Feeding Your Baby When Milk Supply Is Limited
Jun 03, 2022 Victoria Pelham
Milk supply, whether from breastfeeding or baby formula, is the most crucial ingredient in an infant's development. Figuring out a reliable feeding process can also be one of the biggest challenges of early parenting.
While children's health experts recommend exclusive breastfeeding for at least an infant's first six months, if possible, there are many valid reasons why a parent might rely on or supplement with formula, says Cedars-Sinai pediatrician Dr. Pamela Phillips.
"For most healthy children, the bulk of formulas are going to be interchangeable. They may have slightly different taste, textures and smell, but in terms of their nutrients and composition, they're very similar."
What parents can do about limited milk supply for an infant
Some new moms struggle to produce enough milk or become severely ill and unable to breastfeed safely. Others have difficulty getting their baby to latch correctly. It might be tough to reconcile pumping and work schedules, or an infant could develop a milk allergy.
A national baby formula shortage, triggered by pandemic supply-chain problems and a recall of Abbott Nutrition formulas that shut down production in early 2022, exacerbated these obstacles for millions and worried many others about future supply. Nearly 20% of newborns receive supplementary formula in their first two days, according to the Centers for Disease Control and Prevention (CDC), while about three-quarters of infants are fed some formula milk by 6 months.
"The shortage impacts any parent with children under 1," Dr. Phillips emphasizes.
Still, there are steps you can take to help protect your baby's diet during times of limited milk supply, she adds—whatever the cause.
Milk banks and support groups provide relief
Human milk banks offer a safe supply of donated breast milk. The nonprofit agencies follow stringent requirements for donor and milk screening, as well as milk collection and storage. The supply is also pasteurized to guard against infectious bacteria.
Pediatricians don't recommend direct breast milk donations, due to the risk of infectious disease, but many parents share formula. If you don't have access to enough milk for your infant, check social media and parenting groups to see if anyone's offering powdered formula boxes in your area, Dr. Phillips says.
She cautions that parents should never accept any milk that's been opened or tampered with already.
It's safe to switch formula brands of the same type
Your infant might have a preference, but there are no health concerns to changing formula if your brand is running low or out of stock.
"For most healthy children, the bulk of formulas are going to be interchangeable," Dr. Phillips says. "They may have slightly different taste, textures and smell, but in terms of their nutrients and composition, they're very similar."
To ease the transition, parents can gradually introduce new formula over a one-week period. Start by mixing 1 ounce of new formula with 3 ounces of the old for a 4-ounce bottle.
If there isn't time to ease in to a new diet, a picky infant might reject new formula for a few feedings—but will ultimately accept the switch, she adds.
Consult your pediatrician if you're struggling to meet your child's dietary needs
Your pediatrician can refer you to lactation consultants for any breastfeeding or combination feeding difficulties, provide in-office formula samples or point you in the right direction for formula milk.
This is key for parents of underweight children or infants who require specialized formulas due to severe food allergies or metabolic disorders. Pediatricians can submit requests for specialized formulas on behalf of patients.
Because more than one company makes hypoallergenic and other specialty formulas, your provider might also be able to suggest another appropriate option.
Cow's milk can be an alternative
In a bind, babies over 6 months old—who are already eating solids—can have cow's milk, Dr. Phillips notes. Keep the dairy to under a week.
Babies allergic to cow's milk can also drink soy milk fortified with calcium and vitamin D, she adds.
But don't try goat or almond milk. Goat's milk is typically unpasteurized, potentially exposing your child to germs. And almond milk is low in protein.
While toddler formula doesn't provide the correct nutritional balance for young infants, you can feed it for up to two weeks to those 9 months and older, Dr. Philips adds. Premature formulas are higher in calories but can also be used if you have no other options.
Leave formula-making to manufacturers
Homemade formula attempts are dangerous, the American Academy of Pediatrics (AAP) stresses.
"It really is impossible to replicate what we get in formula with ingredients from home," Dr. Phillips says.
Baby formulas are manufactured to have the exact electrolyte balance to encourage brain and body growth during the critical first year, according to AAP—enough protein, iron, calcium and vitamins but not too many of the nutrients (such as salt) that hurt infant kidneys or livers in large doses.
Don't try to stretch baby formula
Diluting ready-to-feed formula to try to make it last longer is also unsafe, pediatricians warn. It weakens nutritional content and throws off the electrolyte balance.
Because babies' kidneys aren't fully able to filter yet, watering formula down can make them very ill, Dr. Phillips explains. It can even cause seizures.
Avoid expired baby formula, as well.
"We just don't know how quickly it degrades and what the issues might be," she says.
Most baby formulas need to be used within a month of opening the container, the CDC notes. The agency recommends storing it in a cool, dry, indoor place.
Save breast milk
Once you stop nursing, it's extremely difficult and time-consuming to start again, Dr. Phillips cautions. You would likely need a breastfeeding specialist and medication.
Lactating moms unsure of their future supply might want to pump and store extra. Expressed breast milk can be safely refrigerated for up to four days, according to the CDC, and frozen for six months—or all the way to a year if necessary. Never microwave frozen breast milk: When it's ready for use, refrigerate overnight or thaw it either under running lukewarm water or in a container of warm or lukewarm water.
Dr. Phillips recommends stimulating short-term milk supply with tricks typically used for parents of newborns: mother's milk herbal teas and lactation cookies high in brewer's yeast.