Hello everyone!

I have a question about supplementation in the first 24hrs or so.

Assuming a baby has a legitimate need for supplementation, my first recommendation is always to have mom pump so that we can use her milk for supplementation, and, hopefully not need to add formula.

For babies that will need continued supplementation - like a late preterm baby with low blood sugars, or a weak suck - I usually recommend a feeding routine where baby breastfeeds, then receives their supplement, and THEN mom pumps.  Whatever mom pumps is saved to use as supplementation for the next feeding.
I prefer baby to have the entire feed (breast and supplement) before mom pumps.

However, the problem with this is - the very first supplementation - I have mom pump, she feeds baby whatever she has pumped.  Great, baby gets breastmilk, hopefully no formula, and life is good!
However, at the next feeding, there is no breastmilk available to use for supplement (because it was given at the last feed).

The only way forward I've seen is (again, I am only talking about circumstances where baby meets criteria for continued supplementation, and NOT supplementing is not an option) to use formula for supplementation that feed, have mom pump, and save that milk for the next supplementation.

However, this makes it almost impossible to strive not to give formula.  

Would you consider having mom pump BEFORE breastfeeding in order that the supplement can be breastmilk?  I don't like that idea because then baby goes to an empty (or emptier) breast for the feed.  On the other hand, it would prevent or reduce formula.

For the most part, I'm talking about my late preterm babies and my hypoglycemic babies, and usually in the first 24hrs.  

Any tips or suggestions?

Thanks,

Casey Clubb, RN, IBCLC
West Linn, OR USA

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