Lynnette Hafken, MA, IBCLC
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Breastfeeding For Dessert
Breastfeeding For Dessert
When you are trying to increase your milk supply or get your baby to breastfeed more effectively, many people believe you must always breastfeed first, then offer a bottle afterwards if baby is still hungry. This usually works well, especially in the first week or two, but in some cases, it is counterproductive.
In situations where:
- the milk supply is low
- baby gets frustrated quickly
- baby falls asleep at the breast after a few minutes
- baby is not gaining weight
- you are working on relactation
the opposite approach often works better—give the bottle as the meal, then the breast for dessert. How much of the bottle you will give first is highly variable based on your baby’s behavior, and your milk supply; but in general, you want to give enough of the bottle to help the baby
- wake up and eat
- become less frustrated and more relaxed
- have the energy to eat until satisfied
- trust that their needs will be met immediately when hungry or thirsty.
When babies always get the bottle after the breast, they learn that comfort and satiety are experienced with the bottle, not the breast. They will either become frustrated and reject the breast, or will just hang out there waiting for the “real” meal that comes after. Either way, the mother’s milk supply will either drop from the baby not emptying her breasts well, or she must continue with the chore of pumping.
When we turn that around—satisfy the baby’s initial hunger and thirst first—they will often have more patience and enjoyment for breastfeeding, and they will experience that blissful milk-drunk feeling at the breast, not with the bottle.
This is a powerful way for mothers with extremely low supply (drops to a few ounces/day) to have a beautiful breastfeeding relationship with their baby that can last years, if desired.
As far as amounts to give in the bottle, this will vary a lot depending on your and your baby’s situation, so I can’t give specific recommendations about the amount to give in the bottle first. What I do recommend is that you get to know your milk supply, and assume that baby is getting what the pump can get,* if—and only if—your baby is actively swallowing at the breast. You should be hearing a swallow after every 1-2 sucks.
*You may have heard that the baby does a better job than a breast pump at removing the milk. This is (almost) always untrue, according to research on breast pumps (see below). It is especially untrue for babies that are sleepy at the breast or who just suck for comfort. The pump doesn’t get tired, bored, or overly relaxed!
HM = human milk, BPSP = breast pump suction pattern
If you’re typically pumping about 2 oz and your baby typically takes 4, try offering a 2–2.5 oz bottle, then finishing the feeding on the breast, using breast compressions to increase milk flow/breast emptying (videos here). If your baby is still hungry and you have to give another bottle, then at the next feeding, start with a 2.5–3 oz bottle.
Over time, you will figure out how much to give the baby first so they’ll want to finish the feeding at the breast and be totally satisfied afterwards. Often babies will need a smaller bottle in the morning (when milk supply is usually highest), and a bigger bottle in the evening.
What about pumping?
With this method, the baby is the pump! But it will depend on your overall goal—if is to maximize your supply, I would still recommend pumping when you can (please don’t give up sleep though!). If your goal is simply to enjoy breastfeeding your baby regardless of how much milk you’re producing, then go ahead and burn/recycle/compost your pump and go snuggle up with your baby!
If your overall goal is exclusive breastfeeding...
You will see over time if your milk production is increasing or staying stable. One sign it is increasing are the baby being willing to take smaller amounts by bottle (try this in the morning first); the other sign is that you are only needing to give your breastmilk, no formula, and your baby is still maintaining their growth percentile.
If you see these things, you can reduce the bottles by no more than 2 oz/day spread over all the bottles (so an average of 1/4 oz per bottle, if your baby eats 8x/day). If your baby was previously taking 16 ounces/day from the bottles and the rest from the breast, your total milk from bottles would reduce to 14 oz. Make sure to breastfeed your baby as often as they are willing to during this time, and get your baby's weight checked every week. You can repeat the decrease in 4-5 days, but if at any point your baby starts wanting another bottle after breastfeeding, you've likely hit a ceiling in your milk supply for this baby. (Remember this is general advice—every mother and baby are unique.)