What’s better – breastfeeding or formula?

It seems like an easy question, but not always.

There’s no doubt that breastfeeding (or pumped breast milk), has many advantages which led the largest global health organizations to recommend it as the best nutrition for your baby. Breast milk is the most balanced nutrition and the different formula producers attempt to come as close as possible to it.

The official recommendation is to breastfeed until the age of 6 months and then continue complementary breastfeeding until the age of one year (or more). Partial breastfeeding is also better than no breastfeeding at all.


But we must remember that not all mothers (and not all families) want or are able to breastfeed.

I sometimes feel that many mothers breastfeed due to pressure (either personal or external) even though breastfeeding doesn’t suit them at all and at times is ineffective.

In addition, breastfeeding has its limitations that are at least as important to discuss as the advantages.

I believe every mother and family should decide what is best for her and them.

I will repeat what is most important : breastfeeding is the best nutrition for babies and is one of the most wonderful things that a mother can grant her baby. But on the other hand, endless babies are formula fed due to one reason or another and grow up to be healthy children and adults.

For example, when we are talking about the reduced risk of breastfed babies to suffer from ear infections (proven), we must remember that this is a study that compared 1000 breastfed babies to 1000 who were formula fed and found statistically less ear infections in the breastfed group.

This does not mean that every formula fed baby will have ear infections, nor does it imply that breastfed babies are completely immune to ear infections. Therefore, we must differentiate between large studies, even if achieving statistically significant results, to real life and your own baby.

Benefits of breastfeeding over formula

Immunity benefits – bottom line is, statistically, a breast-fed baby gets sick less. Less gastro-intestinal infections, less ear infections, less respiratory infections and less urinary tract infections.

Benefits in encouraging growth factors.

Metabolic benefits – less obesity, type 1 diabetes, celiac and inflammatory bowel diseases (Crohn’s disease), less high blood pressure.

Allergic benefits – less allergies, including skin atopy and asthma.

Breast-fed babies were found to have lower incidence of sudden infant death syndrome (read more here, its importent!).

In addition, less tumors, less lymphomas and leukemia, less hospitalizations and child death.

Financial benefits – breastfeeding is cheaper than buying formula.

Don’t forget the advantages for the breastfeeding woman – less type II diabetes, less ovarian and breast cancer.

The success in breastfeeding is dependent on many factors that this review could not encompass. From national efforts to encourage breastfeeding, through transforming hospitals and neonate units to breastfeeding friendly environments and to the individual family level.

Limitations of breastfeeding compared with formula

There are few maternal health conditions, in particular some infectious diseases, when breastfeeding is not allowed.

There is a certain number of neonatal diseases when breastfeeding is not allowed (like rare metabolic diseases such as galactosemia).

Breastfeeding is a low source for providing vitamin D to the baby. This is the reason why in certain countries there’s a recommendation for supplementation with vitamin D for breastfeeding babies. Some also recommend supplementation to formula fed babies.

Pain and infection – breastfeeding can be associated with nipple discomfort and pain, breast congestion and infections (mastitis) in 2-3% of breastfeeding mothers. You can read more here of mastitis in breastfeeding mothers.

Suboptimal intake of the neonate – due to the fact that it is difficult to quantify the amount the baby receives in breastfeeding and due to other various reasons (insufficient milk production, difficulty with establishment of breastfeeding etc.), weight gain in breast-fed babies can be on average slower than in those who are formula fed. Naturally, with the right instruction and close follow-up (including weight measurements) there is no reason for insufficient feeding of neonates, but not all families have a good support, and this just happens.

I recommend all families in which breastfeeding is the main form of feeding not to miss weight follow-up in well-baby clinics or treating physician, mainly in the first 1-2 weeks of life, to make sure that the direction of growth is positive.

Breast milk related jaundice – substance in breast milk that inhibits the ability of the liver to metabolize bilirubin (the substance that causes neonatal jaundice). This jaundice is usually not dangerous but may require medical surveillance or phototherapy.

In summary:

In conclusion, breastfeeding should be the default for babies’ nutrition.

However, if it doesn’t suit for you or just doesn’t work, formula is an appropriate option. And remember, whatever you decide won’t change the fact that you are a great loving mother.

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