Many people wonder if they should supplement breastmilk with formula, juice, sugar water, cereal, or other foods. The answer in a nutshell is no (until your baby is old enough to start solid foods, around six months of age). Many formula ads try to lead you to believe that supplementing with formula is necessary, or at least a good idea. Don't believe them, they are just trying to sell their product.
    Reasons you might have or be given for supplementing:

• Bad advice: Breastmilk alone won't be enough for your baby.
  • Breastmilk is all a baby needs for many months (six to nine for most babies; the AAP's number of four months marks the age at which supplements are unlikely to harm a baby, not the age at which supplements are necessary).
  • Supplementing breastmilk will deprive your breasts of stimulation, and will cause them not to be emptied. This will decrease your milk supply. You might soon end up switching to total bottle-feeding.
• Bad advice: Breastmilk might be enough for most babies, but you don't have enough milk (perhaps your mother didn't enough).
  • Practically every woman is capable of producing enough milk for a baby (or even two or three babies!).
  • The only major exceptions are women with no or little glandular tissue, a condition that is easy to detect during pregnancy, and those who have undergone extensive breast surgery that severed their milk ducts.
• Bad advice: Bottle-feed at night so you can get some sleep.
  • This is based on two things: first, bottle-fed babies tend to go longer between feeds (check the page on bad advice to see why this is not a good reason to bottle-feed).
  • Second, someone else can feed your baby at night.
  • However, if you sleep with your baby (or at least keep your baby's cradle or crib next to your bed), you'll be able to feed at night with minimal disruption to your sleep. You'll end up sleeping better than a bottle-feeding mother.
• Bad advice: You have to use bottles in public, because breastfeeding in public is shameful.
  • If you are ashamed of exposing your breasts, don't worry. It's possible to be very discreet about breastfeeding in public. Many people may not even realize that you're feeding your baby.
  • Many states have laws protecting a woman's right to breastfeed in public. See if your state is among them. If not, write your representative or senator.

All supplementary bottles can cause food allergies in babies. All might cause your milk supply to decrease also. I have created a rough-and-ready ranking of these from the worst to the least bad in terms of potential to decrease your milk supply. Don't take the ranking too seriously, though!

1. The worst supplementary feeding is the topping-up bottle. This is a bottle that you give your baby immediately after nursing.
   • This harms your breastfeeding by keeping your baby full longer.
   • Your breasts remain full, which tells them that they are making too much milk.
   • Your breasts start producing less milk.
   • At the next feeding, your baby gets less breastmilk and more formula.
   • Soon, you stop producing milk altogether.
2. The second worst is the nighttime bottle, especially for a very young baby.
   • A young baby gets up to a third if her or his nutrition at night.
   • Not breastfeeding at night not only challenges your milk supply, it also increases your chances of becoming engorged and getting mastitis.
   • It is OK, however, after your baby is old enough (around six months), and your milk supply is well-established. What you might do at this point is use a water bottle at night (not juice or milk, so your baby doesn't get cavities). However, it's still better to nurse at night.
3. The third worst is the public feeding bottle and the away from baby bottle.
   • How bad these are of course depends on how often you use them. The less you use them the better.
   • If you are only unable to nurse for a short time, you might be able to nurse last thing before going out, give your baby a little water (up to a cup of juice a day is OK if your baby is over six months old) while you're out, and nurse again as soon as you come home or find a comfortable place.
4. The one-a-day bottle.
   • Many people use this in the evening so the mother can devote her attention to an older child while her mate or another person feeds the older one.
   • This is the least likely type of bottle that'll harm your milk supply, but it's of course better to avoid it.

How to supplement:

• Sometimes it is necessary to supplement.
  • Maybe your milk supply is low because of mismanagement of breastfeeding (talk to a lactation consultant before you jump to this conclusion; many people are quick to unfairly blame insufficient milk for any problem)
  • Maybe one of the reasons above is compelling to you.
• Consider using a cup, spoon, or syringe to offer supplementary foods. Bottles with artificial nipples can cause nipple confusion.
• Make sure the supplemental food you are using is appropriate to your baby's age (see the page on introducing solids).
  • No juice for a child under four months old.
  • No solid or mashed foods for a child under four (preferably six) months old.
  • No citrus juice for a child under a year old.
  • No cow's milk for a child under a year old.
  • No honey for a child under two years old.
• Never prop your baby with a bottle or send her or him to bed with one (if you're sure your baby can handle a bottle without choking, a water bottle is OK--but only a bottle of water with nothing added).

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