Breastfeeding: Expressing and supplementing

Breastfeeding provides positive outcomes and is recommended by the World Health Organization and Australian health guidelines. While breastfeeding is the physiologically normal way to feed an infant, there are multiple reasons that supplemental feeds (ie feeds given in addition to breastmilk) may need to be given.

The aim of this article is to outline the current evidence and resources to support general practitioners to provide advice on breastfeeding when patients are expressing and supplementing.

There are only a few absolute and relative contraindications to breastfeeding; however, breastfeeding may be disrupted because of lactation risk factors as well as physiological, psychological and socioeconomic reasons. If breastfeeding needs to be supplemented, families can use expressed breastmilk, donor milk or formula. Supplemental devices should be chosen on the basis of cost, ease of use and access, parental preference and preferably a method that aids breastfeeding. If breastfeeding difficulties can be rectified, decreasing supplements can be considered.