 1/3 of the total daily amount of artificial nutrition. If the baby does not experience constipation, diarrhea, allergies, bloating or colic, the administration of the mixture can be continued. In this case, it is imperative to attach the baby to the breast both before and after feeding with artificial nutrition.

There are 2 schemes that explain how to properly supplement a baby with formula while breastfeeding. According to the first, the total daily amount of the mixture should be divided into 5 parts and given to the baby at regular intervals from 6 to 24 hours. If we talk about the exact time, supplementary feeding should be given at 6, 10, 14, 18 and 22 hours. The second scheme involves supplementary feeding every time before falling asleep and after waking up. The amount of food is also divided into equal portions. There is no need to artificially feed your baby at night.

What to do to increase lactation

Even if a woman had to supplement her baby, she should do everything possible to maintain breastfeeding. To do this, you need to put your baby to your breast as often as possible, especially at night, eat foods, drink plenty of fluids and practice skin-to-skin contact.

When to introduce supplementary feeding while breastfeeding? Which babies need it vitally? How to feed formula correctly? What should you offer it to your child from? How much mixture is needed? And when should you stop? Let's consider the main issues related to the introduction of supplementary feeding during breastfeeding.

Supplementary feeding is the use of formula in feeding an infant up to six months of age. Its purpose is to provide the baby’s body with nutrients that, for various reasons, cannot be compensated for by mother’s milk. In natural feeding techniques, supplementary feeding is the exception to the rule rather than the norm. There are many prejudices associated with the need for its introduction.

When to introduce supplementary food

Often young mothers begin early introduction of supplementary feeding due to lack of confidence in their own abilities. Immediately after birth, when milk has not yet come in sufficient volume, it seems that there is simply nothing to feed the baby. The situation is aggravated by frequent baby crying, which is why an inexperienced mother concludes that the baby is hungry.

Fed from a bottle, the baby calms down and sleeps for a long time. Thus, an incorrect conclusion leaves an imprint on the entire period of breastfeeding. Mom thinks that she has very little milk or that it is “not filling” or “not fatty.” But you can “really” feed a child only with formula.

In fact, in the first days after childbirth there should not be a lot of milk. The child’s kidneys have not yet adapted to life in external conditions and cannot process large amounts of fluid. The mother's body knows this well, so it does not produce liquid milk, but thick colostrum in small quantities. And it is quite enough to compensate for all the food needs of the baby’s body in the first three days of his life.

Here are other situations that do not mean that the child needs supplemental feeding.

• The baby is restless at the chest, crying. This does not mean that the breast is “empty”, but rather that the baby is unsure of how to handle the breast. The mother’s task is to eliminate everything that may interfere with the baby’s ability to suck properly. The main pests of proper breastfeeding are nipples and pacifiers. They develop an incorrect ability to grasp the nipple, as a result of which the child cannot extract anything from it and injures the delicate skin. Calm behavior at the breast is eliminated by rare attachments, because of which the baby is nervous and too upset to properly latch onto the nipple. Crying can also be caused by a short frenulum in the baby’s mouth, which does not allow him to grasp the breast correctly.
• The baby latches on too often. The normal frequency of breastfeeding after childbirth can reach forty times a day. Over time, it decreases to twelve to fifteen times, but can increase if the baby is upset or sick. What seems too frequent to you is a physiological need of the child’s body, not only for food, but also for maternal warmth and affection.
• Too little milk is expressed. The amount of milk expressed does not mean anything. If you are exclusively breastfeeding, there is no need to pump.

In accordance with WHO recommendations, the introduction of supplementary feeding and water supplementation is not justified for breastfed children up to six months of age. It is necessary to use formula for supplementary feeding of children only for medical reasons.

The need to introduce formula feeding during breastfeeding exists in the following situations.

• Premature baby. These babies are too weak to breastfeed productively. Supplemental feeding with the mixture helps the body get stronger faster.
• A child with neurological disorders. Babies cannot coordinate their actions to suckle properly. As a rule, such diseases are diagnosed in the maternity hospital, so the mother is sent home with clear recommendations for supplementary formula feeding.
• Lack of milk in mother. The phenomenon of hypolactation in women is rare and temporary. It is caused by mistakes in organizing breastfeeding, when it was started too late due to the separation of mother and baby. Or they practice rare breastfeeding “according to a schedule.” Frequent feeding of the baby to the breast will help normalize lactation, since the volume of milk production is affected solely by its consumption.

In most cases, formula supplementation during breastfeeding is required temporarily. The mother’s task in this situation is not to completely transfer the child to artificial nutrition, but to maintain lactation. Frequent communication with the baby, sleeping together, and tactile skin-to-skin contact will help with this. And of course, the baby’s unlimited access to the breast, which allows milk production to reach the required level within a week.

What to feed from

When the need to introduce supplementary feeding is established and recommended by a pediatrician, another question arises: how to do this. The simplest solution seems to be to use a “classic” baby bottle with a nipple. But in practice, such a simple solution puts an end to breastfeeding.

The fact is that the technique of sucking a breast and a bottle is completely different, despite the assurances of manufacturers of children's accessories about the ideal anatomical shape of the nipple. Until now, nipples that completely replicate the mother’s breast do not exist. And a child who receives both has to make a choice at some point.

What is the difference between breast sucking and pacifier sucking? Absolutely everyone!

• Grip depth. Correct attachment to the breast requires grasping the entire nipple, including the areola. There is no need to swallow the pacifier so deeply.
• Work of gums and tongue. While sucking at the breast, the baby helps himself with his tongue, while he chews the pacifier with his gums.
• Application of effort. The mixture flows freely from the nipple, while milk must be “extracted” from the breast.

It is much easier to suck on a bottle with a nipple than on the breast. This causes a complete refusal of breastfeeding or provokes improper attachment to the breast. The mixture completely replaces mother's milk, the benefits of which for the child are many times higher than artificial nutrition.

Using other feeding devices rather than a bottle will help prevent your baby from refusing to breastfeed.

Spoon

You can use a regular teaspoon, but a soft silicone one is better. It should be filled halfway and its contents poured into the baby's open mouth by the cheek. You cannot pour it on the root of the tongue, as the baby will spit out the mixture. Before serving the next portion, make sure that the baby has swallowed the previous one.

It is convenient to use special baby spoons for supplementary feeding with a bottle. These are produced by Medela. The mixture is poured into a bottle, and during feeding you can control the intensity of its delivery into the spoon.

Syringe, pipette

The principle of operation is the same. Take a small amount of the mixture and pour it into the baby’s cheek. You can help him open his mouth slightly by inserting a clean little finger behind his cheek. Use a dropper with a rounded tip or a syringe without a sharp tip (for example, a children's antipyretic syrup dispenser).

Cup

A regular cup will be too big for supplementary feeding. Use a sterilized doll, small cap, plastic beaker. It is important that the cup is made of safe material.

Tilt it towards your baby's lower lip and moisten it with the mixture. Wait until the baby begins to make movements with the sponge and tongue. Re-wet the sponge with a small portion of the mixture. Cup feeding, according to mothers, is one of the simplest and most convenient ways to supplement breastfeeding during breastfeeding.

SNS system

Or a supplementary feeding system. It is a soft silicone bottle designed to be filled with a mixture, with a thin tube. The bottle is placed around the mother's neck, and the tube is fixed to the skin of the nipple. The baby, when attached to the breast, grabs both the nipple and the tube. Thus, he eats milk and formula at the same time.

The prevalence of SNS systems in our country is low, although, according to foreign pediatricians, they are the ideal solution for introducing supplementary feeding. They maintain close contact between the baby and the mother, support lactation and provide formula feeding in the required volume.

Regardless of how you offer supplementation while breastfeeding, follow these guidelines.

• Breasts before and after. Your baby's main food remains your milk. It is many times more valuable and healthier than the most expensive mixture. Therefore, offer the breast before and after formula.
• Don't insist. Do not force your child to eat all of the formula. Let him determine how full he is. If the baby stops opening his mouth or starts to turn away, stop.
• Do not increase the portion. If something was spilled during feeding, there is no need to add this amount of mixture to either the current or the next supplementary feeding.
• Feed only a calm baby. If a child cries, shows dissatisfaction, or spins around, first calm him down. Try feeding in a different position or using a different device.

Neither a spoon nor a cup allows the child to compensate for the sucking reflex. Therefore, frequent breastfeeding will solve two important issues. The baby will be able to fulfill the need for sucking. And the mother will receive additional stimulation of the mammary glands, as the main factor in increasing lactation. And after a while you can completely abandon supplementary feeding.

Mixture volume

The introduction of supplementary feeding involves the use of a certain amount of formula for feeding the baby in order to prevent weight gain. Previously, mothers were offered clear standards. For example, at 2 months supplementary feeding during breastfeeding should be 60 grams per day, at 3 months 90 grams, at 6 months - 240 grams. However, the formula volume table does not reflect the baby’s real needs for a number of reasons.

The main one is that it does not take into account the amount of milk that the mother has. A standardized approach encourages a complete transition to artificial feeding. Breastfeeding specialists from the La Leche League and AKEV associations insist on a completely different approach. He is supported by American and European pediatricians.

How to determine how much formula your baby needs? Follow the following tactics.

• Count the number of times your child urinates per day. Normally, it should be 12 times the baby’s monthly age and older. This means that the child receives a sufficient amount of food. Check this amount before introducing supplementary feeding; you may not need it. To test for “wet diapers” for a day, remove the disposable diaper from the baby and count how many times he peed during the day.
• Compensate for any insufficient urination with a mixture based on the child’s age. If at the age of three months the baby pees 10 times a day, you need to add 60 ml of the mixture to his diet. If the baby is four months old and pees 8 times a day, the volume of complementary foods should be 160 ml per day.
  • 3 months - 30 grams;
  • 4 months - 40 grams;
  • 5 months - 50 grams;
  • 6 months - 60 grams.
• Take emergency measures to stimulate lactation. Apply to the breast as often as possible, exclude any substitutes (pacifiers, pacifiers), and be sure to feed at night, especially between three and eight o'clock in the morning.
• Reduce the amount of mixture when urination is sufficient. Do the next wet diaper test after a few days. If there are more than twelve urinations, the amount of mixture can be reduced.

The child should be offered supplementary feeding according to the schedule.

• By the hour. Divide the total volume of the mixture into 5 parts. Feed the baby by the hour, at equal intervals from six in the morning to twenty-four hours. That is, supplementary feeding will be present in the first morning six-hour feeding, then at 10, 14, 18 and 22 hours. Do not supplement with formula at night.
• Around dreams. The total volume of the mixture is divided into equal portions, which are offered to the child before falling asleep and after waking up. In this case, the mother should control that the baby receives all the amount of formula he needs per day.

If there is a sufficient level of urination per day, there is no need for additional feeding, even if the child is not gaining weight. In addition, before introducing the mixture, it is important to eliminate all negative factors that inhibit lactation: normalize the frequency of latches, monitor the correct latch on the breast, give up pacifiers, and spend as much time as possible with the baby in your arms.

The question of how to introduce formula during breastfeeding should not be resolved solely by the use of supplementary feeding. As a rule, it indicates that there are problems and errors in breastfeeding that require correction. Eliminating them will make the use of the mixture a temporary measure. It is possible to recommend maintaining supplementary feeding until the age of six months only for medical reasons, if the baby has diseases that preclude the possibility of full breastfeeding.

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Supplementing a child with formula is not a way to “make life easier” for the mother, but a necessary measure, since it rarely goes without consequences for her and the child. The minimum that can happen is a decrease in lactation and intestinal colic in the baby.

Supplemental feeding of a newborn with formula is introduced only after assessing the following criteria.

1. Weight gain. Weight loss after childbirth should not be more than 10% of birth weight. Children gain at least 500 grams monthly in the first 3-4 months of life.

2. The child’s behavior between feedings. A fed baby is calm, except when his tummy hurts. Doesn't ask for the breast every 1-2 hours.

3. Frequency of urination and stool. A healthy child on breastfeeding urinates at least 10 times a day, more often about 20 times. At the same time, babies usually have very frequent bowel movements, up to 7 times a day. But a normal number of urinations and rare bowel movements do not mean that the child is not eating enough.

4. Real shortage of milk. You can weigh your baby before and after feeding to see how much he is sucking. Information received within at least 24 hours should be considered relevant, that is, the total amount of nutrition the child received per day is important.

Refer to the following standards.
- 1/5 in grams of the actual weight at the age of up to 1 month should be eaten by a child;
- 1/6-1/7 - from 2 to 6 months, before the introduction of complementary foods.
For example, a child weighing 4 kg needs 800 grams of milk per day. When feeding on demand, that is, quite often, about 10 times a day, the child can eat a little. But in the end, he will still eat approximately this amount in a day and night.

If there are no problems with this, but you still feel like your baby is hungry in the evening, try supplementing with expressed milk. It is known that a woman produces the greatest amount of milk in the morning. Then you can express a little to give to your baby in the evening, when lactation subsides a little. This is a temporary measure to avoid introducing supplementary feeding with artificial formulas.

But these signs are not a consequence of insufficient lactation:

• baby crying during feeding with legs tucked to the stomach (this is a symptom of intestinal colic; children may also often begin to suck and release the breast, screaming);
• “empty” breast (if the baby is sucking and you hear him swallowing milk, after the start of sucking there is a rush of milk - everything is fine), after the so-called establishment of lactation, the woman has almost no milk in the glands between feedings, all of it is concentrated in alveoli;
• an increase of 500-600 grams in the first three months (you should not take as an example children who gain 2 kg per month, usually these are children who suckle almost all the time; those who eat on a schedule or sleep often usually gain less , it's not scary);
• poor night sleep (children sleep poorly not only because of hunger, but also because the climate at home is too hot, low humidity, increased gas production, an uncomfortable crib, painful teething, etc.);
• small amount of expressed milk - even very “milky” women cannot always express a sufficient amount of milk.

We repeat that supplementary feeding of a newborn in the maternity hospital and after discharge from it is a necessary measure. Lactase deficiency in the baby, intestinal infection in the mother, or lactostasis are not indications for this. Once every 3-6 months, mothers experience lactation crises. This is when the baby begins to require more milk, but the breasts cannot immediately begin to produce more. This time must be endured. Feed more often and everything will get better within a week. Supplementary feeding during breastfeeding is not introduced in this case. It is possible that feeding not one, but both mammary glands will help. When a woman gives one breast until it is completely empty, and then the other.

Rules for introducing supplementary feeding

1. First let the baby breastfeed, and only then offer supplementary feeding.

2. Give the child the mixture from a spoon in a small amount. For this purpose, you can use either a regular teaspoon or a special silicone or plastic one. The soft drinking spoon for supplementary feeding (Medela) has good reviews. This device does not lead to breast refusal in the future and is very convenient to use. True, it's not cheap. Another good option is supplementary feeding from a syringe without a needle. The measuring syringe that comes with some medications is ideal for this. For example, with the children's antipyretic syrup "Nurofen". The breastfeeding system is very popular now. This is an ideal option for women who dream of maintaining and increasing lactation, without starving the child. This is such a simple device with which the baby sucks formula and at the same time sucks on the mother's breast. And, as we remember, the more the baby suckles, the more milk is produced. Medela's SNS supplementary feeding system, the most famous, is sold in pharmacies. As they say, the wolves are fed and the sheep are safe.

3. Breasts, even with a small amount of milk, must be given at least 3 times a day, otherwise lactation will very quickly disappear.

4. If possible, give the baby the breast at night, and not formula, since the hormone prolactin is produced at night. He is responsible for breastfeeding.

5. The first supplementary feeding should be carried out with a very small amount of the mixture, no more than 10-30 grams. The child's body must get used to the new diet. If there is no gradualness, the baby will experience constipation and colic. Your pediatrician will explain how to supplement your baby with formula.

What happens if, instead of formula, the child is given cow's or goat's milk, as they were fed before? Or introduce complementary foods earlier? This, of course, is not worth doing. Whole animal milk is the strongest allergen. It should not be given to children under one year of age! But supplementary feeding with formula at 6 months can be replaced with complementary foods. For example, give porridge or vegetable puree at one of the feedings. Or perhaps even both, if complementary foods were introduced earlier, at 4 or 5 months. Supplementing your baby with cereal is recommended if the child is not gaining weight well. Usually they first give dairy-free porridges, and then, after 2-3 months, they begin to offer dairy ones. Everything is just from a spoon.
You need to understand the difference between complementary feeding and complementary feeding. Cereal porridge (buckwheat, rice, corn) is the second. And children are fed only with liquid artificial nutrition. Formula or breast milk must be present in the child’s diet until one year of age.

Which mixture to choose for supplementary feeding and why you need to preserve breastfeeding

The choice of mixture should be approached responsibly. Among the huge assortment of this product on the market, making the right choice is quite difficult. We will present the main criteria for choosing this product.

1. Composition of the mixture. It should contain the vitamins and microelements necessary for the baby in the correct proportions. This will make the food as close as possible to mother's milk.

2. Availability of a quality certificate, well-known manufacturer and brand.

4. Normal shelf life and guarantee of compliance with storage rules(you shouldn’t buy the mixture secondhand, even if the price is very attractive).

Based on their consistency, all mixtures can be divided into dry and liquid. Dry mixtures occupy more than 90% of the market for these products. Sold in powder form in sealed packaging. Before feeding, the powder is diluted with boiled water at a temperature of 37-38 degrees according to the instructions.

Liquid mixtures are sold ready-made. Immediately before use, they only need to be warmed up. The main disadvantage of liquid nutrition is its short shelf life.

According to the composition of the mixture, there are adapted, partially adapted and non-adapted.
Adapted ones are made on the basis of demineralized whey. They are perfectly digestible by babies, and therefore are considered the best option for feeding newborns. Supplementary feeding per month is carried out with just such mixtures.

In less adapted mixtures, the main component is casein, and demineralized whey is absent. This food is recommended for children over 6 months. The so-called two.

There are special formulas for premature babies and children with weakened immune systems. They are rich in protein and vitamins that the baby needs for proper growth and development. Promotes rapid weight gain.

For children suffering from iron deficiency, formulas with a high content of this particular trace element are sold. Not recommended for children under 4 months.

For intestinal problems, choose mixtures with probiotics. They reduce the risk of colic, constipation and regurgitation in the baby. For babies who suffer from frequent regurgitation, pediatricians recommend foods that contain thickeners in the form of starch.

For children prone to various types of allergies, hypoallergenic or lactose-free soy mixtures are suitable.

Supplemental feeding of a newborn with an incorrectly selected mixture can lead to intestinal upset and cause weight loss.

Considering that artificial nutrition is an expensive pleasure, you should not focus your choice only on advertising and cost.

But even if you managed to choose the formula well, remember that breast milk is the main and best food for a newborn baby. The main role of breastfeeding is an individual and balanced diet at any time. An important advantage of breast milk is that no equivalent analogue has yet been invented. Why is it necessary to leave GW in the maximum amount?

1. Beneficial effect on the intestinal microflora of infants.

2. Breast milk contains a large number of useful elements necessary for life and growth. Despite this, its digestibility reaches 90%.

3. The correct functioning of the tiny organism is facilitated by the presence of biologically active substances (enzymes, immunoglobulin, hormones, etc.) found in breast milk.

4. By observing basic hygiene rules, maximum sterility of feeding is achieved.

5. Mother's milk, available at any time, is at the ideal temperature for breastfeeding.

6. Each mother’s body individually adjusts the composition of milk to suit the baby’s needs, but on average it contains 88.1% water, 7% carbohydrates, 3.8% fat, 0.9% protein and 0.2% other substances.

7. The main component of milk is water, which allows you to avoid feeding the baby additionally.

8. The amount of protein is sufficient for ideal development and growth rate.

9. Lactose contained in the composition helps the absorption of iron and calcium and affects the development of the central nervous system.

Breast milk contains a large number of microelements that contribute to the normal functioning of the gastrointestinal tract, organ development, optimal growth, and protection from infections.

Maternal instinct is one of the basic female instincts. Every mother feels constant excitement and concern for her child, worrying about whether the baby is cold or whether he is fed? What if he doesn't get enough breast milk?

Most often, her fears are unfounded, but sometimes the baby really feels hungry and lacks breast milk. In such cases, supplementary feeding is required during breastfeeding.

Supplementary feeding and complementary feeding - what is the difference?

Often mothers confuse two concepts - supplementary feeding and complementary feeding. Let's figure out what they mean and how to distinguish them.

Supplementary feeding during breastfeeding means the introduction of special adapted milk formulas into the baby’s diet when there are objective reasons for this: mother’s illness, unsteady lactation, the need for an urgent trip due to separation from the baby, etc.

Complementary feeding is a gradual transition of a child to “adult” food, enriching his diet with new food products.

In what cases is supplementary feeding required during breastfeeding?

1. The mother does not have enough milk, the baby does not get enough to eat.
   This statement must have a basis: the child’s behavior, his weight. If at an appointment with the pediatrician he notices that the baby is not gaining enough weight, he will advise supplementary feeding.
   Statistics show that only five percent of breastfeeding mothers actually have insufficient milk.


2. Mother's illness.
   Maternal health situations may require a pause in breastfeeding, replacing breast milk with formula for a while. This is usually required by potent medications that are incompatible with breastfeeding.


3. Mother's urgent return to work.
   Feeding during working hours is difficult to organize, so mixed feeding is used as an alternative, alternating breast milk with an adapted formula.


4. Child's refusal to breastfeed.
   Sometimes a child, for no apparent reason, refuses his mother’s breast; it is necessary to transfer him to feeding with artificial formulas.


5. Other cases.
   Mother and child have Rh conflict; in case of multiple pregnancy, the born babies do not have enough milk; difficulties resulting from childbirth, resulting in a general weakening of the mother’s body.

Breastfeeding mothers for whom supplementary feeding is an urgent problem need to know some rules:

• A child up to three months of age should receive supplementary feeding in the form of artificial formula mixtures and breast milk.
• For a child up to six months, an adapted milk formula is selected that is as similar in composition to breast milk as possible.
• For allergic reactions to lactose, mixtures with a soy base are used, and for babies who have digestive problems, mixtures containing probiotics are used.
• A trial period is carried out for at least three days, after which a conclusion can be made whether this mixture is suitable for the baby or not.

What should you consider when choosing supplementary feeding during breastfeeding?

• Dry powder mixtures have a longer shelf life.
• The mixture should include carnitine, taurine, whey, and unsaturated omega fats.
• It is unacceptable to include palm oil in baby food, as it reduces the absorption of calcium by the child's body.
• The probiotics contained in its composition can help the mixture be more easily absorbed.
• Lutein in the mixture has a good effect on vision.
• Nucleids, also contained in the mixture, develop the child’s immune system.

Before purchasing any formula, check with other mothers who use formula to see if they are happy with the brand they choose. This way you can exclude a truly low-quality product.

The formula for feeding a child should be as close in composition to breast milk as possible, this is especially necessary until the baby is six months old. It is important, with the help of a pediatrician, to choose a formula that is suitable for your baby so that it does not cause digestive difficulties or allergic manifestations.

How to supplement your baby to maintain breastfeeding?

If you disrupt the feeding regime by introducing the formula incorrectly, then with a high probability the child will refuse the breast. In this regard, if you are determined to breastfeed for a long time, follow the conditions below:

• Supplement your baby with a spoon, as drinking formula from a bottle does not require as much effort as when suckling at the breast.
• If you are unable to feed your baby, express at a certain time. It is convenient to use a breast pump for this.
• Even if you think that there is no milk in the breast, still give the baby the breast and then supplement it.
• Frequent breastfeeding will help increase lactation.
• Proper nutrition is very important for good milk production. You can take special lactation teas purchased at the pharmacy.
• A young mother needs not to worry unnecessarily and believe that she will certainly be able to feed her baby with her milk.

What are the norms for supplementary feeding during breastfeeding?

The pediatrician can tell you the amount of formula your child needs. Usually, up to 2 months, the volume of the formula drunk should be one fifth of its weight - from 700 to 900 g. From two to 4 months - one sixth of the child’s weight. From 4 to six months - one seventh, from six months to one year - one eighth or one ninth of the baby’s body weight.

Is additional soldering required?

Experts believe that if a child is fed both mother’s milk and an adapted formula, then he does not require additional feeding. The exception is hot summer days or the baby is sick, then you can supplement the baby with boiled or special children's drinking water.