Avoiding the Top-Up Trap: How Formula Feeds Can Undermine Breastfeeding — and What You Can Do Instead

If you’re a new parent feeling anxious about whether your baby is getting enough milk — you’re not alone. It’s one of the most common concerns we hear as lactation consultants. And when in doubt, many parents understandably reach for a bottle of formula to “top up” their baby after breastfeeding.

But this well-meaning move can unintentionally lead to what we call the Top-Up Trap — a cycle that can actually decrease your milk supply and create the very problem you were trying to avoid.

One of our expert consultants at SACLC recently put together a brilliant visual to explain how this cycle works, and we’re expanding on it here to help you understand the process — and most importantly, how to get support before getting caught in the trap.

What is the Top-Up Trap?

Here’s how it usually unfolds:

You think you don’t have enough breast milk.

Maybe baby is fussy, feeding often, or not sleeping as expected. These behaviors are totally normal — but they can trigger worries that your milk isn’t enough.

You give baby a top-up bottle of formula.

This seems like a quick fix. Baby takes the bottle, settles down, and you feel reassured… for now.

Baby prefers the easy flow of the bottle.

Bottles often deliver milk faster and with less effort than the breast. This can lead to nipple confusion or flow preference, where baby starts rejecting the breast in favor of the bottle.

Your breast isn’t being stimulated.

Breast milk works on supply and demand. When baby skips a feed or suckles less, your body gets the signal to produce less milk.

Baby starts refusing the breast.

This can be emotionally distressing, and it often leads to more top-up feeds, further reducing breast stimulation.

Your milk supply drops.

And suddenly, it feels like you really don’t have enough milk — confirming your original fear, even though it was the top-ups that triggered the problem.

And just like that, you’re stuck in the Top-Up Trap.

What Can You Do Instead?

The most important step is this: Talk to a lactation consultant before you top up.

Many common concerns around milk supply can be managed with good information and the right support. For example:

• Is baby’s latch effective?

• Are they having enough wet and dirty nappies?

• Are they gaining weight appropriately?

• Are they feeding frequently enough to stimulate your supply?

Often, what looks like low supply is actually a normal pattern of feeding or a minor issue that can be corrected — no formula needed.

There Are Times When Supplementing Is Necessary

There are definitely situations where top-ups are needed — for medical reasons, low weight gain, or milk supply issues that don’t resolve with adjustments. But even then, a lactation consultant can help you supplement strategically while protecting and rebuilding your milk supply.

There’s no one-size-fits-all solution — but there is help available.

Final Thoughts

Breastfeeding is a learned skill, for both you and your baby. If you’re feeling unsure, overwhelmed, or frustrated, reach out. You don’t have to figure this out alone.

A huge thank you to one of our own SACLC consultants for creating the insightful graph that inspired this post. You can learn more about her work and get in touch via her website: www.loveandbreastmilk.com 

And remember: before reaching for that top-up, reach out for support.