December 8, 2016
The Breastmilk and Formula Transition

I have the pleasure of getting to meet with women and families, all eager to learn about how to manage the first moments and years of their child’s life. Facilitating an environment of love and support in a group setting is the best part of my job. Recently, I was asked by a new Mom about best way to transition from breastfeeding to formula, how long they should keep their child on formula if they are also solid food feeding, how was she to know if the formula was facilitating the best for her baby, and how do you transition from formula at 12 months?

I figured this was a great opportunity for a little write up!

If you’ve been purposefully avoiding any advice that might make you feel like a terrible person, I say, “good for frickin’ you!” As you all know what I may loathe the most on this earth are others (who do or do not know you) putting you down. Guilt is the drapery of darkness and I am totally opposed to implementing fear or guilt into anything that I write/speak. However, it’s pretty easy to find yourself immersed in the wormhole of heart break, feeling like you are totally blowing it as a parent. Guess what? We all blow it. And all those blows lead to a whole lotta good most of the time, because we learn from them.

I’m convinced that most “blown-it” moments stem from the breastfeeding to formula feeding transition or the “I can’t breastfeed at all because it’s damn hard and I don’t feel like I can do it.” And all of the sudden a bottle is really a bomb waiting to go-off like a howler from Harry Potter yelling profanities and addressing all of the ways that formula or bottle-feeding breast milk is going to ruin your kid.

 

So let’s distill this down to some real facts.

 

  • You aren’t going to ruin your child.
  • Formula is the best option if it works best for you and your child.
  • Breastmilk is the best option if it works best for you and your child. If you have lots of love and support and feel like you can breastfeed, by all means! It truly is an amazing fluid that shifts as your child’s nutrient/growth needs change.
  • There are ways to supplement formula to encourage a nutrient profile that helps robustly address what your child may not be ingesting from formula, such as:
    1. 400 IUs of infant vitamin D drops daily (We like Nordic Naturals Infant drops).
    2. At least 120 mg of DHA daily (We like Nordic Naturals Omega Boost or DHA Infant drops).
    3. Adding a full spectrum infant probiotic (Klaire Infant probiotics daily). Specifically look for the probiotic strain called Lactobaccillus Rhamnoses as we know that L. Rhamnoses reduces the incidence of infant atopy and is associated with a healthy growth pattern for a child up to 4 years of age.
    4. 800 mcg-1 mg of methylfolate daily (We like Thorne 5-MTHF, 1 mg).
    5. Iron stores in your baby’s body until 6 months of age, at which time you will need to either: 1) add a liquid iron supplement or 2) focus on iron rich foods to help meet their developmental needs. If you are worried about an iron deficiency, usually you can ask for a hemoglobin check at your pediatrician and they can make sure everything is in balance. Most formulas include iron in the nutrient profile.
    6. All of these supplements can be added to ONE bottle a day.
  • We do suggest looking for a formula that is organic (We like Baby’s Only Organic Formula). This will ensure the cleanest and least toxic nutrient base is the foundation of your child’s daily food intake.
  • If you have started solid food introduction and are still breastfeeding, remember that your child will need a minimum of 24 fl oz up to 32 fl oz of breastmilk a day on top of their solid-food intake until 12 months of age.
  • If you have finished breastfeeding, transitioned to formula feeding, and are also including daily solid-food, your child will need a minimum of 24 fl oz up to 32 fl oz of formula a day on top of their solid-food intake until 12 months of age.
  • Formula is not a necessary food after 12 months—continue to include the same supplements you added to a daily bottle. All of the supplements we suggest taste good and/or can be mixed into water, yogurt, or a bottle.
  • At the 12-month transition off of formula, we do not believe that cow’s milk is a necessary food for growing infants. We like alternate dairy sources such as goat’s milk or dairy alternatives such as almond milk or coconut milk. Be aware that dairy alternatives do not have the same nutrient/protein/fat profile as a diary milk product. Goat’s milk is known for its hypoallergenic properties vs. cow’s milk, which still graces the list for the top 9 foods that account for 90% of all food allergies.
  • If you continue to breastfeed, the WHO recommends that you breastfeed a minimum of 6 months-2+ years.

As always, please check with your primary care provider to ensure that our suggestions work with your overall health plan. And let me know if you have any questions!

 

Sources:

Probiotics in Pregnancy and Lactation, New Perspectives for Pre and Post Natal Care, Belinda Reynolds, BSc, Diet & Nut (Hons), Webinar, 2016

 

Maternal intake of L. rhamnosus (at end of pregnancy and during lactation) reduces the incidence of infant atopy (Kalliomaki et al, 2007; Niers et al, 2009)

Johns Hopkins, Feeding Guide for the First Year, Johns Hopkins Medicine Health Library