1.5 L-CERPs + 1.5 CEUs

Turn Up the Volume: Managing Supplementation

Rebecca Costello, IBCLC, MPH

Start learning now

Start learning now

Course description
Our first goal as an IBCLC is to “feed the baby!” But how do we know we are feeding the baby enough? What is appropriate weight gain? If we see a baby gaining weight poorly, how do we tell if it’s due to poor intake? How do avoid overfeeding when supplementing, and tell if a baby is being overfed by other caregivers?
Standard ranges of like 19-30 oz or averages of 24-25 oz are quite broad and difficult to apply to specific situations. In this talk, we discuss the evidence for individualizing intake needs for each baby, how to do so, ways to split up or combine supplementation amounts to simplify routines, and how to adjust and wean supplement over time. 
These skills are vital in a range of clinical situations including excess weight loss and poor weight gain, low milk production, transitioning NICU graduates to direct feeding, separation from the nursing parent, and more. The talk will conclude with a number of clinical scenarios that allow the learner to apply and practice these skills.
🎉 BONUS: Self-study questions to deepen your understanding.
Knowledge Gap

Understanding individualizing infant intake needs and optimal infant weight gain.



Describe appropriate expectations for infant growth based on World Health Organization growth charts.


Estimate supplementation needs based on current weight gain and feeding observations.


Identify signs of overfeeding and describe strategies to manage.
IBLCE Content Outline
I. A. 11 Term development and growth
I. A. 12 WHO growth charts with gestational age adjustment
V. 4 Employment - returning to work
VI.9 Test-weighing
VII. A. 6 Scales
Excellent presentation, loved the visual examples & case study :)
Sonya Horan, IBCLC

Course Lessons

Meet the Instructor

Rebecca Costello


Rebecca began her lactation journey with her undergraduate senior thesis evaluating a breastfeeding education program. After working as a doula and childbirth educator, she decided to pursue a Master’s in Public Health in Maternal and Child Health. There, she was also in the first class of the Mary Rose Tully Training Initiative, a Pathway 2 IBCLC training program.

After graduating, she first worked full time as an IBCLC in a large academic hospital. She then became the Director of Lactation Services at a busy freestanding birth center. After making the move to a new state, she went into private practice part-time, and expanded her focus on a longtime passion: providing education for IBCLCs, lactation trainees, and health care providers.

She also has special interests in research, support for the LGBTQ+ community, and coalition-building to advance and support IBCLC services.
Patrick Jones - Course author
Very clear information with helpful tools to make more specific/directed feedback for families.
Maria Peddy, IBCLC
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