Breastfeeding is a wonderful way to nourish your baby, but sometimes, supplementing with formula may be necessary. Parents often ask which formula is best when supplementing, whether due to supply concerns, weight gain issues, or personal choice.

Key Points

  • Evaluate necessity first: If you are concerned or have been advised that supplementing is necessary, confirm it’s needed by consulting your pediatrician or lactation consultant. Many breastfeeding concerns, like perceived low milk supply, can often be resolved without formula.
  • Choose a standard milk-based formula: For most breastfed babies, standard milk-based formulas are closest to breast milk and easiest to digest. Specialty or “gentle” formulas are typically unnecessary unless your baby has specific medical needs. These are not as healthy as standard formulas.
  • Preserve breastfeeding and your milk supply: Use paced bottle feeding, slow-flow nipples, and limit formula use to what’s needed to maintain breastfeeding and avoid nipple preference. Continue regular breastfeeding or pumping alongside supplementing to maintain your milk production.

More information is available in our guide to supplementing.

Do You Need to Supplement?

It is important to evaluate whether supplementation is necessary before deciding to do so. Many common breastfeeding challenges, such as concerns about milk supply or weight gain, can often be addressed with support from a pediatrician or lactation consultant.

Here are a few common scenarios where supplementation may not be needed:

  • Slow feeding in the first few days: This is normal. Newborns are sleepy and not very hungry in their first few days of life.
  • Initial weight loss: Some weight loss after birth is normal and not necessarily a sign of inadequate milk supply.
  • Your milk is “not in” yet: Healthy mothers start making colostrum during pregnancy and the first few days after birth. A few teaspoons of this nutrient-rich milk every few hours is all healthy newborns need.
  • Perceived low milk supply: Many mothers worry they’re not producing enough milk, but often, babies are getting enough even if you can’t see it. Tracking diapers and weight gain is more reliable than relying on perceived supply.
  • Cluster feeding or growth spurts: Babies naturally feed more frequently during these periods, signaling your body to produce more milk.

If supplementation is recommended, ensure it is necessary by discussing it with your pediatrician or lactation consultant.

Be especially cautious during the first week of life. Many mothers interpret the regular feeding and milk supply pattern as insufficient milk, which is usually untrue! Be sure you are getting the right advice.

Be sure to see our article on breastfeeding in the first week. It will help you determine whether breastfeeding is going well and whether supplementing might be needed.

Choosing a formula

When supplementation is required, selecting the best formula is essential. A standard milk-based formula containing lactose is ideal for most breastfed babies.

Why Standard Milk-Based Formula?

  • Closest to breast milk: Milk-based formulas are the closest to human breast milk, including balanced protein, fat, and sugar content.
  • Easy to digest: Unless your baby has a diagnosed intolerance or allergy, milk-based formulas are generally well-tolerated by most infants.
  • No added benefits from “gentle” or specialty formulas: While many parents may be drawn to formulas marketed as “gentle” or “for sensitive stomachs,” there is no evidence that these provide extra benefits for breastfed babies. They cost more, are unnecessary, and may be unhealthier than milk-based formulas. Specialty formulas are typically recommended only for specific medical conditions like cow’s milk protein allergy.

If your baby has specific needs, such as a diagnosed allergy or premature birth, your pediatrician may recommend a hypoallergenic or specialized formula. However, a standard milk-based formula is the best option for most babies.

There is no known benefit to giving organic formulas. The only demonstrated difference in using organic foods in older children and adults is decreased pesticide intake.

Milk-based formula options

Here are the options available in the US at this time. The names change frequently.

  • Enfamil, including Infant, NeuroPro, and Enspire Optimum
  • Similac, including Advance and 360 Total Care
  • Store brands: standard formula, all of which are all the same formula made by Perrigo
  • Bobbie, including Organic Original, Grass-fed Whole Milk, and Organic Gentle (the only gentle formula we would recommend because it is lactose-based)

Other brands, including European and Australian formulas, are now available in the US.

  • Kendamil: Classic, Organic, and Goat formula
  • Bubs: Essential, Goat, and Grass Fed

Any of these are acceptable to supplement breastfed babies.

There is also Good Start/Dr. Brown’s (formerly Gerber) formula, which Perrigo now owns. However, these formulas are different from those of Perrigo’s store brands. They have added sweeteners to their basic formula, which we do not recommend.

Supplementing Safely to Protect Breastfeeding

To ensure supplementation doesn’t interfere with breastfeeding, follow these tips:

  1. Use a syringe, small cup, or spoon the first few days: Newborns take only a few teaspoons at a time the first few days. Using these methods instead of an artificial nipple can help prevent nipple preference.
  2. Use paced bottle feeding: This technique resembles breastfeeding by allowing the baby to control the pace of milk flow. It helps prevent overfeeding and reduces the risk of nipple preference.
  3. Choose slow-flow nipples: These simulate the milk flow from the breast.
  4. Limit formula use to what’s needed: Offer only the amount your pediatrician recommends to supplement breast milk, ensuring that baby still nurses frequently.
  5. Maintain your milk supply: Continue breastfeeding or pumping regularly to protect your supply. Supplementing with formula doesn’t mean your breastfeeding journey has to end.
  6. Be sure to mix the formula according to the directions on the package. Always use water to prepare the formula; never use breastmilk as the liquid to mix with powdered formula. It can make your baby very sick.

These methods can help protect your baby’s ability and interest in nursing from your breasts and prevent feeding/nipple preference (formerly called nipple confusion).

Final Thoughts

Supplementing a breastfed baby doesn’t have to disrupt your breastfeeding goals. Choosing a standard milk-based formula is usually the best option, as it provides the nutrition your baby needs and is closest to breast milk.

Need more help? Our office is here to support you through your breastfeeding journey. Call or schedule a visit with our team for personalized guidance.