There are rare indications for supplementation, but often supplements are suggested for "convenience" or due to outdated hospital policies. If supplements are required, they should be given by lactation aid at the breast (see the information sheet Lactation Aid), not cup, finger feeding, syringe or bottle. The best supplement is your own colostrum. It can be mixed with 5% sugar water to give more volume if you are not able to express much at first. It is difficult to express much at first because even though there is usually enough for the baby, expressing is not always easy when there is not a lot of milk, as is expected in the first few days. Formula is hardly ever necessary in the first few days. (See our GamePlan for Protecting and Supporting Breastfeeding in the First 24 hours of Life and Beyond, which can be ordered at nbci.ca
• Free formula samples and formula company literature are not gifts. There is only one purpose for these “gifts” and that is to get you to use formula. It is very effective and it is unethical marketing. If you get any from any health professional, you should be wondering about his/her knowledge of breastfeeding and his/her commitment to breastfeeding. "But I need formula because the baby is not getting enough!" Maybe, but, more likely, you weren't given good help and the baby is simply not getting the milk that is available. Even if you need formula, nobody should be suggesting a particular brand and giving you free samples. Get good help. Formula samples are not help.
Under some circumstances, it may be impossible to start breastfeeding early. However, most "medical reasons" (maternal medication, for example) are not true reasons for stopping or delaying breastfeeding, and you are getting misinformation. See the information sheets Medication and Breastfeeding and also Illness and Breastfeeding. Get good help. Premature babies (see the information sheet Premature Baby and Breastfeeding) can start breastfeeding much, much earlier than 34 weeks of age that seems to be the rule in many health facilities. Studies are now quite definite that it is less stressful for a premature baby to breastfeed than to bottle feed. Unfortunately, too many health professionals dealing with premature babies do not seem to be aware of this (See the information sheet Premature Baby and Breastfeeding).
Not latching/Not breastfeeding? If for some reason baby is not taking the breast, then start expressing your colostrum by hand (often much more effective than using even a hospital grade pump) should be started within 6 hours or so after birth, or as soon as it becomes apparent baby will not be feeding at the breast. See the information sheet When the Baby Does Not Yet Latch On.
Questions? Get Dr. Jack Newman's book The Ultimate Breastfeeding Book of Answers.
Jack Newman graduated from the University of Toronto medical school as a pediatrician in 1970. He started the first hospital-based breastfeeding clinic in Canada in 1984 at Toronto's Hospital for Sick Children. He has been a consultant with UNICEF for the Baby Friendly Hospital Initiative in Africa, and has published articles on the subject of breastfeeding in Scientific American and several medical journals. Dr. Newman has practiced as a physician in Canada, New Zealand, and South Africa.
Written and revised (under other names) by Jack Newman, MD, FRCPC, 1995-2005
Revised Jack Newman MD, FRCPC, IBCLC & Edith Kernerman, IBCLC, 2008, 2009