Infrequently, as a breastfeeding supporter, educator, staff nurse or lactation consultant, you may need to feed the breastfed infant a supplement. What should you give and how should you give it?
The Academy of Breastfeeding Medicine (3) recommends expressed breast milk from the infant’s mother to be the first choice. If not available, donor human milk is the second choice. And if neither of the human milk choices is available, the use of a protein hydrolysate formula should be considered. Cow’s milk or soy artificial infant milks should only be chosen after examining the risks vs. benefit considering the family allergy history, available resources, family resources, infant age, and the impact formula use would have on breastfeeding. Water or glucose water are no longer advised.
When feeding the supplement, providers should consider the many choices other than a bottle: spoon, cup, syringe, drip method, finger-feeding, or others as suggested by Watson (1) or Walker (2). Should a bottle be the only choice, use of a slow-flow nipple and pacing the feed will allow the infant to feed only to satiety as well as stop to breathe comfortably throughout the feed.
Knowing the physiologic (4) size of the infant stomach will prevent overfeeding and stretching of the stomach itself. The amount of supplement used will depend on the age and gestation of the infant.
How does your facility choose a supplement for a breastfed infant? Are alternative feeding methods used when a supplement is needed? How much supplement is given? It is your responsibility to the families with whom you work to be informed and well-practised in the supplementation choices for the breastfed infant.
Kathy Parkes, MSN-Ed, RN, IBCLC, FILCA CHC
Professional Development Educator
1. Watson Genna, C. (2016). Selecting and using breastfeeding tools: Improving care and outcomes. Praeclarus Press. Amarillo, TX, USA.
2. Walker, M. (2016). Breastfeeding management for the clinician: Using the evidence, 4th edition. Jones and Bartlett. Burlington, MA, USA.
3. Kellams, A., Harrel, C., Omage, S., Gregory, C., Rosen-Carole, C., and the Academy of Breastfeeding Medicine. (2017). ABM Clinical Protocol #3: Supplementary Feeding in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeeding Med; 12(3). https://www.bfmed.org/protocols
4. Bergman, N.J. (2013). Neonatal stomach volume and physiology suggest feeding at 1-h intervals. Acta Paediatrica; 102:773-777.
When you visit the Site, we automatically collect certain information about your device, including information about your web browser, IP address, time zone, and some of the cookies that are installed on your device. Additionally, as you browse the Site, we collect information about the individual web pages or products that you view, what websites or search terms referred you to the Site, and information about how you interact with the Site. We refer to this automatically-collected information as Device Information."
We collect Device Information using the following technologies:
Additionally when you make a purchase or attempt to make a purchase through the Site, we collect certain information from you, including your name, billing address, shipping address, payment information (including credit card numbers), email address, and phone number. We refer to this information as "Order Information."
We use the Order Information that we collect generally to fulfill any orders placed through the Site (including processing your payment information, arranging for shipping, and providing you with invoices and/or order confirmations). Additionally, we use this Order Information to:
We use Student Access Information to provide accurate tracking to Users and Clients on completion and use of the courses, as well as for analysis on how to improve our services.
We use the Device Information that we collect to help us screen for potential risk and fraud (in particular, your IP address), and more generally to improve and optimize our Site (for example, by generating analytics about how our customers browse and interact with the Site, and to assess the success of our marketing and advertising campaigns).
We share your Personal Information with third parties to help us use your Personal Information, as described above. For example, with your employer who needs to verify your completion or progress of your studies. We also use Google Analytics to help us understand how our customers use the Site--you can read more about how Google uses your Personal Information here: https://www.google.com/intl/en/policies/privacy/. You can also opt-out of Google Analytics here: https://tools.google.com/dlpage/gaoptout.
Finally, we may also share your Personal Information to comply with applicable laws and regulations, to respond to a subpoena, search warrant or other lawful request for information we receive, or to otherwise protect our rights.
As described above, we use your Personal Information to provide you with targeted advertisements or marketing communications we believe may be of interest to you. For more information about how targeted advertising works, you can visit the Network Advertising Initiative's ("NAI") educational page at https://www.networkadvertising.org/understanding-online-advertising/how-does-it-work.
You can opt out of targeted advertising by:
Additionally, you can opt out of some of these services by visiting the Digital Advertising Alliance's opt-out portal at: http://optout.aboutads.info.
Please note that we do not alter our Site's data collection and use practices when we see a Do Not Track signal from your browser.
If you are a European resident, you have the right to access personal information we hold about you and to ask that your personal information be corrected, updated, or deleted. If you would like to exercise this right, please contact us through the contact information below.
Additionally, if you are a European resident we note that we are processing your information in order to fulfill contracts we might have with you (for example if you make an order through the Site), or otherwise to pursue our legitimate business interests listed above. Additionally, please note that your information will be transferred outside of Europe, including to Canada and the United States.
When you place an order through the Site, we will maintain your Order Information and Student Access Information for our records unless and until you ask us to delete this information. We are required to keep course completion records for at least 5 years in order to comply with certain accreditation requirements.
For more information about our privacy practices, if you have questions, or if you would like to make a complaint, please contact us by e-mail at email@example.com or by mail using the details provided below:
5890 Monkland Avenue, #16, Montreal, QC, H4A 1G2, Canada
Last Updated: September 2018