Ask the Dietitian - How Do I Supplement or Transition from Breast Milk to Formula?

Ask the Dietitian - How Do I Supplement or Transition from Breast Milk to Formula?

Posted by Diane, MPH, RD, LD - Director of Nutrition Services on May 11th 2020

I want to start using!

Many moms may need to make the difficult decision to supplement their breastfed baby or transition their baby from breast milk to formula. The reason for these decisions are often personal and sometimes medically needed for either the baby's or mother's health situation. When introducing formula to your baby, usually a dairy-based formula will be recommended by a baby's doctor. One interesting fact is that breastfed babies get exposed to various flavors based on what mom eats and drinks. This starts in utero as flavors will be in the amniotic fluid and continues during breastfeeding as breast milk will also contain flavors from mom's diet. When feeding a dairy-based formula, milk flavors may be somewhat familiar to a breastfed baby if the mom was consuming dairy products during pregnancy and while breastfeeding. So, acceptance based on what flavor is usually not an issue.

If your baby is reluctant to a bottle of formula, here are a few tips you can try:

  • To prevent your milk supply from lessening and to make sure your baby gets all the special "goodies" of breast milk like immune support features that are not found in formulas, breast feed baby first and then give a bottle.
  • Start with one bottle per day and then gradually increase to more bottles if you are transitioning to formula feeding.
  • Offer the formula at a time during the day when your baby is happiest. Night-time feedings can sometimes be a problem as your baby may get cranky.
  • Check the nipple on the bottle to make sure that it drips formula when turned upside down. If the nipple flow is more than your baby is used to while breastfeeding, your baby may be getting too much milk and could be gulping to keep up with the flow... the result? An unhappy baby! You may need to try different nipples to see which one your baby likes best.
  • Bottle feeding can sometimes result in your baby taking in excess air. Burping more frequently can help.
  • Your baby may prefer a different position while being bottle fed. Try a different position if your baby shows some fussiness.
  • Put some soothing music on for both you and your baby.

If your baby still resists the formula, try the following (this isn't ideal as we always want your baby to get all the advantages of breast milk first but this may help):

Day 1 - mix ¾ breast milk with ¼ formula

Day 2 - mix ½ breast milk with ½ formula

Day 3 - mix ¼ breast milk with ¾ formula

Day 4 - only formula in the bottle

If your baby shows signs of a possible cow's milk protein intolerance or allergy like:

  • Rash
  • Excessive gas
  • Constipation - small hard pellet like stools or cries of pain when pooping
  • Diarrhea
  • Excessive spit up
  • Blood in the stool or vomit

You will need to call or visit your child's healthcare provider.

My next article will be on coping with cow's milk protein intolerance. So stay tuned! And as always, let me know what questions you may have for me! I am happy to help!


**For specific medical care and nutritional advice on product usage, please see your healthcare professional