How often have you been told, just give your breastfed baby a bottle of formula at bedtime to make him sleep?
Although this advice is almost some kind of ‘folk-lore’ among the believers, there are some health professionals who may advise you to do this, even with a newborn. Some will tell you that giving a bottle is a great way for fathers to ‘get involved’.
But really, does this work and what could be the trade-offs?
Your milk supply
Your breasts work on a basis of ‘supply and demand’. This means that whatever milk you remove from your breasts, they will be signalled to make more milk. So, if you start offering bottles of formula at any stage of breastfeeding, your breasts won’t receive the signal to make milk – research by Dr Peter Hartman at the University of Western Australia affirms that an ‘empty’ breast (your breast is never actually empty) makes milk more quickly than a fuller breast. So, by offering a bottle of formula, unless you also express at this time, you could be compromising your milk supply. Another consideration is that at night time, your prolactin (milk making hormone) levels are naturally higher so by giving a night time feed you will be taking advantage of these hormone levels and boosting your supply.
If you have concerns about your milk supply, you can download our FREE Ebook "Making More Mummy Milk,Naturally" by Pinky McKay, IBCLC Lactation Consultant
Tiny tummies Your newborn’s tummy is only the size of his tiny fist so it’s normal in the early weeks for your baby to need frequent feeds. This is a time when your own milk supply is being established and in these early weeks, you will be developing more prolactin (milk making hormone) receptors in your breasts, so if you feed less because your baby is zonked out on formula, your body will not only get the message to make less milk, but you could be inhibiting breast development and influencing your ongoing milk supply. On the other hand, if you feed according to your baby's cues in these early weeks, you will encourage more breast development and you will set your milk production at a higher point so that, as your baby's tiny tummy grows and he can manage a bigger volume of milk, you will be producing a good amount so he will naturally start spacing out feeds and sleeping longer.
Nipple confusion There is a very different tongue, jaw and sucking action required to drink from either a breast or a bottle: when your baby latches onto the breast, he needs to open his mouth wide, flange his lips and draw the nipple deeply into his mouth, while his tongue has to ‘milk’ the breast with rhythmic movements; when bottle feeding, a baby doesn’t have to open his mouth so wide or flange his lips to form a seal, nor does he have to work to get the milk out – he can simply latch onto the tip of the teat. If the bottle milk flows too quickly, the baby may thrust his tongue upwards to stop the flow. This means that if you offer unnecessary bottles to your baby in the first 4 to 6 weeks, your baby may become confused by the different sucking actions and he may breastfeed less effectively or he may prefer the faster flow of the bottle and refuse the breast.
If you do need to supplement in the early days, ask if you can try a small cup or a syringe and at any time you need to supplement, if you use a bottle, finish a feed at the breast (after the bottle) so your baby associates a full tummy with breastfeeding – this can avoid baby preferring the bottle and refusing the breast altogether.
Exposure to potential allergens
Your baby is protected from potential allergens through your breast-milk. He is also protected against viruses and bugs through the immune factors in your milk, so by introducing formula to try and get more sleep, the trade-off could be an unwell baby who is actually more wakeful if he becomes constipated or has an allergic response to the foreign proteins in formula.
Some parents do find it helpful to offer a 'dream feed' - an extra feed just before they go to bed, whatever time their baby last fed, so that their baby's longer sleep may coincide with their own. However there are no guarantees that this will help all babies sleep longer - some babies will happily gulp an extra feed but they might seem to be thinking, 'bonus! and I'll still wake up in a couple of hours, while others will refuse to drink at all. If you do want to try this as a way of getting more sleep, please make this feed either a breastfeed top up or a bottle of expressed breast milk so that you maintain your milk supply and eliminate exposure to potential allergens from formula.
Night milk and brain development
Consider, your day and night milk have different components: evening breast milk is rich in tryptophan, a sleep inducing amino acid that is a precursor to serotonin. Seratonin is a vital hormone for brain function and development that makes the brain work better, keeps one in a good mood and helps with sleep cycles. We now know that ingestion of tryptophan in infancy leads to more serotonin development, creating the potential for life-long well-being. Night time breast milk also has amino acids that promote serotonin synthesis, so evening and night time breastfeeds could be more important to your baby’s development than simply promoting sound sleep.
Getting more sleep – will formula really help?
If you are sleep deprived and wondering, could a bottle of formula get us some more sleep? The answer is, probably not. A 2015 study of babies aged 6 to 12months in the Academy of Breastfeeding Medicine journal found that night wakings or night feeds didn’t differ between mothers who breastfed or formula fed. Another study showed that infants who were breastfed in the evening and/or at night slept an average of 40-45 minutes more than parents of infants given formula. And while you may think 45 minutes isn’t a big deal, these researchers say, parents who supplement their infant feeding with formula under the impression that they will get more sleep should be encouraged to continue breast-feeding because sleep loss of more than 30 minutes each night can begin to affect daytime functioning, particularly in those parents who return to work.
Parents and partners
Of course it is your choice how you work out ways to get enough rest as well as ways for partners to parent (they aren't just 'getting involved'). There are plenty of ways for partners to connect with your baby other than giving a bottle - try bathing with your baby, wearing your baby or giving your baby a massage (see my baby massage streaming video here it's available as a streaming download).
And, partners, if you want her to express so you can give your baby a bottle, please note: you wash the breast pump and tubing. It's an extra chore to express, without also doing a load of washing up - one of the best things about breastfeeding is that you just whip out a boob and snuggle your baby, you don't have anything to clean up.
Pinky McKay is an Internationally Certified Lactation Consultant (IBCLC) and best-selling baby-care author. She is also the creator of Boobie Bikkies and Boobie Brekkie all natural and organic foods to boost your energy and support a healthy milk supply. Download Pinky's FREE ebook "Making More Mummy Milk,Naturally" HERE