Breastfeeding vs Formula Feeding: How To Choose?

Breast milk vs. formula

Breast milk is the mother’s milk produced in later pregnancy and after giving birth (2). To know about it, it’s important to understand how it develops to fulfill a baby’s nutrition.

Many hormones, like estrogens, progesterone, oxytocin, prolactin, etc., are included in lactation (3). Colostrum secretion can occur in late pregnancy and after birth, a baby’s first food (2).

It is thick and yellow milk having protein, fat-soluble vitamins, minerals, and immunoglobulins, which is very beneficial for a baby (4). The transitional milk comes after 2 – 5 days of birth and may last two weeks. It has high fat, lactose, and water-soluble vitamins (5).

Finally, there is mature milk production, which is 90% water; the rest is carbohydrates, proteins, and fats (4). The milk supply depends on demand and fulfills the baby’s needs at different stages of growth (6).

In comparison, formula milk is made to replicate human milk. There are still a lot of ‘ tailor ingredients’, such as a bunch of types of immunoglobulin and microbiota in human milk that can barely be replaced (7). However, the main macronutrients can be replicated to help replace or partially replace with human milk. It comes in different forms, like powder and liquid concentrates (8). 

Majorly, formula milk has protein, fat, carbohydrates, vitamins, minerals, and other nutrients, such as probiotics and prebiotics (9). Also, it is usually made from cow’s milk and is treated to ensure it is safe for infants (10).

Depending on your baby’s unique requirements, it can be consumed in different formulas like (11):

• first infant formula (first milk)
• Goats’ milk formula
• Hungrier baby formula (hungry milk)
• Anti-reflux (stay down) formula
• Comfort formula
• Lactose-free formula
• Hypoallergenic formula
• Follow-on formula and many others

Many parents choose combined or exclusive formulas due to various factors. For example, some mothers may be unable to breastfeed due to certain circumstances. So, choosing the feeding style after a discussion with your doctor is advised.

Benefits of breastfeeding

Here are some benefits of breast milk feeding:

The unique composition with essential nutrients

Human milk is an ideal and customized form of food that has all the nutrients for your baby. It has 87% water, 1% protein, 4% lipid, and 7% carbohydrate (including 1 to 2.4% oligosaccharides) (12). It also contains many essential minerals (Calcium, Phosphorus, Magnesium, Potassium, Sodium, etc.) and vitamins (12).

All of this fulfills each individual baby’s requirements, which boosts growth.

Antibodies and immunological protection

Another amazing benefit of breast milk is that it has immunoglobulin antibodies that fight off germs, illness, and disease (13). These antibodies give active immunity against diseases and long-term protection, including resistance to infection and development of immunological tolerance to harmless environmental antigens (14).

Reduced risk of infections and diseases

Breastfed babies get protection from infection and diseases due to antibodies. For example, there may be a lower risk of asthma, obesity, type 1 diabetes, stomach bugs, ear infections, and sudden infant death syndrome (SIDS) (15, 16, 17).

Faster healing and uterine contraction

Breast milk naturally is associated with oxytocin release, which leads to uterine contractions (18). This contraction may lead to the normal size of the uterus after birth (19). Also, it may reduce bleeding after delivery (18, 19). 

Lower risk of postpartum depression

Postpartum depression is very common after giving birth. It can be due to so many sudden changes in the body (20). However, there has been an inverse relationship between breastfeeding and postpartum depression. Studies have found that women who breastfeed their infants reduce their risk of developing PPD (21).

Health benefits for mothers

Breast milk feeding is associated with many health benefits to mothers. Moreover, it’s linked with lowering the risk of breast and ovarian cancers, type 2 diabetes, and high blood pressure (22, 23, 24).

Skin-to-skin contact and secure attachment

The skin-to-skin attachment with a baby creates a very beautiful bond (25, 26). It stimulates the love hormone– oxytocin, which induces the ‘let down reflex’ and helps the mother and baby calm down and enjoy feeding (27).

Cost savings and cost-effectiveness

Another excellent benefit of breast milk feeding is that it is very cost-effective. You don’t need to buy, prepare, or do anything. You can feed your baby at any time and actually any place you want. This makes it convenient and cost-friendly. 

Breastfeeding challenges & tips

Here are some challenges and tips to overcome during breast milk feeding:

Latching difficulties

Latching is when a baby attaches to the mother’s breast to breastfeed. Initially, it may take time to initiate a perfect latch, but gradually, you will learn it. For example, you and the baby should be comfortable during an ideal latching. Plus, there should be no discomfort in the body or nipple area. 

Some tips for latching (28):

• In any breastfeeding position, your baby’s body should face the breasts(you shouldn’t tilt their head).
• Make yourself comfortable by using a pillow or cushion to support your back, arm, and neck, if needed.
• Tickle the baby’s lips so that they open their mouth.
• Now, aim your nipple just above your baby’s top lip.
• The baby’s mouth should be opened wide.
• When latching on, the baby’s lower lip must be away from the base of the nipple.
• Also, the lips should be like a fish protruding outwards.
• The baby’s tongue should cup under your breast.
• Ensure that the baby’s ear, shoulder, and hip are in a straight line with good support.

If you have trouble latching, consult a lactation consultant or an experienced female. 

Sore nipples and breast discomfort

Yes, there may be some nipple pain and discomfort. To check on it, you can check if you are latching properly and if the baby has a tongue-tie(29)(30). Therefore, ask the breastfeeding professional for help without hesitation. Sore nipples can occur even if you and your baby’s condition and position are perfectly correct. There may be other underlying issues (31, 32). Therefore, do not hesitate to seek help from a breastfeeding professional. Also, putting some breast milk on the nipples may help to ease the condition too (33).

Milk supply issues

Some mothers may have issues with their breast milk supply. But, to ensure that the baby gets enough milk, you should check the number of diapers, their mood, sleep schedule, etc (34).

Also, feeding on demand can help increase the milk volume (35). While breasts are never truly empty, it is ’emptier.’ The more milk that is removed quickly, the more new milk is produced (40). A good latch is the most effective way to remove milk, so take time to practice to achieve your best results (25). Remember to treat yourself well. Eating, drinking, sleeping, and relaxing well is always the most important thing for both you and your baby (35). Finally, consulting a breastfeeding professional will be a good choice too.

Breastfeeding in public

Many nursing moms feel uncomfortable breastfeeding in public. However, lots of awareness is being made to normalize it. After all, breast milk is a baby’s food, and they can have it anytime, in any place. But, if you feel uncomfortable, you can use nursing rooms. 

Time scheduling when back to work

For all working moms, breastfeeding at the same interval may be tough when they return to work. For this, you can gradually establish the best breastfeeding and milk pumping routine for both you and your baby during maternity break time. Storing milk beforehand and breastfeeding at night before sleeping can be a good choice for working moms who still want to breastfeed their babies.

Medical conditions

Mothers with some medical conditions may have been advised not to breastfeed. There can be some infections, treatments, or drugs you may be undergoing. So, seeking professional advice is important. 

Benefits of formula feeding

Here are some benefits of formulas:

Addressing special dietary needs

In some conditions, you may need to address your baby’s special needs and requirements with formula milk. Different formula kinds have cow’s milk, soy-based milk, special formulas, low iron, hydrolyzed, lactose-free, and many others available in the market (36). However, you must discuss this with your baby’s doctor before starting with any formula. 

Increased involvement for other family members

One of the beneficial advantages of formulas is that it is easier for everyone to be involved. As a mother, you can explain the timing and preparation of formal milk to your partner and other family members. This may increase the baby’s bond with everyone.

Enhanced flexibility for lifestyle

With formula feeding, it usually feels less stressful. You can feed the baby anytime if you have formula milk in store. If you are traveling or uncomfortable feeding in public, bottle feeding can be great.

No diet restriction for mothers

During breastfeeding, you may have to check the consumption and quantity of seafood, caffeine, etc. (37). But if your baby feeds on formula, you can avoid it. It usually enhances flexibility for mothers. 

Formula feeding challenges & tips

Here are some formula-style feeding challenges & tips:

Preparing and handling formula safely

Preparing and handling formulas with caution is very important (38). You should read the instructions and mix the suggested ratio of water and formula. Also, you must ensure a hygienic environment while doing it. 

Some important tips should be ensured to follow (38):

• Always use the formula before its expiry date.
• Sterilize the bottle and nipple.
• Wash your hands before the procedure.
• Mix the formula and water in the right ratio. An over- or under-dilution can cause either too few or too many calories consumed or more severe issues such as water intoxication.
• Feed the baby with the formula temperature they like.
• Mixing the formula the baby drinks in one feeding is better. Over-mixing and storing it for the next feeding should be avoided. 
• Refrigerate the formula once opened. 

Dealing with digestive issues

Some formula-fed babies may have digestive issues (39). To deal with this, you must discuss the symptoms with a doctor for the best recommendations.

Managing formula intolerances

Some babies may be allergic to certain formulas (40). Therefore, there can be symptoms of an allergic reaction. Consequently, you must discuss it with your doctor for the best advice. 

It is costly

Another downside of formula milk is its cost. The powder, concentrated liquid, and ready-to-use all have different prices. Additionally, the necessary equipment, such as bottles, nipples, and sterilizers, can also be heavy on your pockets. So, choosing the best option according to your affordability is advised.

Breastfeeding vs. formula: Is formula better than breast milk?

Breastfeeding

Nutrition:

• It’s a completely nutritious food.
• Easy to digest
• Contains antibodies
• Changes according to the baby’s needs

Pros:

• It’s always available
• No preparation or heating is required.
• It has immunoglobulins.
• It leads to skin-to-skin contact.
• It releases oxytocin which is beneficial for the mother.

Cons:

• Mother must be present.
• Initially, it can take time to get a perfect latch.
• There can be nipple soreness.

Cost:

• Free of cost (cost of nursing pads, nursing bras, etc.)

Formula

Nutrition:

• Nutritional content varies according to type.
• You can track the amount.
• Takes time to digest.

Pros:

• Anyone can feed the baby.
• A Good option for public feeding.
• Ease for moms who work etc.

Cons:

• You have to prepare milk perfectly.
• Need bottles.
• Some babies may be allergic to some formulas.

Cost:

It may range between $54 to $198 per month. (bottles, nipples, etc.)

Supplemental feeding: Combine breastfeeding and formula

Supplement feeding(mix feeding) is combining breastfeeding and formula. Many parents choose this method as it is convenient or a simple choice. 

Some of the reasons for supplemental feeding can be:

• Some mothers may have a low breast milk supply, which formula may help with (41).
• You may have twin babies, and mixed feeding can be easier.
• Your partner and other family members can also feed with formula.
• Also, try to combine feeding if you start working soon.

Moreover, there can be other reasons for it too.

 Benefits of supplemental feeding:

• It may boost the weight of the preterm baby (42).
• It’s a great option if you are not available.
• It adds flexibility to feeding.
• The formula usually contains vitamin D, which is an important supplement recommended for every baby (43).

Challenges of mixed feeding:

• Your baby may not like certain forms of feeding. It would be best if you tried to build the habit slowly.
• The baby may not take the mixed feeding well. You must consult a breastfeeding professional for the right pair-up.
• Also, there will be extra expenditure if you start with formula milk.

Mixed feeding or supplement feeding is great for adding flexibility to feeding. But discussing it with your doctor is advised for best practices.