by Jack Newman, MD, FRCPC
Breastmilk is the only food your baby needs until about 6 months of age. There is no advantage to adding other sorts of foods or milks to breastmilk before about 6 months, except under unusual circumstances.
Many of the situations in which breastmilk seems to require addition of other foods arise from misunderstandings about how breastfeeding works and/or originate from a poor start at establishing breastfeeding.
In other words, if your baby is breastfeeding well and gaining weight well, then add solids only when the baby shows signs of being ready to eat solids. See the information sheet Protocol to Manage Breastmilk Intake.
It is thought by many that there is "no milk" during the first few days after the baby is born, and that until the milk "comes in" some sort of supplementation is necessary. This idea seems to be born out by the fact that babies, during the first few days, will often seem to feed for long periods and yet, not be satisfied.
However, the key phrase is that "babies seem to feed" for hours when in fact, they are not really feeding much at all (see the video clips of young babies, younger than 2 days, breastfeeding very well and getting milk well, at the website nbci.ca). A baby cannot get milk efficiently when he is not latched on properly to the breast, particularly when the supply is not yet abundant.
Note, breastmilk is not supposed to be abundant in these early days. But during the first few days, if the baby is not latched on properly, he cannot get milk easily and thus may "seem to feed" for very long periods. There is a difference between being "on the breast" and drinking milk at the breast.
The baby must latch on well so he can get the mother's milk that is available in sufficient quantity for his needs, as nature intended. In the first few days, the mother does have the appropriate amount of milk that baby requires. She is not supposed to have a large amount and nobody has proved that the large amount of formula a baby will take in the first few days is good for him or safe!
Yes, the milk is there even if someone has proved to you with the big pump that there isn't any. How much does or does not come out in the pump proves nothing -- it is irrelevant. Also note, no one who squeezes a mother's breast can tell whether there is enough milk in there or not.
A good latch is important to help the baby get that milk that is available. If the baby does not latch on well, the mother may be sore, and if the baby does not get milk well, the baby may want to be on the breast for long periods of time worsening the soreness. Or the baby may fall asleep at the breast and seem to have fed well; but babies tend to fall asleep at the breast when the flow of milk is slow.
1. A baby who drinks well (see video clips at the website nbci.ca) and falls asleep at the breast > that's the way it should be.
2. A baby who drinks poorly and then falls asleep at the breast > that’s not the way it should be. The mother and baby need help with the breastfeeding.
When the mother's milk becomes more plentiful, after 3-4 days, the baby may do well even if he is not well latched on (the mother may be sore, but even this is not necessarily so -- many mothers just put the baby to the breast any old way and both she and the baby do fine). If a better latch, and compression (see the information sheet Breast Compression) do not get the baby breastfeeding, then supplementation, if medically needed, can be given by lactation aid (see the information sheet Lactation Aid).