Breastfeeding Vs. Formula: Postpartum Considerations

Overview

Welcoming a new life into the world is a transformative experience for parents, and choosing the best feeding option for their newborn is a critical decision that impacts both the baby's and parents’ well-being. Many of us are familiar with the age-old debate, breastfeeding versus formula, but how much do we know about the differences between them and how do we make this decision? 

The postpartum or postnatal period is typically considered to be the time between the birth of the baby and 6-8 weeks after birth, but postpartum recovery can last up to 6 months.¹ Often referred to as “the fourth stage of labour", the changes happening to a postpartum body can have a large and lasting impact on a parent’s health and well-being. These changes can influence decisions about lifestyle and how best to care for their baby, including what method to use for feeding.  

There are many complex factors to consider when deciding how best to feed an infant. This article aims to explore the postpartum considerations of breastfeeding and formula feeding, providing a deep-dive into the benefits, potential risks, and importance of postpartum nutrition and mental health. We hope this advice will support new parents to make informed decisions about their baby’s needs as well as their own. 

Benefits and considerations of breastfeeding 

Nutritional advantages & immune system development for the baby 

The official recommendation from the World Health Organisation (WHO) is for infants to be exclusively breastfed until they are 6 months (or 24 weeks) old, with breastfeeding to continue alongside the introduction of solid foods until 2 years. This is because breast milk has incredible nutritional benefits and contains antibodies that support the baby’s immune system. It contains water, fat, proteins, natural sugars, immune cells, and hormones, all of which are vital for infant brain development and growth. 

Breast milk also has anti-inflammatory and anti-infectious properties. Breast milk can also change its composition to meet the baby’s nutritional needs as the parent’s body receives feedback from its surroundings, including the baby.² 

Some long-term benefits of breastfeeding include:³

• Greater cognitive development 
• Better memory 
• Better cardiovascular health 
• Lower rates of obesity  

Improved recovery for breastfeeding parents 

Beyond providing the best possible nutrition for the newborn, breastfeeding can have a positive impact on the feeding parent and support their recovery. Thanks to the option of pumping and storing breast milk for later use, it doesn’t have to be a restrictive practice.
During breastfeeding, the body produces a hormone called oxytocin, also known as the “love chemical”, and prolactin, which promotes milk production and contributes to the parent and baby bonding.⁴  Oxytocin can also cause the uterus and other pelvic muscles to contract which reduces postpartum bleeding and urinary incontinence.⁵  
Breastfeeding can also support feeding parents in postpartum weight loss, a common goal for many parents who gain a significant amount of weight during pregnancy and may have a negative impact on body image and self-esteem.⁶ 

Physical demand & complications of breastfeeding 

Breastfeeding can be an arduous task and can severely limit the breastfeeding parent’s options in terms of lifestyle choices. Alongside taking care of a newborn baby, breastfeeding parents must focus on their own nutritional needs to maintain the quality and quantity of their milk supply, aid their recovery, and adjust to a daily schedule that can accommodate frequent feeding sessions.⁷ 
Breastfeeding may also present with specific challenges, like difficulties with latching, sore nipples, and engorgement of the breasts. These difficulties are not only physically taxing, which can prolong recovery from birth, but they can also lead to feelings of guilt or shame. This, combined with the lack of sleep and general stress of being a new parent, can lead to postpartum mood disorders, like depression. It is easy to see why so many parents stop breastfeeding despite its benefits.⁸  

Sexualisation of breasts 

The common sexualisation of breasts may also cause some parents to feel uncomfortable with breastfeeding or worry about feeding their infant in public.⁹ In many cases, experiences of sexual trauma can result in breastfeeding parents experiencing complications and discomfort.¹⁰ Some transmasculine parents may also experience dysphoria or similar feelings due to breastfeeding or chest-feeding.¹¹
These concerns are common and should be addressed. It’s important for those close to the breastfeeding parent to be as supportive as possible, and to reach out for professional help when needed. Parents should feel understood and confident. Midwives, lactation consultants, and other natal healthcare providers will be able to advise and support parents through breastfeeding and mental health difficulties.

Benefits and considerations of formula feeding

Convenience & flexibility for families 

Infant formula may not have the same nutritional benefits as breast milk, but it is a practical option for many parents. It offers greater flexibility and rest time for the recovering parent, as other family members and caregivers can prepare the milk formula. Parents who choose to formula feed may find this to be an opportunity for other caregivers to bond closely with the baby.
Parents who formula feed may also experience a faster recovery from pregnancy and childbirth than those who breastfeed, as their bodies don’t have the additional task of producing and expressing milk. 

Easier monitoring of nutritional intake & supplementation

Formula feeding also allows parents to more closely monitor how much milk their baby is consuming as it can be precisely measured. In certain situations, when a baby is born with a health condition, like an allergy or intolerance, formula feeding may be necessary.  

It’s very common for parents to experience a delay in milk production after they have given birth or to have difficulty producing enough milk to feed their babies sufficiently. 

This is more common in parents who have undergone a C-section delivery, or who have a pre-existing health condition, like diabetes. Formula milk provides a solution to this problem by ensuring babies can be adequately fed and continue to develop, even if the parent is experiencing difficulties. 

Cost effectiveness 

Formula feeding does come with the additional costs. The formula itself, as well as bottles and sterilising equipment, needs to be purchased and requires strict adherence to storage guidelines. This may not be appropriate for certain families. 

Stigma around formula feeding

The British Pregnancy Advisory Service (BPAS) suggests that only 1% of babies are exclusively breastfed by 6 months. Despite how common it is to choose formula feeding, parents who make this choice continue to face significant criticism.^12,13 
This harsh judgement may cause feelings of shame and guilt, negatively impacting a parent’s mental health. Unfortunately, this experience is so common that it has led to the development of the ‘Fed is Best’ movement in the USA, in direct opposition to the popular ‘Breast is Best’ slogan often used in healthcare services. 

The message behind ‘Fed is Best’ is to highlight the importance of infants being adequately fed, regardless of the method, due to a rise in babies being admitted to hospital due to insufficient feeding after many healthcare providers adopted an exclusive breastfeeding policy.  

Combination feeding (mixed feeding)

Many parents experience difficulties with exclusive breastfeeding or formula feeding. Combination or mixed feeding offers a solution to some of those difficulties.
Combination feeding involves alternating between breast milk and infant formula based on the parent’s and baby’s needs. Exactly as it sounds, it’s the best of both worlds and can provide a balance between the nutritional benefits of breastfeeding and the convenience of formula, without causing unnecessary stress or pain to the parent.

Postpartum nutrition and self care 

No matter which method of feeding a parent chooses, it is also essential that parents look after themselves.  

Nutrition for breastfeeding parents

Breastfeeding parents will need to support their body’s increased nutritional demands and should try to eat foods rich in the following nutrients: 

• Protein
• Calcium 
• Iron 
• Omega-3 
• Fatty acids 

There are no major dietary restrictions for breastfeeding parents, and a lot of parents restrict certain foods unnecessarily. Unless an infant has a negative reaction, there is no reason for any specific foods to be avoided while breastfeeding.
Despite popular belief, there is no significant evidence to support the idea that consuming alcohol or caffeine will have a negative effect on breast milk production and composition, or the infant’s health.^{14,15,16,17,18}

The importance of rest 

It’s easier said than done, but birthing parents should try to get as much rest as possible in the postpartum period to support their body’s recovery. Sleep deprivation is common with a newborn, so it is vital to ask for help and engage in activities that can provide joy and relaxation to help reduce stress and maintain a healthy emotional balance.  

Summary

Understandably, the decision to breastfeed or formula feed is one that fills many parents with trepidation. Each method offers its advantages and challenges, and parents should make an informed decision based on what works for their circumstances and the best interests of their baby. Breast milk may be considered “liquid gold” but breastfeeding isn’t a viable option for everyone. Combination and exclusive formula feeding are both perfectly acceptable methods of feeding an infant. Ultimately, the most important factors to consider are the health and well-being of both the parent and baby.