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Breastfeeding vs. formula feeding

As a new parent, you have many important decisions to make. One is to choose whether to breastfeed your baby or bottle feed using infant formula.

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 1 and better 2 years old.

There are very few health problems that make breastfeeding not possible. There are other reasons women are unable to breastfeed, but with good support and knowledge, most of these can be overcome.

Here are some things to consider when deciding about breastfeeding. The decision about how to feed your baby is a personal one, and only you can decide what is best for you and your family.

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Benefits of Breastfeeding

Breastfeeding is a wonderful way to bond with your little one. Here are some of the many other benefits of breastfeeding:

• Breast milk naturally has all the nutrients babies need to grow and develop.
• Breast milk has antibodies that can help prevent your baby from getting sick.
• Breastfeeding can help prevent health problems in your baby, such as allergies, eczema, ear infections, and stomach problems.
• Breastfed babies are less likely to be hospitalized with breathing infections.
• Breastfed babies are less likely to become obese or have diabetes.
• Breastfeeding may help prevent sudden infant death syndrome (SIDS).
• Mothers who breastfeed find it easier to lose weight after pregnancy.
• Breastfeeding may help lower the risk for breast and ovarian cancers, diabetes, and certain other diseases in mothers.

Breastfeeding is also more convenient. You can breastfeed almost anywhere and anytime your baby is hungry. You do not need to make formula before feeding, worry about clean water, or carry it with you when you go out or travel. And you save money on formula, which can cost $1,000 or more a year.

Breastfeeding is the natural, healthy choice for mom and baby.

Preparing to Breastfeed

It is true that breastfeeding is not always easy and natural for moms and babies.

It can take a little time for you both to get the hang of it. It is important to know this up front, so that you can make sure you have all the support and commitment you need if a problem does come up.

Skin to skin contact at birth will help you and your baby get a good start with breastfeeding. Ask your health care provider to put your baby on your chest, if everyone is healthy and stable after birth.

Being a new parent takes time, and feeding is no exception to this rule.

• Breastfed babies will sometimes eat every hour for a while, before they take a long nap. Try to nap when your baby does.
• If you need a longer break, you can also express milk (by hand or pump) and have someone else feed the breast milk to your baby.
• After a few weeks, a breastfed baby's schedule becomes quite predictable.

You do not need to follow a special diet when you breastfeed. It is rare that a baby will seem sensitive to certain foods, like spicy or gassy foods such as cabbage. Speak with your baby's provider if you think this could be the case.

Breastfeeding and Work

It is easier than ever before to work and continue to breastfeed. Allowing women to breastfeed often leads to less missed time due to illness, and decreased employee turnover.

Hourly workers eligible for overtime pay who work for companies with more than 50 employees are required by law to be given the time and a place to pump. This does not include salaried employees, though most employers will follow these practices. Some states have even broader breastfeeding laws.

But not all mothers are able to pump their breasts on the job so they can continue to breastfeed. Certain jobs, such as driving a bus or waiting tables, may make it hard to stick to a regular pumping schedule. If you have more than one job or if you travel for work, finding a place and time to pump and store milk may be hard. And, while some employers provide a comfortable place for mothers to pump milk, not all do.

Overcoming Breastfeeding Problems

Certain problems can get in the way of breastfeeding for some moms:

• Breast tenderness and nipple soreness. This is normal in the first week. It can also take a couple of weeks for mother and baby to learn how to breastfeed.
• Breast engorgement or fullness.
• Plugged milk ducts.
• Not enough milk for the baby's needs. Though many women worry about this, it is rare that a mother will produce too little milk.

It is well worth doing all you can to overcome breastfeeding challenges. Most mothers find that the early struggles pass quickly, and they settle into a workable and enjoyable feeding routine with their little one.

Health and Safety Issues

If you are a smoker, it is still a good idea to breastfeed.

• Breast milk can help to cancel out some of the risks to your baby from exposure to smoking.
• If you smoke cigarettes, smoke after breastfeeding, so your baby gets the least amount of nicotine.

It is safe to breastfeed your baby if you have hepatitis B or hepatitis C. If your nipples are cracked or bleeding, you should stop nursing. Express your milk and throw it away until your breasts heal.

Mothers who should not breastfeed include those who:

• Have HIV or AIDS, as they can pass the virus to their baby by breastfeeding.
• Are taking certain medicines needed to treat ongoing health problem. If you take medicines for a health problem, ask your provider if it is still safe to breastfeed.
• Have an alcohol or drug addiction.

Bottle Feeding Your Baby

There is no question that it is best to feed your baby breast milk for as long as you possibly can, even if it is just for the first few months or so.

A small number of mothers are not able to breastfeed. This can be hard to accept, but it does not make you a bad mom. Infant formula is still a healthy choice, and your baby will get all the necessary nutrients.

If you choose to feed your baby formula, there are some benefits:

• Anyone can feed your baby. Grandparents or babysitters can feed your baby while you work or get some well-deserved time with your partner.
• You can get round-the-clock help. Your partner can help out with nighttime feedings so you can get more sleep. This can be a bonus for your partner, giving them the chance to bond early on with their little one. Keep in mind though, if you breastfeed, you can also pump your breasts so your partner can feed your baby breast milk.
• You may not have to feed as often. Babies digest formula slower, so you may have fewer feeding times.

Remember that everything you do as a mother, your love, attention, and care, will help give your baby the best start in life.

References

Louis-Jacques A, Lawrence RM, Lawrence RA. The breast and the physiology of lactation. In: Lockwood CJ, Copel JA, Dugoff L, Louis J, Moore TR, Silver RM, Resnik R, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 11.

Meek JY, Noble L. Section on breastfeeding. Policy statement: breastfeeding and the use of human milk. Pediatrics. 2022;150(1):e2022057988. PMID: 35921640 pubmed.ncbi.nlm.nih.gov/35921640/.

Newton ER, Stuebe AM. Lactation and breastfeeding. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 25.

Parks EP, Shaikhkhalil A, Sainath NA, Mitchell JA. Feeding healthy infants, children, and adolescents. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 56.

United States Department of Labor website. Wage and Hour Division. Fact Sheet #73: FLSA protections for employees to pump breast milk at work. www.dol.gov/agencies/whd/fact-sheets/73-flsa-break-time-nursing-mothers. Updated January 2023. Accessed May 25, 2023.

Review Date: 4/25/2023  

Reviewed By: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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