Replacement feeds

What are replacement feeds and how are they given?

A replacement feed is a milk feed given to a baby when the mother is away or when the mother or baby is unable to breastfeed. It can be given by bottle, cup, or finger-feeding, or by a feeding tube if the baby is hospitalized or ill. Bottle-feeding is the easiest and most common method, but babies tend to overeat a little on the bottle. Parents should pause regularly during bottle-feeding and assess the baby’s need for milk. The amount of milk depends on the baby’s age. After receiving enough milk, a baby should not show any hunger signs. They may not be settled after a replacement feed; there are several options to manage this.

A) Describing replacement feeds

Milk that is given to babies in addition to or instead of breastfeeding is called a supplement. The latter can also be called a replacement feed.

If a baby receives a replacement feed and the mother wants to feed her baby breast milk, she needs to express around the time the baby receives the feed. Not breastfeeding and not expressing can lead to problems for both the baby and mother.

B) Reasons for replacement feeds

Replacement feeds will be required if the mother:

  • Is separated from the baby.
  • Is in too much pain to breastfeed.
  • Is too sick to breastfeed.
  • Has a medical reason not to breastfeed.
  • Chooses not to breastfeed.

Replacement feeds will be required if the baby cannot breastfeed because the baby is:

D) Replacement feed amounts

The amount of milk the baby needs depends on:

  • The weight of the baby.
  • The age of the baby.
  • When the baby last fed.

Generally, you can determine  the exact amount of milk  to feed your baby  by watching your baby’s hunger signs.

Bottle-feeding and breastfeeding are very different and babies tend to overeat a little on the bottle. Pause regularly during bottle-feeding and assess the baby’s need for more milk.

Cup-feeding is less likely to result in overeating, because the baby is more in control of how much milk is taken in. If the baby refuses to lap, the milk will simply run down the baby’s chin.

The typical amount of a replacement feed depends on the baby’s age. Here are some general guidelines.

Table: Expected total milk intake per day and per feed for various ages (estimate based on 7 feeds in 24 hours)

E) Settling after a replacement feed

After receiving enough milk, a baby will not show any hunger signs. If there are, the baby should be given more milk.

Babies sometimes need to breastfeed for a few minutes to settle after being supplemented or to go to sleep. This is normal and not caused by hunger; Rather it is driven by the need for comfort. If possible, offer the baby the breast for a few minutes.

This doesn’t work if a mother is separated from her baby or if the baby cannot breastfeed. In this case, they can be rocked, held, bounced, or walked. A pacifier is also appropriate and may help prevent overfeeding by bottle.