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Q & A: The Transition to Formula

Frequently asked questions and answers for breastfeeding moms

The major health organizations — including the American Academy of Pediatrics (AAP), American Medical Association (AMA), the Academy of Nutrition and Dietetics (AND) and the World Health Organization (WHO) — agree that breast milk is the ideal form of nutrition for babies (especially during the first 6 months). However, it's every couple's choice to decide what's best for them and their babies. And commercially prepared formulas are designed and strictly regulated to provide the nutrients your baby needs.

Whether you've decided to formula feed your baby from the start, are supplementing your breast milk with formula, or are switching from breast milk to formula, you're bound to have questions. Here are answers to some common inquiries about formula feeding.

Q. I'm breastfeeding but also want to start giving my baby formula. Is this OK?

A. The AAP recommends exclusively breastfeeding (that is, giving the baby no other food, beverages, or formula) for the first 6 months. And many of the health benefits of breastfeeding come during the first 2 months from protective antibodies in breast milk that can help keep babies healthy.

Unless your child's doctor recommends it, avoid giving your baby formula and breast milk (this is called supplementing) at least until your milk supply has had a chance to develop and both you and your baby are used to the concept of breastfeeding. Most lactation professionals recommend that parents wait at least 1 month before offering pacifiers or artificial nipples of any kind to avoid nipple confusion. Early supplementing also can lead to a reduction in your milk supply.

If you are having a hard time pumping or need to go back to work, supplementing breast milk with formula may be the only option if you still want to continue breastfeeding. After all, some breast milk is better than none at all.

It's important to remember that your baby's health and happiness is, in large part, determined by what works for you as a family and is not solely based on recommendations. So if you need to supplement or even go to 100% formula, your baby will be fine and healthy, especially if it creates less stress for you.

Q. If I want to begin giving my breastfed baby formula how should I start?

A. Depending on how much formula you'd like to give your baby (whether it's one bottle a day, one bottle a week, or several bottles throughout the day), you can begin by eliminating the desired amount of breastfeeding or pumping sessions. Of course, as you eliminate feedings, your milk supply will decrease and your body will begin to adapt to produce enough milk to accommodate your new feeding schedule. To reduce uncomfortable engorgement from skipping regular feedings, you may want to gradually decrease feedings over time.

Starting your breastfed baby on formula can cause some constipation or hardening of the stools (or poop), but continuing to nurse and adding some prune juice to the formula can help keep your baby's stools soft. Mixing some of your pumped breast milk with formula also can help your baby to better digest the formula and get used to the new taste, but this isn't necessary. You can still nurse from the breast and introduce the bottle as you need to. Be sure to talk your child's doctor, though, if your baby is having trouble pooping.

Q. Should I give my baby the bottle at first or should I have someone else do it?

A. You should have someone else give your little one the bottle at first. Why? Because babies can smell their mothers and they're used to receiving breast milk from mom, not a bottle. So try to have someone else - such as a caregiver or partner - give a breastfed baby the first bottle.

Also consider either being out of the house or out of sight when your baby takes that first bottle, since your little one will wonder why you're not the doing the feeding as usual. Depending on how your baby takes to the bottle, this arrangement may be necessary until he or she gets used to formula feeding. If your little one has a hard time adjusting to this new form of feeding, just be patient and keep trying.

This information was provided by KidsHealth.org, one of the largest resources online for medically reviewed health information. Produced by The Nemours Foundation Center for Children's Health Media in Wilmington, DE, KidsHealth includes sections specifically written for parents, kids and teens. For more frequently asked questions about formula feeding, visit  KidsHealth.org (search: formula FAQs).

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