Use of supplementary feeding for medical reasons during breastfeeding in newborns

Introduction. Currently, there are frequent cases of both underestimation of the importance of prescribing additional nutrition to a breastfed child by medical personnel, and unjustified introduction of infant formula, especially during the early neonatal period. The reason obviously lies in the lack of clear criteria for assessing the adequacy of lactation in a nursing mother and medical indications for the introduction of supplementary feeding in current recommendations. The aim of this publication was to analyze the existing literature on the presence of transient conditions in newborns over the early neonatal period associated with insufficient consumption of breast milk and to develop a methodology for their correction through the timely introduction of supplementary feeding with infant formula followed by its discontinuation.

Materials and methods. Implementation of the “Supplemental Feeding for Full-Term Breastfed Newborns” checklist at a perinatal center. Retrospective analysis of medical records.

Results. The introduction of a checklist into the perinatal center’s work, with the registration of the rationale for the introduction and withdrawal of supplementary feeding in medical records, allows, on the one hand, eliminating the unjustified prescription of supplementary feeding to newborns. On the other hand, to promptly identify infants who need of additional nutrition, select the optimal amount, monitor the condition of the newborn and the trend in his body weight and ensure the timely cancellation of supplementary feeding, which contributes to the creation of an effective model for supporting breastfeeding among newborns.

Conclusion. During the neonatal period, there are various conditions, that may require supplemental feeding in the newborn due to insufficient maternal milk. The developed checklist for the purpose of supplementary feeding is a modern technology for maintaining breastfeeding and an important practical step in supporting it from the first day of the life.

Contribution:
Belousova T.V., Skvortsova V.A. — research concept and design;
Lukoyanova O.L., Andryushina I.V., Borovik T.E., Malyutina L.V., Zakharova N.I. — collection and processing of material;
Belousova T.V., Skvortsova V.A., Andryushina I.V., Lukoyanova O.L. — writing the text;
Belousova T.V., Skvortsova V.A. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: November 01, 2025
Accepted: November 27, 2025
Published: December 25, 2025

1. Guidelines «Program for Optimizing Feeding of Infants in the First Year of Life in the Russian Federation». Moscow; 2019. (in Russian)

2. WHO. Guideline: Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services; 2017.

3. Del Castillo-Hegyi C., Achilles J., Segrave-Daly B.J., Hafken L. Fatal hypernatremic dehydration in a term exclusively breastfed newborn. Children (Basel). 2022; 9(9): 1379. https://doi.org/10.3390/children9091379

4. Adamkin D.H. Low blood sugar levels in the newborn infant: Do changing goal posts matter? Semin. Fetal. Neonatal. Med. 2021; 26(3): 101202. https://doi.org/10.1016/j.siny.2021.101202

5. Flaherman V.J., Maisels M.J. ABM Clinical Protocol #22: guidelines for management of jaundice in the breastfeeding infant 35 weeks or more of gestation-revised 2017. Breastfeed. Med. 2017; 12(5): 250–7. https://doi.org/10.1089/bfm.2017.29042.vjf

6. Hannan F.M., Elajnaf T., Vandenberg L.N., Kennedy S.H., Thakker R.V. Hormonal regulation of mammary gland development and lactation. Nat. Rev. Endocrinol. 2023; 19(1): 46–61. https://doi.org/10.1038/s41574-022-00742-y

7. Budanov P.V. Physiology and pathology of lactation. Evraziyskiy soyuz uchenykh. 2019; 66(9-3): 20–33. https://doi.org/10.31618/ESU.2413-9335.2019.3.66.311 https://elibrary.ru/dpqjml (in Russian)

8. Huang Y., Liu Y., Yu X.Y., Zeng T.Y. The rates and factors DPQJML of perceived insufficient milk supply: A systematic review. Matern. Child Nutr. 2022; 18(1): 13255. https://doi.org/10.1111/mcn.13255

9. Boyce J.O., Reilly S., Skeat J., Cahir P. ABM Clinical Protocol #17: guidelines for breastfeeding infants with cleft lip, cleft palate, or cleft lip and palate-revised 2019. Breastfeed. Med. 2019; 14(7): 437–44. https://doi.org/10.1089/bfm.2019.29132.job

10. Baybarina E.N., Ryumina I.I., Klimov A.G., Bitova A.L. Frenulotomy in newborns: pro and contra. Neonatologiya: novosti, mneniya, obuchenie. 2024; 44(2): 69–72. https://doi.org/10.33029/2308-2402-2024-12-2-9-72 (in Russian)

11. Boyle E.M., Mielewczyk F.J., Mulvaney C. Late preterm and early term birth: Challenges and dilemmas in clinical practice. Semin. Fetal Neonatal Med. 2024; 29(6): 101564. https://doi.org/10.1016/j.siny.2024.101564

12. Timofeeva L.A., Kirtbaya A.R., Degtyarev D.N., Sharafutdinova D.R., Coj T.A., Karapetyan A.O., et al. Late preterm infants: do they require neonatal intensive care or not? Neonatologiya: novosti, mneniya, obuchenie. 2016; 14(4): 94–101. https://elibrary.ru/xipnsr (in Russian)

13. Boies E.G., Vaucher Y.E. ABM Clinical Protocol #10 Breastfeeding the Late Preterm (34-36 6/7 Weeks of Gestation) and Early Term Infants (37-38 6/7 Weeks of Gestation), Second Revision 2016. Breastfeed. Med. 2016; 11: 494–500. https://doi.org/10.1089/bfm.2016.29031.egb

14. Timofeeva L.A., Karavaeva A.L., Makieva M.I., Zubkov V.V., Ryumina I.I., Baybarina E.N., et al. Basic care for a fullterm newborn in the delivery room and the scope of activities in the postpartum ward. Updated recommendations, 2024. Neonatologiya: novosti, mneniya, obuchenie. 2024; 12(2): 73–81. https://doi.org/10.33029/2308-2402-2024-12-2-73-81 (in Russian)

15. Kellams A., Harrel C., Omage S., Gregory C., Rosen-Carole C. ABM Clinical Protocol #3: supplementary feedings in the healthy term breastfed neonate, revised 2017. Breastfeed. Med. 2017; 12: 188–98. https://doi.org/10.1089/bfm.2017.29038.ajk

16. Flaherman V.J., Schaefer E.W., Kuzniewicz M.W., Li S.X., Walsh E.M., Paul I.M. Early weight loss nomograms for exclusively breastfed newborns. Pediatrics. 2015; 135(1): e16–23. https://doi.org/10.1542/peds.2014-1532

17. Durrani N.U.R., Imam A.A., Soni N. Hypernatremia in newborns: a practical approach to management. Biomed. Hub. 2022; 7(2): 55–69. https://doi.org/10.1159/000524637

18. Mujawar N.S., Jaiswal A.N. Hypernatremia in the neonate: neonatal hypernatremia and hypernatremic dehydration in neonates receiving exclusive breastfeeding. Indian J. Crit. Care Med. 2017; 21(1): 30–3. https://doi.org/10.4103/0972-5229.198323

19. McKinlay C.J.D., Alsweiler J.M., Anstice N.S., Burakevych N., Chakraborty A., Chase J.G., et al. Children with Hypoglycemia and Their Later Development (CHYLD) Study Team. Association of neonatal glycemia with neurodevelopmental outcomes at 4.5 Years. JAMA Pediatr. 2017; 171(10): 972–83. https://doi.org/10.1001/jamapediatrics.2017.1579

20. Ivanov D.O., Petrenko Yu.V., Tyrtova L.V., Ditkovskaya L.V., Chumakova G.N., Olenev A.S., et al. Neonatal hypoglycemia (draft federal clinical guidelines). Pediatr. 2024; 15(5): 5–23. https://doi.org/10.17816/PED1555-23 https://elibrary.ru/dvecog (in Russian)

21. Suda-Całus M., Dąbrowska K., Gulczyńska E. Infant of a diabetic mother: clinical presentation, diagnosis and treatment. Pediatr Endocrinol. Diabetes Metab. 2024; 30(1): 36–41. https://doi.org/10.5114/pedm.2024.137891

22. Hassan B., Zakerihamidi M. The correlation between frequency and duration of breastfeeding and the severity of neonatal hyperbilirubinemia. J. Matern Fetal. Neonatal. Med. 2018; 31(4): 457–63. https://doi.org/10.1080/14767058.2017.1287897

23. Kemper A.R., Newman T.B., Slaughter J.L., Maisels M.J., Watchko J.F., Downs S.M., et al. Clinical practice guideline revision: management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics. 2022; 150(3): e2022058859. https://doi.org/10.1542/peds.2022-058859

24. Degtyareva A.V., Degtyarev D.N., Golubtsova Yu.M. Non-Hemolytic Jaundice in Newborns [Negemoliticheskie zheltukhi u novorozhdennykh detey]. Moscow: GEOTAR-Media; 2019. (in Russian)

25. Zhdanova S.I., Malinovskaya Yu.V., Yunusova E.F. Establishment of lactation at the early stages, risk factors and prevention of hypogalactia Meditsinskiy sovet. 2018; (11): 39–44. https://doi.org/10.21518/2079-701X-2018-11-39-44 https://elibrary.ru/xsvspr (in Russian)

26. Meek J.Y., Noble L. Section on Breastfeeding. Policy statement: breastfeeding and the use of human milk. Pediatrics. 2022; 150(1): e2022057988. https://doi.org/10.1542/peds.2022-057988

27. Halken S., Muraro A., de Silva D., Khaleva E., Angier E., Arasi S., et al. EAACI guideline: Preventing the development of food allergy in infants and young children (2020 update). Pediatr. Allergy Immunol. 2021; 32(5): 843–58. https://doi.org/10.1111/pai.13496

28. Jaafar S.H., Ho J.J., Lee K.S. Rooming-in for new mother and infant versus separate care for increasing the duration of breastfeeding. Cochrane Database Syst. Rev. 2016; 2016(8): CD006641. https://doi.org/10.1002/14651858.CD006641.pub3

29. Volodin N.N., Degtyareva D.N., eds. Neonatology: A National Handbook. Volume 1 [Neonatologiya: natsional’noe rukovodstvo. Tom 1]. Moscow: GEOTAR-Media; 2023: 74–8. (in Russian)

30. Gavine A., Shinwell S.C., Buchanan P., Farre A., Wade A., Lynn F., et al. Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database Syst. Rev. 2022; 10(10): CD001141. https://doi.org/10.1002/14651858.CD001141.pub6

31. Lukoyanova О.L., Borovik T.E., Skvortsova V.A., Yakovlev Ya.Ya., Nodvikova О.V. Secondary hypogalactia: a modern view on diagnosis and treatment. Meditsinskiy opponent. 2025; 31(3): 22–30. https://elibrary.ru/nswsdf (in Russian)