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August 09, 2018

Breastfed vs. Formula: Do I have to pick one?

The Facts:

Breast milk is alive. It contains bio-dynamic factors, meaning that it will change throughout the day, season and year to support your baby’s growth, brain, immune system and gut - meeting her needs as she matures. Like all living tissue, it is variable.  The fat, water, electrolytes and the calories rise and fall in response to your baby’s body, the time of day and her environment.

Formula is predictable.  Every ounce has exactly the same number of calories, fat, water...it’s manufactured to be consistent. In the 1950’s, when ready-to-feed infant formula was originally manufactured, there was no “breast vs. formula“. Designed to replace breastmilk, medical advertising espoused the modernity of infant formula as smart parenting...being scientific...after all it is called ”formula”.

It doesn’t have to be Breast vs. Formula, as if we were discussing a competition.  Breastfeeding exclusively, breastfeeding partially or fully formula feeding your baby is your choice.  Make it your informed choice.  

There are several medical reasons that could be incompatible with breastfeeding.  There are several psychological reasons that could make formula feeding the best choice for some women. You have to assess your pro’s and con’s and seek advice from lactation educators and your health care providers. Speak to mothers who are experienced at breastfeeding their healthy children.  A few well-placed, wise words can help you make an informed choice.

There is a time and place for formula - alongside breastfeeding. When I first became a lactation consultant, in the 1990’s, I would never say,  “Sure, use formula.” I would make the remark, “When you’re ready to give up on the breastfeeding, that’s the time for one formula feeding.” Now I have come to recognize the functionality of formula. No more Breast vs. Formula.  Breast + Formula works for many mothers.

After a careful evaluation of latch and positioning, I will frequently  suggest a Medela Supplemental Nursing System (SNS) to a mom with a low milk supply and baby that is unsatisfied at the breast and therefore won’t sustain a suck-swallow pattern. If there is no available expressed breastmilk for the supplementer bottle, I suggest formula be used. In this way your hungry baby can get your breastmilk and the flow of formula, through a tiny tube at your nipple, to keep her stimulated and sucking with swallowing. Allowing her to feed from your breast rather than a bottle will stimulate your body to produce more milk, perhaps eliminating the need for the supplementer after a short period of time.

Another 1990’s concern was nipple confusion. I haven’t found that to be common any more. While I still recommend no artificial nipples be introduced until you and your baby have had a chance to figure it out naturally...there is a time and place for formula in a bottle in the early stages of breastfeeding. With so many nipple sizes and shapes available today, and some experimentation, babies go can go between breast and bottles quite easily.  

Please remember that you will produce enough breastmilk to satisfy the growing appetite of your baby if she is put to breast as often as she shows signs of hunger.  A short, less than successful breastfeeding followed by a bottle of formula and no pumping will decrease your milk supply. Guaranteed.

Breast vs. formula should be a phrase of the past.  There is no fight. If you choose...the judicious use of formula supplementation can be a solution for you. If you choose to exclusively formula feed your baby, you can be assured that she will also grow to be strong and healthy.

Please seek the advice of a lactation consultant if you have chosen to use formula because of difficulties arising with your breastfeeding.

Paula Zindler
RN IBCLC



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