Breast or bottle: Making the decision

I am newly pregnant and trying to decide whether to formula feed or breastfeed. What are the pros and cons to each method?

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ABOUT THE EXPERT

Kathy Kuhn

Kathy Kuhn is a registered nurse who has been working with breastfeeding families since 1981. She has been an International Board Certified... Read more

Congratulations on your new pregnancy and your interest in making informed decisions about feeding your baby. Breastfeeding is what nature intended for infants and is your baby's perfect first food and immunization against many diseases. There are many risks associated with feeding artificial infant formulas that have been very well documented over many years of research.

When compared to breastfed babies, formula fed babies have higher rates of many illnesses. Bacterial infection is increased ten times in formula fed infants, meningitis is increased by four times, diarrhea is five times more likely and ear infection is three to four times more likely in formula fed infants. (Solveig et al.2000) All of the following illnesses or conditions are also seen in greater frequency in formula fed infants: respiratory infections including respiratory syncytial virus (RSV), sudden infant death syndrome (SIDS), reflux, allergies, asthma, type I diabetes, obesity, (Hypponen et al 1999), childhood cancers such as lymphoma and leukemia, Crohn's Disease, colitis, multiple-sclerosis, eczema, necrotizing enterocolitis in preemies, rheumatoid arthritis, etc.

Infants who are fed formula also have a diminished protective response to the many vaccinations they receive and produce less antibodies against disease.

Babies tend to suck differently from the breast than from bottles. This is thought to impact the way the jaw develops and may be the reason more bottle fed babies need orthodontic care and are slower to develop clear speech patterns. (Newman 2000)

Formula feeding presents risks for mother as well. Women who formula feed have an increase risk of early postpartum hemorrhage because breastfeeding stimulates hormones that help the mother's uterus contract and return faster to it's pre-pregnancy state. Women who formula feed have a higher risk of premenopausal breast cancer and ovarian cancer as compared to breastfeeding women. (Newman 2000) (Solveig et al. 2000)

Artificial formula is also very expensive when compared to breastfeeding. Currently the cost of the cheapest formula is about $100 to $200 per month and some of the more costly types for allergic babies are as much as $500 to $600 per month. This calculation is based only on the cost of the formula. This does not include the well documented higher costs of health care for formula fed infants, due to the increase rate of illness that requires trips to the pediatrician and frequent prescription medications. (Riordan, 1997)

Employers benefit financially, as well, when mothers breastfeed. One large U.S. city found that medical claims dropped 35 percent when services were provided to encourage employees to breastfeed. Another study in the US showed that breastfeeding mothers accounted for only 25 percent of missed work days, while the formula feeding mothers accounted for 75 percent of the missed days.(Solveig et al.2000)

Formula fed babies, on average, have IQs about ten points lower than their breastfed counterparts. This is most likely related to special fatty acids and other components in breastmilk that are known to promote brain cell growth, development of vision and the nervous system. These components are absent in formula. (Anderson et al 1999) (Newman 2000) (Solveig et al.2000)

Additionally, there have been numerous recalls of artificial infant formulas due to mistakes in the composition, and/or contamination with toxins and bacteria. Some of these mistakes have lead to injuries, including brain damage in babies fed these recalled formulas. (Newman 2000)

Formula is a static substance, meaning it remains the same all the time if prepared under the same conditions. Breastmilk is a dynamic food which changes in fat content, volume, and immune components as the daily needs of the growing baby change.

Formula is more likely to stain clothing when the baby spits up and most people agree the formula fed baby's diapers are more foul smelling. Formula fed babies are often more prone to diaper rash too.

Formula feeding strains our ecology because of the additional land and grain it takes to raise dairy cows. It also requires trucks to transport it, electric or gas to warm it and cool it and overflows our landfills with empty containers and used bottles. 2,050,000 kg of steel and 1,230 tons of paper labels are used each year to make formula cans. (Solveig et al.2000) Breastmilk is a very valuable and economical natural resource that should not be wasted.

Formula feeding is time consuming hard work, requiring purchasing, cleaning of equipment, careful refrigeration to prevent the growth of bacteria and time-consuming warming. Breastmilk is always ready to feed at the appropriate temperature, composition, and amount and requires no preparation, refrigeration, warming or clean up.

With the proper information, and support most women can easily and comfortably breastfeed. Both the American Academy of Pediatrics and the World Health Organization recommend exclusive breastfeeding for the first six months of the baby's life and that breastmilk should continue to be the primary source of the infant's nutrition up to a year and beyond.. If a woman is not able to, or does not want to put the baby to breast, the next best choice would be mother's own milk expressed for her baby. The third choice, though difficult to access, would be banked breast milk from other women, and lastly infant formula. (Newman 2000) (Solveig et al.2000)

Breastfeeding also ensures that babies get lots of loving touch, since it is impossible to breastfeed without holding the baby. Loving human touch is a biological need of the infant and breastfeeding ensures that need is easily met. Many mothers find breastfeeding their baby is one of life's most rewarding experiences and are glad they did not miss the opportunity to lovingly provide natures best food to their infant.


References

  • Anderson J. B. Johnstone & D. Remley, "Breast-feeding and cognitive development: a meta-analysis" American Journal of Clinical Nutrition, (1999) 70 (4) 525 to 535.
  • Howie, P. "Protective effect of breastfeeding against infection" British Medical Journal (1990) vol 300 1 to 16.
  • Hypponen E, et al. "Infant feeding, early weight gain, and risk of type 1 diabetes. Childhood Diabetes in Finland" Diabetes Care, (1999) 22(12):196 to 1965
  • Newman, J. and T. Pitman, Dr. Jack Newman's Guide to Breastfeeding, Harper Collins, (2000) 9-13.
  • Riordan, J. "The cost of not breastfeeding: a commentary" Journal of Human Lactation, (1997) 13 (2): 93 to 97.
  • Solveig, F., C. Mulford, S. James, & P. Schellenberg, " The Milk of Human Kindness" Crossroads Books (2000).
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