Breastfeeding Vs Formula 

  • Loise KabiruMSC Global Healthcare Management, Coventry University, UK
  • Yue ZhangB. Sc. in Population Health Sciences, University College London

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Best Milk Alternative

Overview

One of the decisions that all new parents must make is whether to breastfeed or formula-feed their babies, while both options have benefits and challenges. Medical professionals recommend breastfeeding as the optimal choice for both mothers and infants in terms of health benefits. The World Health Organization (WHO) recommends giving your baby nothing but breast milk for at least six months (26 weeks) of life after birth, babies aged six months or more may start taking solid foods alongside breast milk until one to two years or even longer.1

Formula feeding is mainly recommended when breastfeeding is not possible or preferred because of its convenience.

What's in breast milk?

Each drop of breast milk contains thousands of beneficial components, ranging from colostrum, which coats and seals your newborn's stomach lining, to mature milk, which helps your infant grow strong2, other components include:

  1. Antibodies to protect against illnesses
  2. Hormones that promote bonding and regulate appetite3
  3. Stem cells, which may aid in organ development and repair4
  4. White blood cells that fight infection
  5. Good bacteria that protect your infant's digestive system/gut 5
  6. Prebiotics called oligosaccharides that support a healthy gut5
  7. Long-chain fatty acids to help develop your baby's brain, nervous system and eyes6
  8. Enzymes to support the immune and digestive systems7
  9. Nucleotides and hormones that help develop healthy sleep-wake patterns7

What's in the formula?

Baby formula milk is typically made of processed skimmed cow's milk with additional emulsifiers and stabilisers to help fat and water bond together when you prepare the feed. However, the ingredients of the formula might vary by brand and location/country8, therefore the following ingredients may also be found:9

  1. Lactose (a natural sugar found in milk) and/or other sugars such as corn syrup, fructose or maltodextrin
  2. Plant-based oils, such as palm, rapeseed, coconut, sunflower and soybean oil
  3. Fatty acids, usually derived from fish oil
  4. Vitamins and minerals from plant and animal sources
  5. A couple of enzymes and amino acids
  6. Probiotics (in some formulas)9

Breastfeeding

This is the natural process of feeding an infant with milk directly from the mother's breast.

Pros

Mother:

  1. Helps with recovery – Aids in uterine contraction which makes the uterus get back to pre-pregnancy size10
  2. May help with weight loss for some individuals, as production of milk burns extra calories that can lead to weight loss
  3. Breastfeeding aids in maintaining iron levels by delaying the return of menstruation, thereby reducing the risk of iron deficiency postpartum10
  4. Allows your body to release hormones (like oxytocin) that help you bond with your baby11
  5. Lowers risk of some diseases, such as breast and ovarian cancer12, heart disease, and diabetes13
  6. Lowers risk of postpartum depression, a 2018 study indicates that the benefits are even greater when you breastfeed for longer than 4 months14

Baby:

Breastfeeding your baby offers the following benefits. It reduces your baby's risk of:

  1. Infections – Breast milk has protective properties (essential nutrients and antibodies) that help strengthen the immune system
  2. Diarrhoea and vomiting – Breastfed babies are less likely to have an upset stomach since breast milk is easier to digest, promoting a healthy digestive system
  3. Breast milk also naturally contains vitamins and minerals that a newborn requires
  4. Sudden infant Death syndrome (SIDS) also known as cot death
  5. Obesity16
  6. Cardiovascular disease in adulthood
  7. Asthma17
  8. Allergies17

Moreover, breast milk to preterm infants or babies in the neonatal intensive care unit lowers the rate of necrotising enterocolitis (NEC), hence increasing their survival rate and lowering NICU stays.18

Compared to using formula, breastfeeding is also free and reduces any costs associated with buying formula and prep work.

Some studies also suggest that breastfed babies have higher IQ compared to their formula-fed counterparts.19 Moreover, breastfeeding strengthens the connection between mothers and children more than formula feeding.

Cons

Breastfeeding is the healthier choice, but it also comes with some challenges, which can include;

  • Discomfort, especially during the first week. Latch-on pain is normal for the first two weeks and lasts less than a minute. While the pain can be reduced with proper education, support, and practice from a lactation/breastfeeding consultant or doctor, pain with proper latching technique might indicate an ongoing infection that requires a review from experts20
  • The mother might have to limit or keep off some medications, as well as caffeine and alcohol as some substances can be passed through breast milk. Just like during pregnancy, breastfeeding women should avoid eating fish high in mercury. Even a minimal amount of alcohol consumed by a mother may be transferred to the infant through breast milk, therefore mothers should wait for at least two hours after consuming one alcoholic beverage before breastfeeding. Caffeine intake should be limited to no more than 300 mg (about one to three cups of ordinary coffee) per day or fewer because it can make some newborns agitated and restless21
  • As newborns need to be fed frequently, breastfeeding might interfere with the mother's schedule, especially mothers in employment

Recommendations for successful breastfeeding

Learn about proper latching and positioning with the help of a lactation consultant.

In order to support milk production, keep up a balanced diet that includes vegetables and water to maintain hydration.

Practise skin-to-skin contact and feed on demand to enhance bonding and milk supply.

Formula

Manufactured infant formulas provide a nourishing option in lieu of breast milk, and they even incorporate certain vitamins and nutrients essential for breastfed babies, often obtained through supplements.

Commercial formulas are created under sterile conditions and replicate breast milk by blending diverse proteins, carbohydrates, fats, and vitamins that cannot be replicated at home. Consequently, it is crucial to rely solely on professionally produced formulas and refrain from attempting to concoct your own.22

Some of the reasons why some mothers might choose formulas as opposed to breastfeeding include:

Medical concerns

Certain medical conditions or situations might prevent a mother from breastfeeding or make it medically inadvisable. These include infections like active tuberculosis, certain medications that could harm the baby, chemotherapy or radiation treatment, severe maternal illness, breast surgeries or injuries, substance abuse, thyroid disorders, breast cancer treatment, and chronic maternal illnesses affecting breast milk quality. It's crucial for mothers to consult healthcare professionals to assess whether breastfeeding is safe and suitable for their specific circumstances.23

Convenience

The infant can be fed with a bottle at any time by either parent (or another caregiver, though this also applies to women who store their breast milk in bottles). Formula feeding enables the mother to divide the feeding responsibilities and aids in making her partner feel more involved in the vital feeding process and the resulting bonding.

Adaptability

Once the bottles are made, a formula-feeding mother can trust that her kid will be fed if she leaves her child with a partner or caretaker. It is not necessary to organise work, other commitments, or activities around the baby's feeding schedule or to pump breast milk. Additionally, mothers who use formula don't need to find a discreet location to nurse in public.

Pros

  • Another family member or caregiver has the ability to nourish your baby in your absence
  • You have the opportunity to observe the amount your baby consumes during each feeding
  • Formula-fed babies do not require feeding as frequently as breastfed infants
  • During feeding time, fathers, siblings, and other family members can bond with the infant

Cons

  • The formula doesn't provide the same protection against infections, diseases, and conditions as breast milk, as it contains no antibodies
  • You need to mix and prepare the formula to make sure it's the correct temperature
  • Bottles, formulas can be expensive
  • Formula can cause digestive issues such as constipation and gas
  • Access to clean water is necessary for preparing powdered formula, which could pose health concerns depending on the location

Tips for successful formula feeding

  • Choose a formula recommended by healthcare professionals
  • Follow proper hygiene and sterilisation protocols for bottle preparation
  • Pay attention to the baby's cues of fullness to prevent overfeeding

The decision between breastfeeding and formula feeding depends on individual circumstances and preferences. Both methods have their own advantages and disadvantages, and it's crucial for parents to make an informed choice that prioritises the health and well-being of their infants.

FAQ's

Are breastfed babies really healthier than formula fed?

Breastfed babies tend to have certain health advantages over formula-fed babies as breast milk is specifically tailored to meet the nutritional needs of infants, and thus it contains antibodies and other immune-boosting components that protect babies from infections and diseases.

Is formula milk as good as breast?

Formula milk is designed to provide essential nutrients and support infant growth and development, but it is not identical to breast milk. While formula milk aims to imitate breast milk in terms of nutritional components, certain unique properties of breast milk cannot be replicated in formula.

Is 4 oz of breastmilk the same as 4 oz of formula?

While 4 ounces of breast milk and 4 ounces of formula measure the same volume, they are not exactly the same in terms of composition and nutritional content.

What are the disadvantages of formula feeding?

Formula feeding has several potential disadvantages compared to breastfeeding. These include

  • Differences in nutrient composition
  • Higher costs
  • Preparation and storage demands
  • Reduced bonding opportunities
  • The absence of natural immune protection and potential cognitive benefits from breast milk
  • Increased allergy and sensitivity risk
  • Increased risks of digestive issues like constipation and gas
  • Slightly elevated risk of ear infections and respiratory illnesses

The decision to formula-feed should consider individual circumstances, and parents should consult healthcare professionals for informed choices.

Summary

Health experts recommend breastfeeding due to its various advantages, including health benefits for both mother and baby, cost-effectiveness, and potential cognitive benefits. However, it can also present challenges such as discomfort and dietary restrictions. Formula feeding offers convenience and shared caregiving responsibilities but lacks some protective properties of breast milk and involves careful preparation. The decision depends on individual circumstances, and both methods aim to prioritise the well-being of the infant.

References 

  1. Breastfeeding [Internet]. [cited 2023 Aug 18]. Available from: https://www.who.int/health-topics/breastfeeding
  2. Palmeira P, Carneiro-Sampaio M. Immunology of breast milk. Rev Assoc Med Bras [Internet]. 2016 Sep [cited 2023 Aug 18];62:584–93. Available from: https://www.scielo.br/j/ramb/a/QZDBjJ8VTYpWVpXs6RxVjrF/
  3. Mazzocchi A, Giannì ML, Morniroli D, Leone L, Roggero P, Agostoni C, et al. Hormones in breast milk and effect on infants’ growth: a systematic review. Nutrients [Internet]. 2019 Aug 9 [cited 2023 Aug 18];11(8):1845. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6724322/
  4. Verduci E, Banderali G, Barberi S, Radaelli G, Lops A, Betti F, et al. Epigenetic effects of human breast milk. Nutrients [Internet]. 2014 Apr [cited 2023 Aug 18];6(4):1711–24. Available from: https://www.mdpi.com/2072-6643/6/4/1711
  5. Boudry G, Charton E, Le Huerou-Luron I, Ferret-Bernard S, Le Gall S, Even S, et al. The relationship between breast milk components and the infant gut microbiota. Frontiers in Nutrition [Internet]. 2021 [cited 2023 Aug 18];8. Available from: https://www.frontiersin.org/articles/10.3389/fnut.2021.629740
  6. Isaacs EB, Fischl BR, Quinn BT, Chong WK, Gadian DG, Lucas A. Impact of breast milk on IQ, brain size and white matter development. Pediatr Res [Internet]. 2010 Apr [cited 2023 Aug 18];67(4):357–62. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2939272/
  7. Kim SY, Yi DY. Components of human breast milk: from macronutrient to microbiome and microRNA. Clin Exp Pediatr [Internet]. 2020 Mar 23 [cited 2023 Aug 18];63(8):301–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402982/
  8. Zhao J, Li M, Freeman B. A baby formula designed for chinese babies: content analysis of milk formula advertisements on chinese parenting apps. JMIR mHealth and uHealth [Internet]. 2019 Nov 29 [cited 2023 Aug 18];7(11):e14219. Available from: https://mhealth.jmir.org/2019/11/e14219
  9. Green Corkins K, Shurley T. What’s in the bottle? A review of infant formulas. Nutr Clin Pract [Internet]. 2016 Dec [cited 2023 Aug 18];31(6):723–9. Available from: http://doi.wiley.com/10.1177/0884533616669362
  10. Manisha JP, Kumari N, Sarkar U. STUDY OF EARLY INITIATION OF BREASTFEEDING AND IT'S OUTCOME ON THIRD STAGE OF LABOUR. Int J Acad Med Pharm. 2023;5(3):1301-4.
  11. Uvnäs­Moberg K, Ekström-Bergström A, Buckley S, Massarotti C, Pajalic Z, Luegmair K, et al. Maternal plasma levels of oxytocin during breastfeeding—A systematic review. PLOS ONE [Internet]. 2020 Aug 5 [cited 2023 Aug 18];15(8):e0235806. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235806
  12. Chowdhury R, Sinha B, Sankar MJ, Taneja S, Bhandari N, Rollins N, et al. Breastfeeding and maternal health outcomes: a systematic review and meta-analysis. Acta Paediatr [Internet]. 2015 Dec [cited 2023 Aug 18];104:96–113. Available from: https://onlinelibrary.wiley.com/doi/10.1111/apa.13102
  13. Prentice AM. Breastfeeding in the modern world. Annals of Nutrition and Metabolism [Internet]. 2022 Jun 9 [cited 2023 Aug 18];78(Suppl. 2):29–38. Available from: https://doi.org/10.1159/000524354
  14. Borra C, Iacovou M, Sevilla A. New evidence on breastfeeding and postpartum depression: the importance of understanding women’s intentions. Matern Child Health J [Internet]. 2015 Apr 1 [cited 2023 Aug 18];19(4):897–907. Available from: https://doi.org/10.1007/s10995-014-1591-z
  15. Jin X, Perrella SL, Lai CT, Taylor NL, Geddes DT. Oestrogens and progesterone in human milk and their effects on infant health outcomes: A narrative review. Food Chemistry [Internet]. 2023 Oct 30 [cited 2023 Aug 18];424:136375. Available from: https://www.sciencedirect.com/science/article/pii/S0308814623009937
  16. Savino F, Liguori SA, Fissore MF, Oggero R. Breast milk hormones and their protective effect on obesity. Int J Pediatr Endocrinol [Internet]. 2009 Dec [cited 2023 Aug 18];2009(1):1–8. Available from: https://ijpeonline.biomedcentral.com/articles/10.1155/2009/327505
  17.  Herrmann K, Carroll K. An exclusively human milk diet reduces necrotizing enterocolitis. Breastfeed Med [Internet]. 2014 May 1 [cited 2023 Aug 19];9(4):184–90. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025624/
  18. Brahm P, Valdés V. The benefits of breastfeeding and associated risks of replacement with baby formulas. Revista chilena de pediatria. 2017 Feb 1;88(1):7-14.
  19. Bar S, Milanaik R, Adesman A. Long-term neurodevelopmental benefits of breastfeeding. Curr Opin Pediatr. 2016 Aug;28(4):559–66
  20. Bourdillon K, McCausland T, Jones S. Latch-related nipple pain in breastfeeding women: the impact on breastfeeding outcomes. British Journal of Midwifery. 2020 Jul 2;28(7):406-14.
  21. CDC. Diet considerations for breastfeeding mothers. [Internet]. Centers for Disease Control and Prevention. 2023 [cited 2023 Aug 19]. Available from: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/diet-and-micronutrients/maternal-diet.html  
  22. Martin CR, Ling PR, Blackburn GL. Review of infant feeding: key features of breast milk and infant formula. Nutrients [Internet]. 2016 May [cited 2023 Aug 19];8(5):279. Available from: https://www.mdpi.com/2072-6643/8/5/279
  23. Lawrence RA, Lawrence RM. Breastfeeding: a guide for the medical professional. Elsevier Health Sciences; 2021 Apr 17.

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Best Milk Alternative
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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Loise Kabiru

MSC Global Healthcare Management, Coventry University, UK

She has several years of experience in both clinical practice and healthcare administration. Her passion lies in simplifying intricate medical concepts and translating complex information into clear, engaging messages tailored for diverse audiences. Through her unwavering dedication, Dr. Kabiru effectively communicates critical research findings and fosters collaboration and understanding within the healthcare community.

She has a track record of impactful communication and has received accolades for her efforts in bridging the gap between medical expertise and public understanding. Inspired by her experiences in the healthcare field, she is driven by a deep commitment to improving healthcare outcomes and ensuring that vital information is accessible to all. Her approachable demeanour and genuine enthusiasm for healthcare communication make her a go-to expert in the field.

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