Fortifying Breast Milk: What You Need to Know

Courtney Lee MS, RDN, CLT, CFCS

Fortifying breast milk has become a topic of interest for breastfeeding moms although the concept isn’t new. In the not-too-distant past, we were adding baby cereals to bottles and cutting open wider nipples for babies before bed to increase caloric intake. Healthcare providers know now that we shouldn’t be giving babies extra calories that way, but what is appropriate for increasing caloric intake for breast-fed babies?

Breast milk is the best source of nutrition for babies for many reasons. Breast milk has the perfect macronutrient profile to support baby’s nutrient needs, it’s easy to digest, and it passes mom’s immunity to baby. Breast milk is produced on demand — milk supply is directly related to how much baby is breastfeeding. Breast milk is the preferred milk for all babies — including those born prematurely and with medical conditions. If breast milk is so great, why would it need to be fortified?

Does Breast Milk Need To Be Fortified?

Actually, breast milk rarely does need to be fortified. It is rare for a breastfeeding mom to be unable to produce enough milk to support her baby’s growth or that the nutritional quality of the breast milk would need enhancement. The exceptions would be for vitamin D and iron.

Breastfed babies generally need a vitamin D supplement, and an iron supplement may be needed after six months of age in healthy babies. But when it comes to calories, needing fortification of breast milk is rare. The way to know if baby needs some extra calories is by his or her growth. If baby is growing, no supplementation is needed. If baby is not growing (according to your pediatrician), baby needs supplementation. This most often occurs in premature babies when they experience rapid growth spurts.

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Breast Milk Fortifying Options

Fortifying breast milk is the first-line treatment for increasing calories in babies under six months of age. This allows the baby to still receive all the benefits of breast milk plus additional nutrients, as opposed to the exclusive use of formula first.

Commercially prepared human breast milk fortifiers are available in liquid and powder form. Breast milk can also be fortified by adding powdered formula to it and giving the combination in a bottle. It is not appropriate to use cow’s milk or other milk alternatives to fortify breast milk.

Remember, unless the pediatrician believes that a child’s growth is inadequate, breast milk typically doesn’t need to be fortified. If baby does need some additional nutrients, encourage moms not to give up on breastfeeding! It’s the best nutrition for baby. If fortification is needed, determine the best method for both mom and baby before switching to formula.

Want to learn more? Check out more resources for dietitians on this topic from Dietitians On Demand.

Are you a consumer looking for more pregnancy and breastfeeding nutrition information? Check out these courses from our new branch, Dietitians On Demand Direct:

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Courtney Lee, MS, RDN, CDN, CLT, CFCS consults locally with Dietitians On Demand and also has a virtual private practice, Kitchen Nutrition, LLC. Courtney enjoys equipping dietitians and dietetic interns with the tools they need for professional success so they don’t have to learn the hard way. Courtney enjoys baking, running, and hosting friends and family in her home.
Find her on Instagram @yourkitchennutrition.

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