Breastfeeding vs Formula

When comparing formula feeding to breastfeeding options, most experts agree that breastfeeding is the preferred choice for infant feeding and nutrition. But there are also reasons why a mother may have to formula feed or supplement breastfeeding with formula, and these options still provide adequate nutrition for your baby. Each type of feeding has its advantages and challenges, and mothers should discuss these with their medical provider.

“Breastfeeding is the healthiest way to feed a baby, and it provides great benefits for the mother as well. However, certain reasons exist that make formula feeding a necessary alternative,” according to family physician, Jennie Stanford.

There are instances when a mother may have no choice but to formula feed a baby or supplements breastfeeding with formula. Medical reasons include HIV infection in the mother, or a condition called galactosemia in infants, according to the American Academy of Pediatrics. In other cases, mothers who are taking medications or have other medical issues may not be able to breastfeed. More often, mothers may have other reasons they choose not to or cannot breastfeed.

Babies born prematurely or babies with difficulty thriving may have special dietary needs. In these cases, a pediatrician may recommend baby formula feeding or supplementing breast milk with formula.

Research has shown breastfeeding has several health advantages for both the infant and mother, such as better immunity for the baby and decreased breast cancer risk for the mother. The American Academy of Pediatrics (AAP) recommends that, if possible, infants be breastfed exclusively for at least six months and then transitioned to breastfeeding with complementary foods for at least the first year.

The World Health Organization (WHO) says that breast milk is clean and safe, and it helps support a healthy immune system. Breast milk has also been shown to provide future developmental benefits for children and helps them to stay healthier as they age. Babies who are breastfed have a decreased risk of several childhood illnesses, which may last into adulthood. Breastfed children also perform better in intelligence tests, according to WHO.

A mother’s breast milk changes specifically for the baby’s needs as it grows, and a premature baby’s mother’s milk contains extra nutrition for at least the first few weeks. Even donor breast milk can provide many of the same benefits as the mother’s milk.

Mothers also benefit from breastfeeding their children. Breastfeeding lowers a mother’s risk of ovarian cancer, breast cancer, Type 2 diabetes and high blood pressure, according to the Centers for Disease Control and Prevention. Breastfeeding has also been shown to help mothers achieve a healthy weight after pregnancy.

In addition, the AAP says breastfeeding may decrease the risk of rheumatoid arthritis and excessive menstrual blood loss. Be sure to check with your medical provider for more health information on breastfeeding.

While breastfeeding is the recommended way to feed babies, breastfeeding challenges, such as the baby’s health or medical conditions of the mother, may make it difficult or impossible to breastfeed. Breastfeeding may also cause uncomfortable issues, such as fungal infections, nipple soreness, or mastitis.

According to one study published in Nutrients, “Around 70.3% of mothers experienced breastfeeding difficulties, reporting cracked nipples, perception of insufficient amount of milk, pain, and fatigue. Difficulties occurred mostly within the first month.”

Premature babies may have a difficult time breastfeeding because being underdeveloped makes it harder for them to coordinate suck, swallow and breathe actions. They may also need more nutrients than those occurring naturally in breast milk. In these cases, your preemie’s doctor may recommend supplementing breast milk with preemie formula or exclusive formula feeding.

Mothers taking certain medications shouldn’t breastfeed. For example, breastfeeding is contraindicated for mothers going through chemotherapy. Make sure to tell your doctor if you are taking any medications if you plan to breastfeed to make sure it’s safe to do so. The National Library of Medicine provides a drug database for breastfeeding safety.

Other challenges include low milk supply, engorged breasts, plugged milk ducts, fatigue, heavy time commitment, feelings of sadness or depression and dealing with the judgment of others who may not support breastfeeding. Seek help from your medical provider or check out resources from the Office on Women’s Health for common problems and solutions.

“In addition to the primary care pediatrician, lactation experts can be largely helpful in assisting mothers and babies who have challenges with breastfeeding,” according to nurse practitioner Steven Powell.

Baby formula advantages include convenience and the ability to tailor nutrition for individual babies. Formula also provides an alternative way to nourish a baby if breastfeeding is not recommended by a medical provider. Lactose-free formula and hypoallergenic formula are available for babies with special needs.

Mothers who need to pause breastfeeding because of medications, illness or surgeries can use formula to feed their babies. Using baby formula may also help preemies with catch-up growth. Studies have shown that preemie formula can help premature babies achieve short-term growth and weight gain.

While breastfeeding is the preferred choice, baby formula is still a nutritionally balanced way to feed your baby. All commercial formulas for sale in the U.S. must adhere to the FDA’s guidelines for nutrition.

Experts do not recommend trying to make homemade baby formula, especially from recipes you find online. Babies who consume homemade formula run the risk of being nutritionally deficient, experiencing dangerous electrolyte imbalances, and contracting infections.

Baby formula disadvantages include its cost, inability to provide antibodies and immune support to babies, and baby formula side effects.

Formula feeding is expensive. It can cost between $800 and $2,800 a year. With inflation, this figure could be higher. Brand-name formulas that babies are given at the hospital can be as much as 66% more expensive than store brands, but mothers are most likely to stick with the brand they know. Baby formula recalls may also cause extra stress because of formula shortages.

Babies who aren’t breastfed miss out on the unique immune and cognitive development benefits breast milk gives them. This includes antibodies and other health protections from breast milk. And while baby formula side effects are typically limited to mild digestive issues, some health risks may be serious or even fatal.

Preemies fed cow’s milk baby formula have a higher risk of a serious digestive disorder called necrotizing enterocolitis than preemies whose main diet is breast milk, and NEC can be fatal. According to one of the first NEC studies published in the Lancet, NEC was 6 to 10 times more common in exclusively formula-fed babies than in babies fed breast milk alone.

Parents whose babies became ill with or died from NEC have filed baby formula lawsuits against the makers of Similac and Enfamil.

If breastfeeding isn’t working for the mother or baby, supplemental feeding with formula or donor breast milk is an option to make sure the baby is well fed. Many breastfeeding challenges are out of a mother’s control.

For instance, doctors may recommend supplemental feeding if a mother can’t exclusively breastfeed or if a baby requires extra vitamins and minerals in addition to what breast milk provides. Premature babies often need supplemental feeding to help them catch up in growth.

“If we see that a baby has lost more than 10% of its birth weight and is not able to gain that back adequately enough and quickly enough with breastfeeding, then we will recommend to do supplementation with formula,” family medicine physician Kisten Stoesser told University of Utah Health.

While at the hospital and eventually when they come home, preemies may receive human milk fortifiers to add extra vitamins and minerals to their mother’s milk. Preemies may have to be fed through a tube in their stomach while in the hospital and slowly taught to breastfeed after.

Be sure to ask your medical provider for tips on how to introduce your baby to supplemental feeding and weaning your baby off breast milk. Your provider can teach you how to properly supplement and set up a feeding schedule for your baby.

“You shouldn’t make this decision alone. If you’re struggling, I recommend talking with your medical providers. They can help you understand the reasons why you may need to supplement and if it is temporary or long term. We can go over all the options, so you feel you’ve made the best choice for you and your child,” according to Cleveland Clinic pediatrician Heidi Szugye.