- You are not making enough milk and need to give your baby formula—see a lactation specialist.
- Your breastfed baby is not gaining well and that you should supplement—see a lactation specialist.
- Your breastfed baby has jaundice and you’re going to need to use formula to flush it out of his system*—see a lactation specialist.
- Your breastfed baby has reflux and needs thickened bottles—see a lactation specialist.
- You’ll need to go on medication that is not compatible with breastfeeding, so you’ll need to stop—see a lactation specialist.
- You have a medical condition that is not compatible with breastfeeding—see a lactation specialist.
- Your breasts are too small or too big to breastfeed, so you’ll need to use bottles—see a lactation specialist.
- Your nipples are flat or inverted, so you won’t be able to breastfeed—see a lactation specialist.
- Your baby is fussy because she is allergic to something in your milk—see a lactation specialist.
- Your baby is not getting enough calories or enough of a certain nutrient, so you need to give formula—see a lactation specialist.
Maybe this could be distilled down into a simple formula:
If a healthcare provider says [anything that suggests replacing breastfeeding with another feeding method]—see a lactation specialist.
Sometimes supplementation is warranted, but if your goal is to continue breastfeeding, your best bet is to talk to or visit an IBCLC to ensure, first, that supplementation is necessary, and, secondly, how to go about doing it in a way that preserves your breastfeeding relationships. A lactation professional can work with you to come up with a plan for supplementation that will help you or your baby reach optimal health while continuing to breastfeed.
Experts in lactation can also help determine if supplementation is necessary in the first place; sometimes it’s just a matter of looking at the big picture from a standpoint of what is normal for a breastfed baby to know that supplementation wouldn’t fix the problem at hand. IBCLCs can help figure out if a baby is transferring milk well, a milk supply is good, and if there are structural problems that might be contributing to low weight gain or other issues.
This is not to say that supplementation is never appropriate or that you should ignore your care provider’s advice to supplement entirely. I want to see babies well-fed and healthy; I also want to see parents with solid plans in place that look at the whole picture, without blaming breastfeeding or breastmilk for every problem.
The bottom line? Breastfeeding problems are not solved by switching to bottles, and if a healthcare provider suggests bottlefeeding instead of fixing your problem, it’s time to seek out the help of a specialist.
*The “cure” for jaundice is to flush bilirubin out, and expressed or donor breastmilk does the trick even better than formula. This is a case where formula supplementation may be needed, and an IBCLC can help you supplement while protecting and building your milk supply.
