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Breastfeeding/Breastfeeding & Supplmentation


Hi Sally!
 I have a 10.5 week old baby boy! We went for his 2 month checkup today and his height, weight, and head circumference are all below average. His weight is 9 lbs 14 oz. He was 8.6 at birth. He is my 3rd child and I have successfully breastfed my other 2; each for 1 year. They had low weights as well, but not this low (he's not even on the % chart, his is so low.) I have been exclusively breastfeeding the entire 10 weeks for him.

  He is a very happy baby, but does love being held and loves his paci. At the appt. the Dr is concerned about his weight. Saying that it could be genetics as my other 2 had low weights too until they began solids. However, he also said it could be that my milk doesn't have enough fat content. He usually nurses 20-30 minutes (total for both sides.. I switch sides when he unlatches and begin with the latter side for the next feeding.) He is swallowing the entire time.

  Dr suggested offering a bottle after evening/night feedings as baby is most fussy at those times. I offered him 2 oz at his 6:30 & 8:30 feeding AFTER breastfeeding for 30 minutes. He guzzled the extra 2 oz down!! He didn't even want his paci after that either, which he normally does after solely BF'ng. So, now I'm torn (and honestly feel bad if my other 2 were really hungry afterwards & I just didn't know it.)

  Is there any way to up my fat content in my milk? I am a firm believer in BF if you can (and also monetarily we can't afford solely formula!) So, I'm not sure what to do! :( I don't want to give up BF'ng either. I feed him (normally) every 2 hours.. sometimes he'll go as many as 4 at night, but not always. I pump in the mornings after feeding him to have a supply for when I need to occasionally be away from him.

  Any thoughts/suggestions are really welcome!! Also, can I mix my milk with the formula too?  

Thanks for your help!!

Dear Deborah,

First, congratulations for giving all your children the best start in life by breastfeeding them!

I'm not sure about the issue being inadequate fat content in your milk, but it does seem as if your baby is hungry and you may need to work on building up your production of milk. The safest route for you would be to continue breastfeeding, but supplement with a little bit of formula and follow the baby's weight with your doctor. Then your son will have all the benefits of breastfeeding, the cost will be lower for you, and the baby's weight should be more in the appropriate category on the growth chart.  And it's perfectly fine to mix your breast milk with formula.

I'm attaching an excerpt from my book about increasing milk supply. You'll also see there that many doctors and lactation consultants now recommend giving supplemental formula before the breast feeding rather than after it. You might try that.

Good luck!


P.S. Don't feel bad worrying if your other children were hungry. You did the best you could at the time, and they're healthy now, so just be happy and enjoy your lovely family!
Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Olds & Marks, 4th edition, September 2010, published by Workman Publishing, and available in most public libraries, bookstores & La Leche League chapters.
Ways to Build Up Your Milk Production
New mothers sometimes fear that they won’t have enough milk to feed their babies. They hear stories about other women who “didn’t have enough milk,” and they worry that they might be in this category. But when you look closely at the situations of these other women, the problem can almost always be ascribed to lack of information, lack of encouragement, or faulty nursing technique by either mother or baby. You need to tell yourself that millions of other women nurse their babies, and you can, too. Following one or more of the suggestions below should increase your milk supply within a few days.
• Nurse your baby more frequently for several days, using both breasts at each feeding. This is the single best way to enhance your milk supply.
• Wake your baby, if necessary, to feed him more often -- about every two to three hours during the day and at four-hour intervals during the night.
* Pump or express milk between feedings. But don’t get discouraged if your pumping yields as little as half an ounce of breast milk. Your baby is almost certainly getting more than this. Even the best pump is less effective than a vigorously nursing baby. (More about pumping in Chapters 16 and 17.)
• See a lactation specialist if your baby is not suckling well or nurses only a few minutes at a time.
• Cut back on your schedule. Do less. Rest more. Nap at least once a day, more often if you can manage it. Or at least put your feet up. Ask someone else to help with marketing, cooking simple meals (or getting take-out food), and doing basic laundry. Most people like to help a new mother, so take advantage of this willingness now. You can always reciprocate later on. Although people often want to help, they may not know just what you need. It may help to post a running To-Do list on your refrigerator for all to see.
* Even though everyone wants to see the new baby, ask visitors not to come for several days -- or even weeks -- unless they’re people who will wait on you, not expect you to entertain them. Let your answering machine take phone calls – which you can return later when you’re not so tired. Well-meaning family and friends can wear out the new mom.
• If you can, in the early weeks take an occasional day or two off from work or from other obligations (by, for example, having someone come in to care for your other children) so that you can focus only on nursing your baby.
• Check your diet. Are you eating enough? Are you drinking enough? Some women find that eating or drinking more seems to produce more milk. Keeping a glass of water or juice near the spot where you nurse is a good idea. You don’t need to drink any more than you need to meet your thirst, but some nursing moms find that they are thirstier than usual.
• Make a special effort to relax, as suggested in the box on page tk. Of course, this is hard when you’re concerned that your baby isn’t getting enough milk—but the more you can relax, the more milk your baby is likely to receive.
• Develop a few affirmations that you can repeat to yourself, such as: “I am a bounteous supplier of milk for my baby”; “I am doing the best thing I can as a mother”; “My baby is growing fit and healthy from my milk”; “My milk is my baby’s perfect food.”
* Visualize your baby at a little older age, looking well fed and  happy.
* Galactogogues: Virtually every culture in the world has recommended certain foods or substances to nursing mothers, in the belief that they help to make milk. In China, nursing mothers have been urged to eat “a mixture of pork fat and red gram (a type of bean), cuttlefish soup, shrimps’ heads in wine, and a special sweet wine made from glutinous rice, given together with the larvae of the blow-fly.” In India, it’s garlic, tamarind, and cottonseed; in France, powdered fennel; and in Nepal, chicken soup, buffalo milk, butter, and rice. In the U.S. vitamin B complex, brewer’s yeast, and the herbs fenugreek (also called fenugeek) and blessed thistle are sometimes recommended, as is the controversial prescription drug domperidone, which has not been approved for any use by the U.S. Food and Drug Administration. (See Chapter 10 and the Websites Appendix for more about drugs and lactation.)
  Cheston M. Berlin, Jr., M.D., a professor of pediatrics and pharmacology who has an interest in drugs and lactation, has concluded that the effects of such potions may be largely psychological. The mother thinks that a certain substance will increase her milk supply, so she relaxes and has a good let-down reflex, thus “proving” its value.
As we have stated, though, the best way to build up your milk supply isn’t what you eat. It’s what—and how much—and how often—your baby eats. The cutting edge research of Dr. Peter E. Hartmann’s Australian team (discussed in Chapter 3) has  confirmed what many breastfeeding experts have known for years: that emptying the breast is the best stimulus to milk production. The more often you nurse your baby and the more vigorously she nurses, the more milk you’re likely to have.
• Believe in yourself and trust your body.

Note: Do not offer your baby formula while you’re building up your milk supply. A few ounces soon turn into a full bottle, which soon turns into several bottles, until you find that you’re producing even less milk. If your baby is drinking from a bottle, he is not stimulating your breasts and thus not doing the most effective thing that will increase your supply of milk. In most cases, a breastfed baby should not be offered a bottle until nursing is well established—usually at about four to six weeks of age.
  The only exception to this is if your baby’s doctor (not your friends or relatives!) feels that he absolutely needs a supplement. Your doctor may be worried if your baby is sick, dehydrated, so small that his health is endangered, or if he is not gaining enough weight. Any one of these conditions may leave him without enough energy to nurse vigorously and thereby stimulate your milk production.

If you do supplement with formula, you might try offering a couple of ounces of formula in the bottle first before nursing him. This practice, which reverses previous guidelines for supplementation in the order of breast-followed-by-supplement, has become more widely recommended in recent years. This reversal satisfies the baby’s immediate hunger and gives him the nourishment he needs, but ensures that he will get his final sense of fullness from breast milk, and associate this good feeling with his mother. Another way of supplementing is to use a nursing supplementer, a device that lets your baby suckle at your breast (thus stimulating your milk production) while at the same time receiving formula (see page 328 for a description).
  Once breastfeeding is well established, you may want to give your baby an occasional bottle of breast milk or formula. Ideally, you should wait until your baby is six months old to feed anything besides your good breast milk  (see Chapters 11, 12, and 17).  


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Sally Wendkos Olds


What do you want to know about breastfeeding? I can tell you what`s good for the baby, what`s good for the mother -- and the father, how it`s related to a woman`s sexuality, how working moms can nurse, how to overcome obstacles, and lots more. As the author of THE COMPLETE BOOK OF BREASTFEEDING and author or coauthor of 8 other books and more than 200 articles about child and adult development, I can offer sound, sensible advice on breastfeeding, child care and family issues.


I nursed my 3 daughters and am the grandmother of 5 breastfed children. My book THE COMPLETE BOOK OF BREASTFEEDING (written in consultation with pediatrician Marvin S. Eiger, M.D.) was first published in 1972, and in 1999 came out in an updated 3rd Edition by Workman Publishing & Bantam Books. It is now a classic, with over 2 million copies in print. I am now revising this book for a fourth edition, consulting with pediatrician Laura M. Marks, M.D. This new edition will be published September 2009. I welcome any and all suggestions for the new edition. I coauthored college textbooks A CHILD'S WORLD: INFANCY THROUGH ADOLESCENCE, and HUMAN DEVELOPMENT; both are leading texts in their fields and have been read by 2 million students. I am the coauthor of HELPING YOUR CHILD FIND VALUES TO LIVE BY and RAISING A HYPERACTIVE CHILD, and author of THE WORKING PARENTS' SURVIVAL GUIDE & THE ETERNAL GARDEN: SEASONS OF OUR SEXUALITY. My newest book, A BALCONY IN NEPAL: GLIMPSES OF A HIMALAYAN VILLAGE, published in 2002, tells the story of the way of life in a remote village in Nepal, where all the women breastfeed! My book, SUPER GRANNY: COOL PROJECTS, ACTIVITIES, AND OTHER GREAT STUFF TO DO WITH YOUR GRANDKIDS, will be published March 2009. I speak often to professional, parent and general audiences and make many radio and TV appearances.

Credentials I received my B.A. in English Literature from the University of Pennsylvania, where I minored in Psychology, was elected to Phi Beta Kappa and graduated summa cum laude.

Other points of interest I have received national awards for my writing, and am a former president of the American Society of Journalists & Authors. I am listed in the World Who's Who of Women, International Authors & Writers Who's Who, and Contemporary Authors, and am a member of several professional and civic organizations. I believe: that all parents are working parents; that parents employed outside the home need special support; that mothers' well-being is crucial to their children's welfare; and that the family is the best institution in the world and the one for which we are least prepared. My thrills come when parents or kids tell me they were helped by my writing or speaking or just understanding. To find out more about me, go to

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