Effects of Supplementing

Posted by  | Wednesday, February 3, 2010  at 12:00 AM  
I thought this research was interesting and wondered if anyone might enjoy reading it as well. It pertains to the effects of supplementing in the hospital with bottles of water, glucose water, artificial baby milk, or adding supplements to the mother's milk. Some of the reasons for this include the following:

• to give the mother a rest
• because the mother doesn't have her milk 'in' yet
• to prevent hypoglycemia
• to prevent or reduce jaundice

None of these are indications for giving supplements, with some having the opposite effect to the desired result. Yet a 2005 study found that close to half of infants received artificial baby milk in the hospital!

Here are some of the effects on breastfeeding (and these effects were noted even if the baby received only one supplement!):

• Supplemented babies are significantly less likely to be exclusively or fully breastfed after hospital discharge.
• The risk for shortened duration of breastfeeding is increased 4-fold when supplements were given in hospital, even when the supplement used is predominantly donor breastmilk.
• Exclusively breastfed newborns are fed more frequently then breastfed-plus-supplemented infants. 93% of moms remember which brand of artificial baby milk was used in hospital and most will use that brand. Parents may interpret the use of artificial baby milk as an endorsement by hospital staff, despite clear verbal messages promoting breastfeeding.

So. . . if you hope to succeed in breastfeeding, do everything you can to make sure your baby rooms-in with you and doesn't receive any supplementation. . . both in the hospital and after you go home!


Erin said...

My baby did not room in with me,but I made a sign that said, "Breastfed Baby, Please don't give a bottle or pacifier" to post on her bed. I had the nurses bring her to me whenever she woke to nurse. I am so thankful that the nurses did not even ask me about giving her a supplement, even though my milk hadn't come in. They also didn't even ask me to pump. Pumping early on can mess up the natural supply that your baby will demand.

My pediatrician did ask me to supplement with formula (and gave me a bunch of samples) when she was a few days old b/c my milk still hadn't come in yet. (I had colostrum but not milk--it came in 5 days after she was born). I was so determined that she catch on to the breastfeeding thing and that my milk would come in. I only gave her one ounce (and not all at the same time) of the formula in a Breastflow (made by The First Years) bottle. This type of bottle is supposed to mimic the flow of the mother's breast. I continued to breastfeed frequently to get the milk to come in.

I actually ended up changing pediatricians. There were other reasons as well, but one reason was the fact that she pushed the formula on me.

I was really surprised that my sister's nurses had her pump and encouraged supplementing IN THE HOSPITAL! They did not even give her TIME to let the milk come in! My sister persevered and has been nursing for almost 6 months, but she ended up with several very painful breast infections and had to take all kinds of meds to breastfeed.

I really encourage everyone to read up on breastfeeding (The Nursing Mother's Companion, La Leche League website, Kelly Mom website, Prayer of Hannah) and BE INFORMED before you enter the hospital! I also encourage everyone to SEEK OUT the lactation consultants! I had a wonderful friend who helped me!

Tamara said...

krista--the information that you are sharing this week is amazing--thank you so much! i've nursed both of my bio kiddos (had planned to nurse our adopted child but she came to us at 2 1/2 years of age rather than as an infant) and plan to nurse our next little one who is due to arrive in august. even as as seasoned mama of 3 who has had two positive nursing experiences, i'm STILL learning a TON this week from your breastfeeding posts!

Amy said...

Excellent post.

Jason and Pamela said...

Recently found this blog and love it. Although my daughter is 2 now I was determined to breastfeed her only as long as I could. She weighed 9 lbs. 5 oz. at birth and while in the hospital dropped to 8 lbs. 8 oz by the day we left. I was pressured from the nurses to supplement, but strongly refused. Thankfully I did because she nursed great for a little over a year! Glad I stuck to my guns on this one!

Karen said...

My daughter's pediatrician asked me to supplement every time he saw her in the hospital (four times) and had the nurses encourage me to supplement, too. She was tiny but a great nurser, so there was no need. I read lots of stuff before having her and am a nurse myself, but I still gave into the pressure to supplement her. I don't think it was a bad thing, but it definitely wasn't a necessary thing. I can see how if I wasn't set on breastfeeding that giving her that bit of formula would have given me the knowledge that she would take it okay and then I could have given up on breastfeeding quickly. I don't really like the term of artificial baby milk. You make formula seem like the worst thing possible. I appreciate that you are in support of breastfeeding, as am I, but sometimes the terms used really can rub people wrong. Especially those who had their hearts set on breastfeeding and for some reason couldn't.

Becky said...

I'm so glad breastfeeding is this weeks topic! I've been breastfeeding my son now for over 8 months (he is my first child.) I wanted to give a bit of a different perspective on this....When Declan was born he had to go directly into the NICU because of breathing problems and I had to have an emergency C-section so I didn't even get to really see him until the next day. Needless to say, we weren't able to start breastfeeding right away because of his needing to be hooked up to all those tubes and me needing to recover. I had to pump in the hospital to get my milk to come in and Dec was on IVs so getting him to be interested in breastfeeding once he was off all the breathing masks was about impossible. He recovered quickly but to be able to take him home, he had to be eating. We still weren't latching and I agonized over the decision but I decided I'd rather have him home than hold out for breastfeeding in the hospital, so he had formula. As soon as he was out of the NICU we started the breastfeeding push and after lots of struggles with weight loss and multiple trips to the lactation consultant, we got on the weightgain wagon and were in the clear. At the same time, I was struggling with pp depression and felt like all I did ALL DAY was sit in a chair and try to breastfeed. Once I let myself have a bit of a break and was told by my dr and lactation consultant that a bottle once in a while wasn't going to kill him our breastfeeding actually got better. I think I just relaxed and didn't feel so much pressure. I am a full time teacher and can only pump twice a day so I don't make enough for my son to be exclusively breastfed (and I selfishly don't wake up at night to pump or any of that kind of stuff that I know some women do.) We supplement with (cringe) regular formula. My son doesn't have a weight problem (he's in the 34th percentile), and he's only had two colds in his 8 months. I encourage moms-to-be to not make it so hard for yourself that you quit and to be flexible with your path to breastfeeding- because as we all know, rarely does anything about birth and babies go exactly as we planned. Some breastmilk is always better than none and sometimes I feel lactation consultants don't take your real life situation into account. I also remind them that women are horrible judgers of each other- you'll be judged for if you had a natural birth or an epidural, if you breastfed or didn't, if you cloth diaper or don't....and the list goes on. Healthy babies can come from many different beginnings and mom's sanity (and not her quest for perfection) go a long way to that. I consider the women on Prayer of Hannah as role models of good, dedicated mothering- I am not there in many ways but we are doing well with that we can do. I appreciate the chance to give my perspective. Thanks for all the great, and very helpful discussions each week!
Becky (used to work with some of you at FA)

The Hudgins said...

great information this week...but agree with Karen; "artificial baby milk" is a bit extreme. i've had both experiences..unable to BF my first and then a great experience with my 2nd. I think the content of this weeks postings are great; but a bit abrasive.

mzyelle said...

I had a homebirth with my daughter and planned to breastfeed for a year at least. My mother in law had breastfed my husband (part-time) for the first 2 years of his life. I was determined. After 2 weeks of my daughter's life, she had lost 1.2 lbs. She weighed 7.6 at birth and weighed 6.4 at the doctor's office. I was a wreck! I was starting to get depressed sitting in a chair for up to 10 hours a day nursing. She would nurse for about 45 minutes to 1.5 hours and then I would try to pump for 20 after that. Somewhere in there I was supposed to eat, shower, and "sleep when she sleeps".
I was desperate. Her doctor suggested supplementing and internally I cringed. In the car on the way home, I exhaled to see my baby eat heartily and rest. I didn't want to supplement, but I thought I might never survive if I didn't. I didn't have much support locally---our families live far away. Luckily, we are involved in a wonderful church now and I know I will have female support with our next baby.
I continued to breasfeed until 4.5 months with supplementation. She began to fuss tremendously when the breast was introduced at mealtime. I felt like a failure especially when I would visit the midwives. (this is where that guilt set in.) Eventually, my milk dried up and she has been on formula for 3 months now.
Of course I wish I had had the energy to pump, make oatmeal, rest, look in the mirror and encourage myself, and not deal with PP depression. Next time, I am going to persevere and feed my baby from my breast. I will keep trying.
I am determined to not feel guilty for not being the perfect breast feeding mother. I will give myselft more time, allow my family to help with chores, and concentrate on feeding my baby from the breast. I am relieved that my daughter has never been sick this winter and is in the 75% for weight and 97% for heigth.
***Question here*** When I have another baby (which is 8 months away PTL), is it okay to pump a little for my toddler to have since she didn't get to breastfeed long? Only if there is an excess. Please advise.

Thank you POH! Your blog is a real blessing in my life. My husband knows just who I am talking about when I say "you know, thos Prayer of Hannah ladies...."
: )

Erin said...

I encourage women to seek out other breastfeeding "buddies." My husband's family was the only family around when I had my baby, and none of them breastfed. Thankfully, God provided some great mom friends who breastfed their babies. One was also a teacher like me, and we would even text message each other while we pumped at work!

I think some women do try and have different life circumstances that prevent them from breastfeeding. (medical conditions, life trials, work). I think we need to be supportive either way. I think I have the biggest problem with women who won't even try because they don't want to cover up or be prevented from going out (don't want a cramp in their lifestyle). At least give it a try!

Margaret, Ben, Meredith and Jonathan said...

Just a quick couple of thoughts...

Breastfeeding is a sacrifice. I do feel like a "milk-machine" during the first month or two. But, it really does get easier! The baby will get faster at nursing and they can go longer and longer stretches between feedings. But, that is why the newborn days are so tough! You don't get much sleep and you pretty much need to feed the baby every time they cry to ensure a good supply. That is just the way it is. But, think of how great that time is...it is a precious time of bonding with your newborn and being able to provide something for them that no one else can.

Secondly, I never paid much attention to growth charts at the pediatrician or what percentile my children have been in (in fact, I never knew and still don't now). I just made sure they were growing into the next size of clothing in a reasonable ammount of time and left it at that. Some children are smaller than others, especially breastfed ones and I think pediatricians put too much emphasis on charts, leading many moms to feel like they have to supplement when they don't.

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