“Dessert at the Breast”
Bottle Feeding First and Finishing with Breastfeeding
When a mother has very low supply, people tend to tell her she doesn’t make “enough” milk to breastfeed, so she needs to give up—but this is not true. The “dessert at the breast” method runs counter to the usual advice on combination feeding where bottle feeding occurs mostly after nursing. With this method, the goal is still to meet a baby’s full nutritional requirement but finishes the meal at the breast.
The rationale for this method is that if a baby starts off at the breast with a very limited supply, when a baby is most hungry, this may result in frustration when the milk runs out. Over time, this negative association could result in breast refusal. By reversing the order, we can keep the baby associating comfort and satisfaction with being latched at the breast.
In addition to feeling satisfied at the breast, they have the freedom to continue to comfort feed, where they suckle but receive minimal milk; after all, pacifiers make no milk, but many babies love them anyway.
“This is my second low-supply nursling; not just low, dramatically low. I wasn’t sure we’d make it this long and I’m thrilled to have made it over three years nursing this sweet baby! I just want moms struggling with low supply to know that your nursing relationship is more than the number of ounces you produce, and you can have a successful nursing relationship even producing very little milk. Many thanks for teaching me the ‘Finish at the Breast’ method!” —Joanna Kwaloff-Vedaa
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Do you want to learn more about breastfeeding while ensuring safe and adequate feeding?
Dr. Christie and board-certified lactation consultant Lynnette Hafken have just released the online Fed Is Best Breastfeeding Course, where they discuss all the things that you will not hear from a breastfeeding book or class. In it they include secret tips and tricks that you normally have to pay hundreds of dollars to learn about, for the same cost of a hospital breastfeeding class. Click below to get in on the training!
Dessert at the Breast Method
- Figure out how much milk your baby needs per feed. This should be about 2.5 oz per pound per day or 5.5 oz per kg per day, divided by 8 if feeding every 3 hours, see the Daily Milk Calculator. Underweight babies may need more to catch up on growth; talk with their doctor. Although, do not limit the amount your baby gets first in hope they will breastfeed longer to increase your supply; this does not work and just prolongs the process.
- Estimate how much you are producing in a day by logging weighted feeds or by pumping and bottle feeding your breast milk for 24 hours with a high quality double electric pump; divide your daily production by the number of feeds/day to estimate your breast milk volume output per feed
- Subtract the amount you produce per feed from your baby’s total need per feed.
- Offer them that supplemental volume of formula before breastfeeding.
- Breastfeed on both sides.
- If your baby still seems hungry after that, give them what they need by bottle until they are full; at the next feeding, give 0.25–0.5 oz more in the pre-nursing bottle.
- If you think your breasts are not adequately drained, you may pump to ensure they are.
- If your baby has finished on the breast and left a significant amount of milk over, for the next feed, decrease the pre-nursing bottle by 0.25–0.5 oz and pump again to see whether they have fully drained the breast. (You decide what is a “significant amount” of milk; some mothers wish to get every milliliter, while others may prefer to use this time for something other than pumping, even if it impacts their overall supply.)
- We recommend weighing your baby twice a week until you’ve established a pattern, then weekly for a few weeks, then monthly, or as recommended by your pediatrician.
To learn more about this topic, read the Fed Is Best book available on paperback, e-book, and audiobook.