Necessary for some, damaging for others
“Topping-up” is the practice of giving your baby some “bonus” breast milk or formula via bottle after breastfeeding sessions.
While it is incredibly helpful and necessary in some instances, it can create milk supply issues.
Situations in which bottle top-ups may be recommended include:
– Preterm babies
– Babies who are unable to take in enough during breastfeeding (in the case of tongue-ties, IUGR or small for gestational age babies)
– Low milk supply caused by hormonal or medical issues (Insufficient Glandular Tissue, low prolactin levels, and history of severe postpartum hemorrhage, for example)
– Baby has been unable to gain adequate weight
Like an Insurance Policy for Breastfeeding
Parents like to give bottle top-ups because they like the “insurance” that a bottle feed provides. During breastfeeding, we have no way of knowing how much baby has taken in. Sure, you can keep track of your baby’s poops, pees and overall weight gain, but it still often feels like a “guessing game” to many parents.
Our society loves measurable results.
Breastfeeding and baby tracking apps amplify the situation and make us feel we have to know every exact number of every detail associated with your baby.
The truth is, though, that breastfeeding is not a numerical task, nor is it one that should be analyzed with schedules and numbers. There is a certain amount of “letting go” that needs to occur during breastfeeding.
Get to know your baby. Learn their cues. Soak up the moments. THIS is what your first few weeks with your baby should be about. Not tracking, analyzing, recording, obsessing, or stressing.
When you offer 1-2oz by bottle, then you KNOW they’ve at least eaten, right?
While it might set your mind at ease, it’s important to understand how it may impact your supply.
Babies eat in IRREGULAR intervals throughout the day. They eat different amounts, and for different lengths of time during each feed. Sometimes they just want a snack or a drink, or they may want a full 3-course meal!
So, if someone tells you that you need to feed every 2h for 20min every time they are WRONG!
That being said, most babies will guzzle down anything extra by bottle top-up. Overfeeding at one feed can cause them to be less hungry the next time you offer a breastfeed. Over time, this can lead to them removing less milk from the breast, then filling up via bottle feeds.
The changes can be subtle, but tricky.
When your baby is not removing as much milk from your breasts, your body thinks that it doesn’t need to make as much, and it slows down production.
This can lead to a stressful game of catch-up to increase your milk supply.
How can we overcome this? Call an IBCLC (me, if you’re in the Edmonton area!) to help.
– Help determine if your baby truly NEEDS top-ups. And if so, how much?
– Give you strategies to maximize your baby’s ability to remove milk at the breast
– Tell you how to know if your baby has eaten enough, and help ease your mind
– Lastly, I can help determine if feeding anxiety is taking over, and can point you in the direction of applicable mental health supports. No shame, no judgement.
Every IBCLC should be able to do this, and to help you navigate the world of breastfeeding, top-ups, and baby behavior! Help is out there, you don’t have to do this alone!