*Just as with any article you see online, this is not medical advice specifically for you! This is for general information ONLY. It is important to work with your own doctor and IBCLC when assessing your baby’s intake.*
The myths surrounding breastmilk supply and supplementation keep spreading among social media, scaring women along the way and creating even more confusion around this topic. Here are a few of the most common ones I see…and what the facts actually are.
Just to start with, it’s very important to remember that as an IBCLC, the most important thing I ever learned was that the first rule of infant feeding is, “FEED THE BABY”! If a doctor, midwife, IBCLC, nurse or other health care professional is not supplementing a baby when it is needed then find someone else to help you, who knows what they’re talking about. Having said that, it is also important that we are not telling women to supplement if it’s not necessary! For a woman who wants to exclusively breastfeed, having them “top up” with a bottle, asked to pump or put pressure on them that they are, “Not making enough” can be incredibly disheartening and challenging for everyone involved in feeding the baby. So underfeeding AND overfeeding BOTH need to be avoided. Working with a few different health care professionals if there is a problem or you have questions is so important.
1. Myth: If your baby is breastfeeding more frequently than every 2 hours or longer than 30 minutes your baby definitely needs to be supplemented. FALSE…
so what are the facts?
If your baby is breastfeeding for a LONG TIME (over 45 minutes) at EVERY FEED or breastfeeding on and off the breast while ALSO BEING UNSETTLED after each feed is a baby that most likely WILL need to be supplemented. There are also babies who can become lethargic or sleep A LOT and be very hard to wake and feed. Look at your baby! The time is actually irrelevant as you’ll know something is wrong just by paying attention to your baby. On the other side of the coin, if your baby takes 40 minutes to feed, asks for another feed in 70 minutes and is very settled and content (and of course showing no signs of dehydration) then there is no problem here! Stop looking at the clock, you don’t need a log of times…look at your baby. Then head here for the checklist on how to know your baby is getting enough. Make sure your health care providers look at the whole picture when assessing.
2. Myth: If your baby loses 7% then supplementation is definitely needed. FALSE
…so what are the facts?
Your baby could lose 4% of their birth weight and show signs that they are not getting enough, or your baby could lose 10% of their birth weight and show all signs that they are actually getting more than enough! The number on the chart is ONE piece to the puzzle. Make sure your provider is looking at the whole picture, not just the chart. Again, it’s not rocket science here and it’s not just about the percentile on the chart. LOOK AT THE BABY. Here is an excellent article written by Dr. Jen Thomas, a pediatrician in the USA who discusses why the 10% loss might not mean automatic supplementing is necessary. If your health care provider is just looking at the chart and not your baby or other signs for overall wellness and intake, then find another provider!
3. Myth: If your baby is jaundice they definitely need to be supplemented. FALSE
…so what are the facts?
Aprox 60% of full term babies develop jaundice within several days of birth. Jaundice occurs as a result of bilirubin building up in your baby’s bloodstream faster than they can break it down and poop it out. This is prevented by breastfeeding frequently and increasing their milk intake so your baby can flush it out of their system efficiently and effectively.
Breastmilk jaundice in much less common and only occurs in about 1 in 200 babies. Regardless of whether it not it is treated it rarely causes any problems. The AAP, “recommends against routine supplementation of non dehydrated breastfed infants with water or dextrose water.”
So what does this mean? Jaundice is normal and not cause for concern IF YOUR BABY IS GETTING ENOUGH MILK and their billirubin levels do not get too high! Just having jaundice is not in of itself a reason to automatically supplement. I will be forever grateful to my doctor who helped me when my middle boy was born. He was just 36 weeks, very sleepy and jaundice. He had a few heel pricks over that first week to test his levels and thankfully my doctor knew about jaundice and whether or not he needed to be supplemented…which he didn’t!
4. Myth: If your baby is cluster feeding then you definitely need to supplement. FALSE.
…so what are the facts?
There is a big difference between normal cluster feeding and a baby who is breastfeeding constantly without becoming satisfied. It is very normal for a baby to cluster feed (feed frequently) in the later afternoon to evening hours. It is also a common time for cluster feeding in the early morning hours leading up to sunrise. When is it NOT normal? When your baby is on the breast for up to or over an hour at every feed without being satisfied after. This is a little summary of what I cover in detail HERE.
Know the facts so you can make informed decisions regarding your baby’s first weeks of life. Statistically speaking we know that MOST women will make enough milk for their babies, however some babies will not be able to effectively and efficiently remove enough of your milk which can cause low supply. There are also reasons that a mother might not be able to make enough because of something physically going on with her (some examples: PCOS, thyroid issues, hormonal reasons etc.) It’s important to figure out if the challenges are happening because of your ability to make enough, your babies ability to remove enough, or a combination of both! Always seek help from your doctor and IBCLC to help assess your baby’s intake if you are concerned.
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