Our pediatrician says that because our son is so big (9 lbs 8 oz at birth) we should supplement my wife's breastfeeding with formula. We are worried, however, that this will ultimately cause our son to reject the breast. How can we supplement without causing nipple confusion?

asked 23 Nov '09, 16:45

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Matthew Jones
accept rate: 18%


Does the doctor know for sure that your partners breastfeeding is not enough, or is he suggesting that because you have a lovely big baby who has shown that he needs more milk than his mummy is giving him;?

(23 Nov '09, 17:25) Emi

Without knowing your particular situation, I am concerned that your pediatrician would recommend that you supplement with formula "because your son is so big." Just because he is a big baby does not mean he needs to be supplemented with formula. Check out Dr. Jack Newman's website (http://nbci.ca). He is a world leader in breastfeeding.

He says, "The vast majority of mothers are perfectly capable of breastfeeding their babies exclusively for about six months. In fact, most mothers should be able to produce more than enough milk. Unfortunately, outdated hospital policies and routines based on bottle feeding still predominate in too many health care institutions and make breastfeeding difficult, even impossible, for too many mothers and babies."

He also believes that newborn babies should not be given artificial nipples and writes "...in the first few days, when the mother is normally producing only a little milk (as nature intended), and the baby gets a bottle (as nature intended?) from which he gets rapid flow, the baby will tend to prefer the rapid flow method. Babies like fast flow. You don’t have to be a rocket scientist to figure that one out and the baby will very quickly."

From Jack Newman's page on "How to know a health care provider is not supportive of breastfeeding": "Most problems can be prevented or cured, and most of the time the answer to breastfeeding problems is not giving formula. Unfortunately, many health professionals, particularly physicians, and even more particularly pediatricians, do not know how to help. But there is help out there. Insist on getting it."

Also see the article on Kelly Mom's breastfeeding site (http://www.kellymom.com/bf/normal/newborn-nursing.html). In this article she answers the question "Is Baby getting enough milk?"

Again, I'm not sure if there are other issues in your situation, but for the majority of moms who want to breastfeed, they have more than enough milk and do not NEED to supplement.


answered 23 Nov '09, 17:20

cat_g's gravatar image

accept rate: 25%

Just wanted to add that I had a big baby too and I exclusively breastfeed for 6 months and am still breastfeeding. At 6 months my big baby weighed 22lbs and wears 18month old sized clothes.

(23 Nov '09, 17:27) cat_g

+1 for your first sentence

(23 Nov '09, 18:30) JJJ

I remember all issues surrounding breastfeeding being very confusing, stressful and frustrating. You obviously just want to do what's right for your baby and there are a lot of conflicting messages.

Just to give some perspective, I had to supplement with formula early on (even though this is not what I had initially planned on) as my milk did not come in right away (I was told by the nurses due to anemia). Because I educated myself a great deal on breastfeeding, went to a breastfeeding course and feared nipple confusion I even went so far as to refuse to give my daugther a bottle initially. That is until she started to show signs of dehydration while in the hospital. There were a lot of tears as I felt guilty and somehow less of a mother because I couldn't provide this basic need. Now I don't know what you are experiencing; however, the messages I want to get across are:

1) I was eventually able to breastfeed although never exclusively despite my best efforts. The right lactation consultants were very helpful (I did have one not so helpful experience). There was never any nipple confusion, at one point we believed this to be the case but it was actually a case of my daughter just not being physically capable of latching.

2) I finally realized that my baby is happy and healthy and was well nurished. I did my best to provide as much breast milk as possible. This does not make me any less of mother and I have no reason to feel guilty.


answered 23 Nov '09, 20:21

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Tammy ♦♦
accept rate: 18%

edited 24 Nov '09, 02:08

Here's a pretty good article I think you'll be very interested in: http://www.breastfeeding.com/all_about/all_about_confusion.html. Here are the bullet points from it:

  • If at all possible delay introducing the bottle until the baby has well established nursing and latch on skills.
  • If baby must receive supplements early on, use a Supplemental Nursing System, feeding cup, medicine dropper or spoon to feed baby.
  • Avoid the use of pacifiers, which only further enforce the "tongue in front" nursing
  • Pump or hand express a bit of milk before attempting to latch baby on so that your milk is readily available, as it is with a bottle, and baby doesn't become frustrated waiting for let down.
  • Attempt to nurse frequently, but be prepared to offer expressed milk or formula if your baby is not able to nurse efficiently.
  • Be sure baby is latching on properly - taking the entire nipple and as much areola into his mouth as possible. Do not allow baby to suck on just the tip of your nipple... he will not get milk, and you will end up with sore nipples. If baby is latched on improperly, use your finger to gently break his suction and try again.
  • Seek 'in-person' help from a local lactation consultant or La Leche League leader if one is available. But be sure to find a support person that you feel comfortable with ... working with someone who makes you tense or upset will only make matters worse.
  • Be patient with yourself and your baby. It is common to have difficulties with nursing, and it doesn't mean you or your baby are a failure - it simply means that it will take extra effort and patience to make things work for you.

answered 23 Nov '09, 17:05

Dinah's gravatar image

accept rate: 15%

I'd like to add that when seeking "in-person" help, make sure to diversify, if possible. I had advice from at least 10 professionals before one said what made sense to me. Sometimes even the best advice can be delivered in a way that is confusing. And I'm sure we can all agree that the first weeks of motherhood are very confusing.

(23 Nov '09, 21:28) DarwinsMom

9 pounds 8 oz = 4310 grams

My girlfriend's breasts who fully breastfeed two twin boys with a combined weight of 4700 grams at birth and 7000 grams at six weeks beg to differ with your pediatrician.


answered 23 Nov '09, 23:34

runaros's gravatar image

accept rate: 28%

This answer is of course written according to the information in your post. If there is something additional information your pediatrician probably knows better than me...

(23 Nov '09, 23:38) runaros

We primarily breast-fed our son but even from fairly early on we supplemented with one or two feedings a day from formula (once he had properly learned to take from the breast). This was mostly so I could do a couple of feedings a day while my wife slept or was out of the house (we tried pumping and saving, but she couldn't produce quite enough for that).

Anyway, our experience was that this was all just fine, there was no "nipple confusion" of any kind. At no point did he prefer a bottle when a breast was available (until he self-weaned completely at 10 months).

Anecdotally speaking, I know many more parents whose experiences echoed ours, than those who really did see "nipple confusion". My impression is that the prevalence and seriousness of "nipple confusion" just might be a tad overstated by the "anything other than 100% breast is bad" crowd. (It's all relative. It's also bad if mommy never gets enough sleep, or is constantly stressed out about producing enough milk.)

Aim for as much breast feeding as you can manage. Supplement as required. Don't feel bad about it or be scared. We all make it through somehow.


answered 24 Nov '09, 04:15

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accept rate: 14%

Babies who only receive milk directly from the breast are extremely unlikely to self-wean under one. http://www.kellymom.com/bf/weaning/babyselfwean.html

(25 Nov '09, 19:48) Meg Stephenson

I agree with some of the previous posters about the awsome capability of the human breasts but in answer to your question, the only bottles I have ever come across that help with reducing confusion are the Nuby Naural Touch with the breast sized nipples and the Adri bottles


answered 24 Nov '09, 02:42

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accept rate: 8%

edited 24 Nov '09, 02:55

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Tammy ♦♦

thanks Tammy - I have no idea how to make those links look that pretty :)

(24 Nov '09, 03:01) dreamerisme
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Asked: 23 Nov '09, 16:45

Seen: 6,132 times

Last updated: 24 Nov '09, 04:15