feeding milk

Should I formula feed at night?

You don’t have to be a health expert to know that when it comes to baby feeding, breastfeeding is the best option for most babies. Besides being extremely low-cost, breastfeeding provides a whole host of health benefits to both mom and baby. But let’s be honest — if you have a baby who’s still waking frequently at night, the benefits of breastfeeding are probably among the last things you’re thinking about during those middle-of-the-night feedings! Instead, you’re probably thinking about how tired you are, and wondering how on earth you can get your baby to start sleeping more at night. You may be even feeling like you’re a worse parent because of it.

Some breastfeeding moms may find themselves wondering if the formula is the solution to their problems. They wonder if adding a bit of formula to their baby’s diet might encourage sleep. And a few particularly exhausted moms may toy with the idea of switching to formula altogether as the solution to their babies’ night waking.

Most babies are wired to sleep for short periods. The sleep pattern of frequent night awakenings is typical for babies during their first year of life and likely protects against sudden infant death syndrome (SIDS). Frequent awakenings are a biological necessity for infants and—as tired as parents may feel as a result—are a positive sign of your baby’s overall health and safety.

Your baby may wake at night for several reasons—because he’s hungry, thirsty, lonely, cold, sick, needing a diaper change, or just missing you. Offering a bottle will only directly satisfy the first two needs.

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Will giving my baby formula keep them fuller for longer?

Short answer – yes and no.

Breastmilk and formula both contain carbohydrates, fats, protein and minerals which babies need for physical and mental growth and development. Aside from the obvious differences, breastmilk and formula contain different types of these components which significantly sets them apart.

Protein is the molecule in milk which we consider to be important for satiety (feeling full). Breastmilk protein consists primarily of whey. Whey is easily absorbed by the baby’s immature gut and provides important nutritional factors which contribute to overall gut health. It also contains sleep-inducing factors which encourage babies to sleep. However, because breastmilk is so easily digested, babies wake to feed more frequently. Formula protein consists primarily of casein which is harder for babies to digest and therefore, keeps them fuller for longer. However, the formula increases the risk of an inflammatory response in the gut which can give babies excess wind, bloating and pain – all of this means no extra sleep for poor mum and dad.

feeding milk

Will giving my baby formula help them sleep longer?

Short answer – no.

As mentioned above, breast milk is so easily digested that breastfed babies will frequently wake to feed in the early months. They are biologically programmed this way for their survival. However, it is possible to reduce the amount of night waking and eventually, help baby sleep through the night. All babies will need to feed during the night for the first few months. However, once babies are over five months old, their stomachs are larger, and they are able to last longer stretches without milk. Also, sleep patterns change considerably, and ALL babies will wake 4-6 times during the night. The key here is to teach baby to settle without needing to feed (and ideally without your help). For more information on teaching your baby to self-settle, click here. A recent Harvard University study has shown that babies who are breastfed but do not wake to feed during the night sleep significantly longer than breastfed babies who wake to feed during the night.

Giving formula as an alternative when breastmilk is available is no guarantee that your baby will sleep longer. In reality, you’re playing Russian roulette as it could potentially have unwanted side effects for your baby and cause them to wake even more frequently for comfort.

Although the American Academy of Pediatrics recommends exclusive breastfeeding until a baby is at least six months old, supplementing with formula also has benefits. Breastfeeding during the day and bottle-feeding at night allows you to get more sleep since it lets your partner participate more in feeding your infant. Babies who receive enough formula at night also may not require the vitamin D supplementation like infants who are exclusively breastfed. If you have any specific questions or concerns about the process, contact your doctor or lactation consultant for advice.

Wait until your breast milk is established before supplementing with formula. Wait until your baby is one month old to help avoid nipple confusion because the sucking actions required during breastfeeding and bottle-feeding are different, explains KidsHealth.

Purchase a formula that is appropriate for your infant. Most infants do well with a formula based on cow’s milk that contains DHA and iron, but infants with a milk allergy or sensitivity may require a formula made from soy. Ask your health care practitioner if you are unsure about which type to use.

Prepare the bottle of the formula by following the label on the package. The specific preparation depends on whether you use powder, liquid or ready-to-feed formula. Bottles made with formula stay fresh for up to 24 hours under refrigeration.

Find someone else to feed the baby the bottles of formula at night, if possible. Minimize the likelihood of your baby wanting you to give her a bottle instead of your breast during the day by letting her believe you only provide milk while others only provide formula, suggests KidsHealth.

Offer your baby the bottle of formula at night instead of your breast. If your baby typically eats several times throughout the night, replace one of the feedings at a time and gradually move toward having all the nighttime feedings from the formula.

Express your milk at night. If you would like to minimize your milk production at night, express just enough to prevent you from feeling engorged or uncomfortable. If you would like to encourage your body to keep producing milk throughout the night even though you aren’t nursing, use a breast pump and save the milk you collect for daytime use.

Will Adding or Switching to Formula Help Baby Sleep?

We can answer this question in two words: probably not. If you’re breastfeeding and having issues with your milk production, and if your baby isn’t getting enough to eat as a result, then formula may help your baby sleep better, simply because it would give her the nourishment that she isn’t getting from nursing. However, this isn’t a problem for most nursing moms. Oftentimes, when moms think they’re experiencing low milk production, they aren’t. If your baby is nursing just fine, then adding a bottle of formula in here and there, or switching to formula altogether, isn’t likely to help her sleep any better.

The logic behind assuming formula will help baby sleep is easy to trace. The formula takes longer for a baby’s system to digest than breastmilk; for this reason, formula-fed babies tend to need fewer feedings per day than do breastfed babies. What’s more, babies tend to drink more from a bottle than they do from a breast. Add all of this together, and it’s easy to assume that formula-fed babies must sleep far better than breastfed babies since they won’t wake as much from hunger.

Should You Switch To Formula?

Some breastfeeding moms reach a point of desperation and begin wondering if weaning their babies completely to the formula is the solution for a better night’s sleep. This isn’t a strategy that we recommend. Instead, we recommend that you continue nursing and begin to work on establishing good, healthy sleep habits with your baby.

Breastfeeding baby another side note: other breastfeeding moms may consider making the switch to formula for a different reason — they may be feeling pressure to switch because their babies aren’t gaining weight “properly”, or maybe even because a pediatrician has started using the “failure to thrive” label when discussing their babies’ growth. This can be scary for moms; on the one hand, they want to breastfeed, but on the other hand, they fear their baby isn’t getting enough nourishment. If you’re in this position, you may be wondering, “Should I just give up nursing and switch to formula?”

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Can a bedtime bottle help my baby sleep through the night? 

It’s a common misconception that a bottle of formula before bedtime will help baby sleep through the night. Formula won’t change your baby’s sleep habits. There’s even some evidence that babies given formula at night sleep less than those who are breastfed.

Is bottle-feeding at night healthier for my baby? 

Bottle-feeding is associated with a higher risk of childhood obesity. In part, that may be because a bottle-fed baby will often drink for as long as the bottle nipple is in his mouth. He doesn’t learn self-regulation as easily as the breastfed infant because he takes a more passive role in feeding. By contrast, a breastfed baby actively removes milk from the breast and can control how much he gets at the breast by changing the way he nurses.

If I do bottle-feed at night, how can I avoid overfeeding my baby? 

Crying can be a sign that your baby is hungry. The younger your baby is, the more likely it is that she’s hungry and needs to be fed.

But your baby may cry for other reasons too. Before offering the bottle, you may want to check her diaper and offer comfort in the form of rocking or a back rub. If your baby’s skin feels warm, check her temperature to see if she has a fever.

If she does appear hungry, try offering just an ounce or two of breast milk or formula (or whatever amount you normally put in the bottle). Hold your baby close, and watch for signs that she’s had enough (turning away from the nipple, falling asleep, spitting up milk, and generally acting fussy).

Can I put my baby to bed with a bottle? 

You should never put your baby to bed with a bottle. Caregivers who hold their babies during bottle-feeding enjoy better nonverbal communication and emotional bonding with their children. And there are several health and safety reasons not to put babies to bed with a bottle:

  • Your baby might choke. Babies who fall asleep while drinking from a bottle can draw liquid into their lungs and choke. 
  • Your baby’s teeth may decay. When babies are put to bed with bottles or when they are given their bottles as pacifiers, sugary liquids pool around the teeth while they sleep. Bacteria in their mouths use the sugars as food and produce acids that attack the teeth. In the most serious cases, the front teeth can rot completely and need to be removed. (Learn more about oral care for your baby here.)
  • Your baby may have more ear infections. A baby’s ear anatomy is not fully developed. Drinking while lying down can cause milk to flow through your baby’s ear cavity, which can cause ear infections.

Should You Supplement With Formula?

Other breastfeeding moms want to continue nursing but wonder about “topping off” with a bottle of formula sometimes (like right before baby goes to bed for the night). It’s perfectly fine to combine formula feeding and breastfeeding if you are okay with it. You can even mix powdered formula with breastmilk. Keep in mind that any amount of breastfeeding is beneficial for your baby.

That said, there are three things to be aware of when you “top off” with the formula:

  • If you regularly offer bottles of formula while nursing, it may affect your milk supply, since nursing is a “supply and demand” process. Your baby will need less breastmilk if he regularly gets a bottle of formula each day, which will lead to a drop in supply.
  • If your baby is newborn, switching back and forth between breast and bottle can cause nipple confusion which is when your baby may become frustrated at the breast when they go back and forth between breast and bottle. Consider waiting to offer any formula until nursing is well-established (usually in the first 4 – 6 weeks); at that point, nipple confusion shouldn’t be a concern.
  • Remember that formula is harder to digest than breastmilk and contains ingredients that your baby may not yet be able to digest easily. This means that formula can lead to digestive issues, like gas and constipation. And those digestive issues can make your baby’s already-problematic nighttime sleep even worse!

Tips

Babies who are breastfed require a vitamin D supplement of 400 IU a day, even if they are getting a few bottles of formula a day. However, if your baby gets at least 32 oz. of formula in a 24-hour period, she no longer needs a vitamin D supplement.

Warnings

If your baby develops diarrhea, vomiting, scaly or red skin, extreme fatigue, or weakness after consuming formula, call a doctor. This may be a sign of an allergy to the formula.

Change the Sleeping Habits, Not the Food Source!

While there are a few families we’ve come across who notice a marked improvement in sleep after night weaning, ultimately, changing your baby’s food source probably won’t help him sleep any better. Don’t let that discourage you, though! Even though the solution to your baby’s sleep issues might not be as straightforward and simple as adding or switching to formula, rest assured that there is a solution. And we can help you find it! Why not try a personalized, one-on-one consultation with one of our expert sleep consultants?

What Is The Natural Sleep Pattern For Babies?

It is hard not to look at the evidence and conclude that, much to the dismay of exhausted parents, nature did not intend for babies to sleep through the night reliably. Evolutionary psychologists have even argued that infants nurse at night to prevent their mothers from becoming pregnant again. A younger sibling uses up precious resources, threatening the baby’s health and survival.

The mother’s reproductive fitness is in conflict with her baby’s fitness, according to this theory. A mother’s reproductive fitness is maximized by having relatively short intervals between births (the risk of child mortality is higher, but a larger total number of children survive). But the baby’s survival is maximized by a long interval between his or her birth and the next birth.

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The Bottom Line

Natural or not, breastfeeding usually entails many additional months of broken sleep, and a prolonged period of broken sleep can make caring for a new baby, returning to work–and just about every aspect of existence–pretty miserable. As I can personally attest, suffering through months of broken sleep is not only about fatigue or a mild mental fogginess that can be masked by an extra cup of coffee–or four. Consistently poor sleep heightens hostility, clouds our thinking, adds stress to the already major stress of caring for a baby and–not surprisingly–increases the likelihood of postpartum depression. These problems are bad for mothers and bad for our babies.

So yes, women should certainly be told about the positive effects of breastfeeding. But it is offensive, paternalistic, and intellectually dishonest to provide false or cherry-picked information on breastfeeding’s downsides. These downsides exist. And no one benefits from brushing them under the rug.

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