20/02/2026
Getting out of the “top-up trap”
The top-up trap is a phrase used to describe the phenomenon where parents are giving formula after each breastfeed because there is a belief that the baby is not getting enough milk from the breast.
The trap is because the baby then feeds less from the breast because:
a) the parents stop putting the baby to the breast before they are full, because they are having the top-up instead
b) in a young baby, formula is slow to digest, so the baby doesn’t feel hunger again as soon as they would otherwise, so the following feed happens later than it would have done.
If the baby is stimulating the breast less often, the breast will not need as much milk making gland tissue, and so it will start to shut some of it down, this means that the breast then is unable to make as much milk as quickly as it was before, so then the baby takes even less milk from the breast. So the amount of milk the baby takes from the bottle increases. This becomes a cycle: the baby takes more and more formula, and less and less from the breast.
So … if you’re in this situation, how do you get back out of it?
Do get help for any of this, you probably need an individualised plan, and it’s important to understand why the top-ups were needed in the first place and remove whatever that problem was too. I'm available for support via this page, also at Cottenham Baby Cafe and at Ely Baby Bank. You could also call the NCT infant feeding helpline on 03003300700 8am - midnight.
Consider how you’re giving the formula:
- it’s important to make sure you are not giving more than is necessary. If you’re using a bottle to feed the formula, then ensure you are giving that in a responsive, paced way. Look for feeding cues, you shouldn’t need to coax the baby to take that bottle: if they are moving their head away, keeping their lips tightly closed, try to respect that decision. If they look stressed (hands and feet splayed, for example) during the bottle feed – slow it down, give them a pause.
It can be hard to feel confident that the baby doesn’t need as much from the bottle – look at nappy output for clues as to whether they are getting enough milk: a newborn should be producing at least 2 dirty and 6 wet nappies per 24 hours after the first 5 days.
An alternative to using a bottle would be to use a lactation aid (https://ibconline.ca/information-sheets/lactation-aid/). This way the additional milk is taken at the same time as the baby is on the breast. As well as speeding up the time for feeds, giving parents more time for other things, it makes time at the breast more productive. The baby maintain strong suckling for longer so stimulating the breast more effectively and this means that the breast responds to producing milk more rapidly.
This more rapid milk production is going to help to reduce the reliance on formula. Like growing sweet-peas for their flowers: if you want more, you need to take away as much as you can as often as you can.
Another way to increase stimulation of the breast so as to increase milk production is to add in some expressing. It’s rarely helpful to replace time with the baby at the breast with expressing so, this option tends to need the mother to have the support to find the additional time. Frequent expressing, perhaps for a few minutes just after the baby has been on the breast, will be sending signals to the breasts to make more gland tissue. https://www.nct.org.uk/information/baby-toddler/feeding-your-baby-or-toddler/expressed-milk-your-questions-answered
For some mother/baby pairs, using a ni**le shield can help them to attach and stay attached and feeding, for longer than they manage without. This will lead to more breast stimulation and higher milk production too https://abm.me.uk/breastfeeding-information/using-a-ni**le-shield-with-a-breastfed-baby/
For some mother/baby pairs, breast compressions help the baby to stay feeding and transferring milk, from the breast, for longer, again, leading to higher milk production. https://youtu.be/60R7pd-HCtE?si=_66jPQ_EwCVzv_d4
