Worried about the top-up spiral? You can get your supply back and make enough milk for your baby
If you’ve fallen into the ‘top-up spiral’, supplementing your baby with formula, you’re not alone. Many mums find themselves giving their baby a bottle but wanting to get back to full breastfeeding.
If you are thinking about weaning off formula supplements, it’s important to do so with guidance from your child health nurse and/or lactation consultant. ABA counsellors can also offer support along the way.
How quickly you may be able to wean off formula supplements may depend on:
the reason(s) you are using formula supplements in the first place
the age of your baby
how much formula your baby is having.
When weaning off formula, the aim is to increase your baby’s breastmilk intake while decreasing the amount of formula. In this way your baby’s intake remains as a healthy volume.
How to go about reducing formula supplements
Gradually replace formula with more breastfeeds
Generally, and depending on the situation, you will replace a small amount (eg 30 mL each day) of formula with more breastfeeding. The more milk that is removed from your breasts, the more milk you will make.
If your baby is breastfeeding well, you can offer more frequent breastfeeds. If there are situations where your baby can't be offered another breastfeed, then expressing between breastfeeds can boost your supply.
If your baby is breastfeeding, but doesn’t drain your breast well, expressing after feeds can also help increase your supply.
If your baby is not taking your breast, you will need to express more often than you have been.
Gradually this will help to increase your supply. You will be aiming, eventually, for 8 to 12 breastfeeds in a 24-hour period.
Top up with expressed milk
Some mothers find it motivating to give their baby their expressed breastmilk as a supplement instead of formula. Generally, a baby who breastfeeds well is better at removing milk from your breast than a pump, but some mothers find expressing helps to increase their supply. When expressing, the aim is to remove more milk from your breasts and to keep your breasts more drained more often — both of which help to increase your milk supply.
If a breast pump is going to be easier for you, find out which type of pump will suit you best.
If your baby is not breastfeeding, you will need to express more often than you have been to increase your milk supply.
Check baby's output and growth
It’s important to check your baby’s output (the number of wet and dirty nappies), as this shows if your baby is getting enough milk. Frequent visits to your child health nurse are also important while reducing formula supplements, to have your baby’s growth (weight, height and head circumference) closely monitored.
As your baby continues to show signs of getting enough milk, you may be able to reduce the formula by another small amount every few days. Again, be guided by your child health nurse and/or lactation consultant.
If at any point your baby’s weight gains or output (the number of wet and dirty nappies) are reduced, then you can stay for several days or more at the same supplement level, concentrating on frequent breastfeeds. Or you can go back to the previous supplement level before trying to reduce it again.
If you need to seek support
Before talking with your child health nurse and/or lactation consultant, it can help to record information over a few days about your baby's feeds, their nappy output and their general behaviour.
In a 24-hour period:
How much formula is baby having?
How many breastfeeds?
How much expressed breastmilk?
How many heavy wet nappies is baby having? What colour is baby's urine?
How many poos is baby having? What is their colour and consistency?
How content is baby generally after feeds?
What sort of breast pump are you using?
Answers to these questions will help to work out a plan to increase your breastmilk supply as you gradually wean off the formula supplements.
© Australian Breastfeeding Association April 2022
Find out more about increasing milk supply with ABA's special information booklet:
Find out more about increasing your supply
Evidence-led info and practical tips from our Breastfeeding Information Series