Breastfeeding or Formula Feeding: A Mother’s Choice (2023)

Breastfeeding or Formula Feeding: A Mother’s Choice (1)

Deciding how to feed an infant is a decision that should be made by a mother and her family. The benefits of exclusively breastfeeding an infant for the first six months of life are well established (World Health Organization [WHO], 2017); however, it may not always be feasible or a preferred option. For mothers who cannot or choose not to breastfeed, formula feeding is a great option that can support a healthy and thriving infant. This fact sheet will address common questions about breastfeeding and formula feeding to help mothers make an informed decision on how to feed their infant, whether it is by breastfeeding, formula feeding, or a combination of the two.

Breastfeeding

Breastfeeding or Formula Feeding: A Mother’s Choice (2)

Human breast milk is the gold standard of infant nutrition. It provides nearly all of the essential nutrients and bioactive substances necessary for optimal development and it constantly changes based on the infant’s nutritional needs. Breastfeeding also has many unique benefits for both the mother and baby, described in Table 1. These benefits encompass infant nutritional needs, mother-baby bonding, and maternal health.

Beginning Breastfeeding

Breastfeeding should be initiated within 24 hours of birth in order to stimulate the breasts and increase milk production. Initiating breastfeeding can be challenging for some mothers, and a variety of factors influence whether or not a mother will continue breastfeeding past the first few weeks. Prior lactation education, support from family and hospital staff, concern for the newborn’s health, and cultural perceptions of breastfeeding are a few of the main factors that impact a mother’s decision to breastfeed. The most influential factor on this choice is the support received from partners; however, physicians, lactation consultants, and other health professionals can also make a significant impact on a woman’s desire to continue breastfeeding. In general, mothers and babies need continued support and encouragement in order to succeed in breastfeeding

Table 1. Benefitsof Breastfeeding

Benefits forBaby Benefits for Mother
Breast milk is composed of many nutrients including water, fats, carbohydrates, proteins, vitamins, and minerals. Breastfeeding releases oxytocin, a hormone that helps mothers and babies bond. It also produces nurturing feelings in the mother.
Nutrient composition of breast milk will change to reflect infant age and needs. Breastfeeding for a year or longer may reduce the risk of breast cancer and ovarian cancers in women.
Breast milk has been found to affect gastrointestinal health positively because it contains digestive enzymes. Breastfeeding reduces the risk of type 2 diabetes and cardiovascular disease.
Special carbohydrates found in breast milk called oligosaccharides help develop healthy gut bacteria in infants. Breastfeeding lowers the risk of postpartum depression due to the antidepressant effects of both prolactin and oxytocin, hormones produced during lactation.
The fats found in breast milk are important for brain development, immune function, and vision development Breastfeeding mothers experience less postpartum bleeding and quicker healing of the uterus.
Antibodies passed through milk help develop infant immune systems and protect against infections during the first year of life. Breastfeeding facilitates faster return to prepregnancy weight.
Breastfeeding reduces the risk of:
  • Diarrhea in first year of life
  • Allergies and asthma
  • Type 2 diabetes
  • Obesity
  • Necrotizing enterocolitis
  • Gastrointestinal infections
  • Ear infections
Delays return of menses cycle.

Breastfeeding Challenges

There are several obstacles that may arise when breastfeeding which may also prevent mothers from continuing breastfeeding. Breastfeeding requires that mothers and babies stay in close proximity, which may be difficult for working mothers, even with the aid of a pump. Lack of support in the workplace or social perceptions of public breastfeeding may also make the task more difficult.

Breastfeeding can be physically challenging as well. Many mothers experience sore nipples, plugged ducts, mastitis or other infections, and breast engorgement. These painful issues can cause women to stop breastfeeding. Most complications can be prevented by breastfeeding on demand, using proper breastfeeding techniques, wearing a supportive bra, and completely emptying the breast of milk. More severe complications or infections that persist will require medical attention. It is important that a mother speak with her doctor or a lactation specialist if she experiences any uncomfortable symptoms.

Some mothers may also worry about producing enough milk. Only 5% of women have an insufficient milk supply; however, milk supply may dwindle if mothers are supplementing with formula or not breastfeeding on demand. Understanding the potential issues and how to overcome obstacles to breastfeeding is crucial in helping mothers continue to breastfeed.

Formula Feeding: Benefits and Drawbacks

Breastfeeding or Formula Feeding: A Mother’s Choice (3)

Infant formulas are specifically designed to imitate human breast milk composition and they are the only safe alternative to breast milk for infants. Many families enjoy the convenience of formula since any caregiver can help feed the baby, as opposed to just the mother. This can help in situations where the mother is resting, is unable to feed the baby, or needs to return to work. It also provides an opportunity for other family members to bond with the baby during feedings. Many parents also feel that formula feeding helps their babies sleep through the night at an earlier age, meaning fewer nighttime feedings and more sleep for the mother.

A major drawback to formula feeding is the cost. Formulas cost an average of $1,500 per year. Mothers should also keep in mind that formulas cannot convey all the same health benefits as breast milk, as the non-nutritive substances such as antibodies and digestive enzymes cannot be replicated in formula. If a mother decides to use formula to feed her infant, healthcare providers should support her in her decision by helping her determine which formula provides the best option for her infant.

Choosing a Formula

Standard formulas are meant for babies who have no abnormal health or dietary problems. They are typically based on modified cows’ milk or soy milk, which are then fortified with vitamins, minerals such as iron, and essential fatty acids. Formulas are typically produced in three forms: powder, concentrated liquid, and ready-todrink formulas. Powdered formula is cheapest but requires the most preparation, while ready-to-drink formulas are most expensive but require no preparation.

(Video) Formula Feeding over Breastfeeding, My Story & Support for Moms Feeling Mom Guilt

There are a variety of alternative infant formulas available on the market for babies with specific health conditions, as standard formula may not be suitable for all babies. Table 2 describes the types of formulas and their different uses. These formulas vary in nutritional composition, caloric value, taste, digestion, and cost. Talk with your pediatrician before switching your infant’s formula.

Table 2.Types of Formula and Their Uses

Type of Formula Composition and Use
Standard or cow’s milkbased formula
  • Basis for most formulas
  • Diluted so the protein ratio is similar to human breast milk composition
  • Modified to be safe for infants
  • Contains added vegetable oils, vitamins, minerals, and probiotics
Soy-based formula
  • Good for infants with galactosemia, congenital lactose deficiency, colic, or milk allergies
  • High in protein
  • Contains added vegetable oils to provide nutrients such as vitamins and minerals
  • Not recommended for premature infants
Protein hydrolysates or hypoallergenic formula
  • Have highly hydrolyzed, or broken-down, proteins for infants that have protein allergies or diseases of the gut, stomach, or liver
Amino acid formula
  • For infants with severe cow milk allergies or intolerance to soy formulas
  • Protein is in the form of free amino acids, making it easy to digest
  • Very expensive and not widely available

What to Avoid

Regular cow or goat milks are not safe alternatives to breast milk or formula during the first year of life. Both goat milk and cow milk do not provide enough vitamin E, iron, or essential fatty acids for the baby and can overload the baby’s body with potassium, sodium, chloride, and protein. The high protein levels in both milks can cause babies to urinate more which can lead to severe dehydration.

Likewise, alternative milks such as coconut, almond, or soy do not have the adequate nutrients an infant needs for healthy growth and development. Once a baby begins their first solid foods, it is safe to feed them foods that contain milk and alternative milks.

A Mother's Choice

Breastfeeding is the gold standard for infant nutrition and best for most mothers and babies, but there are times when bottle-feeding is the best choice for some mothers and babies. Many mothers may perceive that how they choose to feed their babies is a moral decision, with breastfeeding perceived as “good” and formula viewed as “bad” because of current stigmas and social norms. It is essential for mothers to feel supported when deciding on an infant feeding strategy that balances personal, financial, and family factors. Reducing stigmas associated with either choice is vital for helping mothers feel at peace with their decision. Most importantly, mothers should know that either breastfeeding and formula feeding can provide babies with all the essential nutrients they need for adequate growth and development.

References

  • American Academy of Pediatrics, S. O. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. doi.org/10.1542/peds.2011-3552
  • Centers for Disease Control and Prevention. (2013). The CDC guide to strategies to support breastfeeding mothers and babies. U.S. Department of Health and Human Services.
  • Dieterich, C. M., Felice, J. P., O’Sullivan, E., & Rasmussen, K. M. (2013). Breastfeeding and health outcomes for the mother-infant dyad. Pediatric Clinics of North America, 60(1), 31–48. doi.org/10.1016/j.pcl.2012.09.010
  • Giugliani, E. R. (2004). Common problems during lactation and their management. Jornal De Pediatria, 80(8), 147–154. doi:10.2223/jped.1248
  • Godfrey, J. R., & Lawrence, R. A. (2010). Toward optimal health: the maternal benefits of breastfeeding. Journal of Women’s Health, 19(9), 1597–1602. https://doi.org/10.1089/jwh.2010.2290
  • Le Huërou-Luron, I., Blat, S., & Boudry, G. (2010). Breast- v. formula-feeding: Impacts on the digestive tract and immediate and long-term health effects. Nutrition Research Reviews, 23(01), 23 doi.org/10.1017/S0954422410000065
  • Martin, C. R., Ling, P.-R., & Blackburn, G. L. (2016). Review of infant feeding: Key features of breast milk and infant formula. Nutrients, 8(5). doi.org/10.3390/nu8050279
  • Meedya, S, Fahy, K & Kable, A. (2010) Factors that positively influence breastfeeding duration to 6 months: A literature review. Women and Birth, 23(4),135–145. doi.org/10.1016/j.wombi.2010.02.002
  • Radzyminski, S., & Callister, L. C. (2016). Mother’s beliefs, attitudes, and decision-making related to infant feeding choices. The Journal of Perinatal Education, 25(1), 18–28. https://doi.org/10.1891/1058-1243.25.1.18
  • Rudzik, A. E. F., & Ball, H. L. (2016). Exploring maternal perceptions of infant sleep and feeding method among mothers in the United Kingdom: A qualitative focus group study. Maternal and Child Health Journal, 20(1), 33–40. https://doi.org/10.1007/s10995-015-1798-7
  • Samour, P. Q., & King, K. (Eds.). (2012). Pediatric nutrition (4th ed). Jones & Bartlett Learning.
  • United States Department of Health and Human Services [USDHHS] Office of the Surgeon General, A. S. for H. (ASH). (2011, January 19). Breastfeeding: Surgeon general’s call to action fact sheet [Text]. Retrieved July 9, 2019, from HHS.gov website: https://www.hhs.gov/surgeongeneral/reports-andpublications/breastfeeding/factsheet/index.html
  • World Health Organization (2018). Counseling women to improve breastfeeding practices. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/280133/9789241550468-eng.pdf?ua=1
  • Ziegler, E. E. (2007). Adverse effects of cow’s milk in infants. Nestle Nutrition Workshop Series.Paediatric Programme, 60, 185–196; discussion 196–199. doi.org/10.1159/000106369

Authors

Trista BriggsDietetics Student; Mateja R. Savoie-RoskosPhD, MPH, RD; Lydia Bangerter Dietetics Student; Casey CoombsMS, RD

(Video) Breastfeeding VS Formula | Benefits + The Truth

Casey Coombs

Create Better Health Utah (SNAP-Ed), Assistant Director

Home and Community Department

Phone: 435-797-3725

Email: casey.coombs@usu.edu

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FAQs

Is it mother's choice to breastfeed? ›

Ninety-seven percent (n = 5531) of women made the decision to breastfeed prior to giving birth. The internet played a role in deciding to breastfeed in 33.7% (n = 2047) of women, while 20.1% (n = 1110) said the same thing about their midwife.

Is it better to breastfeed or formula feed? ›

Health experts agree that breastfeeding is the healthiest option for both mom and baby. They recommend that babies feed only on breast milk for the first 6 months, and then continue to have breast milk as a main part of their diet until they are at least 1to 2 years old.

Do most moms use formula? ›

Formula Feeding Is More Common Than Most Will Admit

This statistic means that over 50 percent of moms were formula feeders by some point within their first year, whether exclusively or in combination feeding. By six months, the statistics are even lower, with only 25 percent of moms exclusively breastfeeding.

Why is breastfeeding the best choice to feed a baby? ›

Breast milk is the best food for babies in the first year of life. It helps them grow healthy and strong and protects them from infections and illness. For example: Breast milk has hormones and the right amount of protein, sugar, fat and most vitamins to help your baby grow and develop.

Is it selfish to not want to breastfeed? ›

Breastfeeding versus formula feeding is just one of them, and it really is no one else's business. If you want to breastfeed from birth and beyond, that is your protected right. You should be able to do it without judgment. If breast never seems like the best choice for you or your baby, there's no shame there.

What happens if I decide not to breastfeed? ›

For infants, not being breastfed is associated with an increased incidence of infectious morbidity, including otitis media, gastroenteritis, and pneumonia, as well as elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden infant death syndrome (SIDS).

What are 5 disadvantages of breastfeeding? ›

Cons
  • You may feel discomfort, particularly during the first few days or weeks.
  • There isn't a way to measure how much your baby is eating.
  • You'll need to watch your medication use, caffeine, and alcohol intake. Some substances that go into your body are passed to the baby through your milk.
  • Newborns eat frequently.

Will formula fed babies be healthy? ›

Formula feeding is also a healthy choice for babies. If you use a formula, your baby will get the best possible alternative to breast milk. (You should not attempt to make your own formula or feed an infant cow's milk or another kind of milk.)

Are formula fed babies more settled? ›

New mums should be advised that it is normal for their baby to cry more if they are breastfed, say experts. The Medical Research Council team says this irritability is natural, and although formula-fed babies may appear more content and be easier to pacify, breast is still best.

When do most moms stop breastfeeding? ›

Solid food is then typically introduced to babies' diets at around 6 months. The survey, which involved more than 28,700 children, also found that by the time they are 6 months old, 4 in 10 babies are receiving no breastmilk at all.

What percentage of mothers breastfeed? ›

Healthy People 2030 Breastfeeding Objectives*BaselineTarget
Increase the proportion of infants who are breastfed exclusively through 6 months of age.24.9%42.4%
Increase the proportion of infants who are breastfed at 1 year.35.9%†54.1%
3 Aug 2022

What are 10 advantages of breastfeeding? ›

  • Perfect nutrition. Breast milk is the best food to help your baby grow and develop. ...
  • Protection. Breast milk helps your baby fight off sickness and disease. ...
  • Brain power. ...
  • Ready and portable. ...
  • Size does not matter. ...
  • Good for mothers too. ...
  • Builds a special bond. ...
  • Advantages continue as baby grows.

Can you alternate formula and breastmilk? ›

It can take several weeks for you and your baby to feel happy and confident with breastfeeding. Once you've both got the hang of it, it's usually possible to offer your baby bottles of expressed milk or formula alongside breastfeeding. This is sometimes called mixed or combination feeding.

What are 6 advantages of breastfeeding? ›

6 Major Benefits of Breastfeeding
  • A Stronger Immune System. Breast milk contains antibodies and unique compounds that help your child's body fight off bacterial and viral infections. ...
  • Fewer Allergies. ...
  • A Better Bonding Experience. ...
  • Saves Time and Money. ...
  • Fewer Chronic Diseases. ...
  • Healthier Bodyweight.
18 Feb 2015

Are breastfed babies happier? ›

Breastfed babies cry more, laugh less, and generally have "more challenging temperaments" than formula-fed infants, a study has found. But such behaviour is normal, and mothers should learn to cope with it rather than reach for the bottle, according to researchers.

Why is breastfeeding so hard mentally? ›

Many factors in breastfeeding can have a positive or negative effect on your mental health. If you're a new parent, you're likely experiencing a rollercoaster of emotions. From hormonal changes to sleep deprivation to feeding choices for your baby, your life — and emotions — may seem to be all over the place.

What are the disadvantages of formula feeding? ›

Formula feeding is linked to higher risk for Type 1 diabetes and bowel diseases such as celiac disease and inflammatory bowel disease. Infants who are formula fed are 50 percent more likely to have ear infections than babies who receive only breastmilk.

Why bottle feeding is not recommended? ›

This can increase your baby's risk of choking, ear infections, and tooth decay. Your baby may also eat more than he or she needs. Do not put your baby to bed with a bottle. Milk can pool around the baby's teeth and this can cause tooth decay.

How long does the average mom breastfeed? ›

The World Health Organization and UNICEF have recommended for a decade that mothers breastfeed for at least two years. But most US women who nurse stop before their baby is six months old – and many never start at all.

How long should mothers breastfeed their babies? ›

The American Academy of Pediatrics and the World Health Organization also recommend exclusive breastfeeding for about the first 6 months, with continued breastfeeding along with introducing appropriate complementary foods for up to 2 years of age or longer.

How long are you supposed to breastfeed? ›

The World Health Organization (WHO) recommends breastfeeding up to 2 years or more. The American Academy of Pediatrics recommends that moms feed their babies only breastmilk for the first six months. Then they say to keep breastfeeding for at least one year.

Can you choose not to breastfeed UK? ›

If a woman decides not to breastfeed her baby it is her choice and must be respected, midwives are being told. The Royal College of Midwives' new position statement makes it explicitly clear that women should be supported if, after being given advice, information and support, they opt to bottle feed using formula milk.

Which countries breastfeed the most? ›

Croatia has the highest rate of breastfeeding in the entire world. More than 98 percent of all babies are breastfed starting at birth. Some of the other countries that also have very high rates of breastfeeding include Rwanda, Chile, and Burundi. All of these countries have breastfeeding rates greater than 80 percent.

Why do most moms stop breastfeeding? ›

Poor attachment, "not enough breastmilk for the child", and an unsettled baby were the top reasons for ceasing to breastfeed cited in the Australian national infant feeding survey (by parents who stopped breastfeeding entirely before 6 months).

Which countries breastfeed the longest? ›

In Mongolia, breastfeeding is celebrated and public breastfeeding encouraged with 65 percent of babies being exclusively breastfed for the first six months of life. Breastfeeding also tends to continue until after the second birthday.

Is it worth breastfeeding once a day? ›

Breastfeeding, even just once a day, is worth it.

Your body is regulating your hormones and your endocrine system with stimulation. Second, the baby receives that contact, that transfer of energy from the parent, and being skin to skin continues to support heart rate, respiration, glucose levels and temperature.

What are the consequences of breastfeeding for too long? ›

As the American Academy of Family Physicians (AAFP) states, “There is no evidence that extended breastfeeding is harmful to parent or child.”

What percentage of mothers breastfeed? ›

Among infants born in 2015, 4 out of 5 (83.2 percent) started out breastfeeding. This high percentage of babies who start out breastfeeding shows that most mothers want to breastfeed and are trying to do so. Almost half (46.9 percent) were exclusively breastfeeding at 3 months.

When can I stop feeding on demand? ›

It is recommended that the best time to switch from on-demand to scheduled feeding is when you introduce your baby to solid foods (earliest 6 months of age). This is because when your baby starts on solid foods, many families begin to have their baby join them at their own mealtimes.

Why is breastfeeding so hard mentally? ›

Many factors in breastfeeding can have a positive or negative effect on your mental health. If you're a new parent, you're likely experiencing a rollercoaster of emotions. From hormonal changes to sleep deprivation to feeding choices for your baby, your life — and emotions — may seem to be all over the place.

Why is formula feeding frowned upon? ›

Children who are formula fed are 17 times more likely to have pneumonia than children who were given only breastmilk as infants. Babies who are formula fed are twice as likely to have diarrhea than breastfed babies. Babies have become very sick and some have died because of harmful germs in formula.

Are breastfed babies healthier adults? ›

Those, who were breastfed babies will become more protected against diseases as adults. This proves the long-term benefits of breastfeeding. They are also less likely to develop obesity and high cholesterol levels in old age and will have lower blood pressure.

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