In an ideal world, all babies will breastfeed within an hour of birth, and mothers will have knowledgeable support to ensure the baby is latching properly. Mothers will nurse on-cue, at least 8-12 times each 24 hours, without routine administration of artificial baby milk and be nursing with ease when the milk transitions from colostrum to mature milk.

Unfortunately, very few women’s breastfeeding experience is reflected above. When things aren’t going perfectly, hospitals tend to focus their attention on the baby, sometimes offering artificial baby milk (formula) if they feel nursing isn’t going well (which many lactation professionals would argue is often not necessary). But many hospitals are much less attentive to protecting the milk supply of the mother.

Because nursing in the early days is as much, if not more, about stimulating milk supply than providing significant nutritional intake to the baby, feeding artificial milk can compound the problem by stifling baby’s instinctual need to nurse. The low volume/dense value of the colostrum in the first days keeps the baby wanting to nurse and provide critical early stimulation. If the baby not latching well, is fed formula, is sleepy from birth trauma or birth anesthesia, or otherwise separated from the mother in the days following birth, it is absolutely critical for mothers to pump while separated or while obtaining help for a problematic latch.

Mothers experiencing these challenges should be sure to request (and demand, if it comes to that) a hospital grade pump to use while in the hospital. Mothers should nurse if and when possible, getting help with latch from a trained lactation professional or even an experienced woman friend. But at minimum, mothers should ensure breast stimulation from an appropriate pump in lieu of and/or to supplement the baby’s nursing at least 8-12 times in 24 hours, with no more than 2-3 hours gap between sessions.

This way, regardless of how nursing is going, the body is receiving the message breast milk is wanted! If help is not available for latch just after birth or if the baby is unable to nurse due to prematurity (or other reason), latch can always be helped after release from the hospital. But if milk supply is compromised due to lack of stimulation, it becomes a double challenge to get breastfeeding established.

If babies do receive artificial milk in the hospital, I think there is little value in a new mother berating herself for "allowing" formula. New mothers do the best they can with the information and support they have and need their confidence built up, not further damaged by focus on something that can’t be changed. If milk supply is protected, whether the baby has had formula will have hopefully have little impact on the success of breastfeeding and once the baby is latched, and milk has transitioned from colostrum, breast milk can mostly or completely replace the artificial milk under the guidance of a lactation professional or other health professional. Having help with latch and then nursing on cue as or after the milk transitions from colostrum will make having had the formula irrelevant and reduce or avoid engorgement for the mother.

It is also worth noting that some babies have trouble latching in the first days after birth for lots of reasons, or may nurse fine and then lose interest once they have removed most of the colostrum from the breast (there are only a few CCs of colostrum, as it is so nutritionally dense, it is all the baby needs!). My second daughter nursed wonderfully the first day and then went on a nursing strike until the milk transitioned, so I pumped her whole second day of life just for the stimulation, but on day three when the milk transitioned, she happily resumed nursing like crazy!

Mothers wanting to breastfeed, but who are unable to resolve latch problems or are separated from their baby in the first days should be sure to pump as indicated above until they are able to establish nursing with an effective latch. Many mothers who later have been told they were unable to breastfeed due to lack of supply might have been able to affect that outcome with this method. Mothers who had been told they had inadequate supply in the past may be able to protect supply for subsequent babies in this way even if there are latch challenges in the early days.


Disclaimer: All material on the BellaOnline.com Breastfeeding website is provided for educational purposes only and does not constitute medical advice. Although every effort is made to provide accurate and up-to-date information as of the date of publication, the author is neither a medical doctor, health practitioner, nor a Board Certified Lactation Consultant (IBCLC). If you are concerned about your health, or that of your child, consult with your health care provider regarding the advisability of any opinions or recommendations with respect to your individual situation. Information obtained from the Internet can never take the place of a personal consultation with a licensed health care provider, and neither the author nor BellaOnline.com assume any legal responsibility to update the information contained on this site or for any inaccurate or incorrect information contained on this site, and do not accept any responsibility for any decisions you may make as a result of the information contained on this site or in any referenced or linked materials written by others.