Breastfeeding or Bottle Feeding?

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The decision of whether or not to breastfeed or bottle feed a baby can be one of the most difficult that an expectant or new mother has to make.  There are several issues that should be taken into consideration prior to making this decision.  It should also be considered that not all women may be able to breastfeed, as comfort level, medical condition, and lifestyle can be a deciding factor.  For those women for whom breastfeeding is not a realistic option, you should trust that infant formula is a healthy alternative to breast milk.  There are also women who express a concern that they will not be able to effectively bond with their baby if they bottle feed, however, a loving and attentive mother will always be able to create a special bond.  Feeding time, whether it be breast feeding or bottle feeding, will always be a great opportunity for mother and her child to bond!

Numerous health care organizations strongly recommend that breastfeeding is the best option for a newborn baby.  Amongst these organizations are the American Academy of Pediatrics (AAP), the American Medical Association (AMA), and the World Health Organization (WHO).  The AAP recommends that a baby should be exclusively breastfed for the first six months of their life, and they highly encourage that a baby be breastfed until at least the age of 12 months.  They also suggest that breastfeeding should continue beyond the age of 12 months if both the mother and child are willing.

The overall composition of breast milk cannot be duplicated by a commercial formula because it is essentially a living substance, and the components of the mother’s milk can change over time to meet the baby’s changing needs.  The vitamin and mineral composition of the breast milk will serve to help defend against infections, to strengthen the baby’s immune system, and to help guard against various chronic conditions that newborn babies can be susceptible to.  Studies have shown that breastfed babies develop fewer infections and have less need for hospitalizations than formula fed infants.  The breast milk contains antibodies and other germ-fighting components that serve to strengthen the immune system.  Some types of infections or illnesses that are protected against are ear infections, respiratory infections, meningitis, and diarrhea.  The reinforced immune system can also offer protection against asthma, allergies, obesity, diabetes, and sudden infant death syndrome (SIDS).  Studies have also shown that breastfeeding can be especially beneficial for babies that are born prematurely.

When trying to decide between breast feeding and bottle feeding, it helps to consider the pros and cons of both options.  First, let us examine some of the pros associated with breast feeding.  Breast milk is considered to be absolutely perfect for the digestive system of an infant because the core components of lactose, protein, and fat are easily digested by a newborn.  This improved digestion helps to limit issues like diarrhea and constipation.  Breast milk also contains a majority of the vitamins and minerals that are necessary for the growth and development of the baby.  The one exception to this is Vitamin D, which is not present in breast milk.  For this reason, it is strongly suggested that a newborn take supplements for at least the first two months of life to account for the missing Vitamin D.  It is also suggested that this practice continue until they are approximately 1 year old, and are able to ingest either milk or formula that is fortified with Vitamin D.

Breastfeeding is free, and other things such as bottles, liners, and nipples will only be necessary if the mother is going to choose to pump and store her breast milk.  The financial savings may also be a byproduct of the fact that breastfed babies tend to be healthier.  Fewer doctor visits and prescriptions for medicine can also translate into money in the bank.  There is a degree of convenience that comes with breastfeeding, as emergency trips to the grocery store for supplies and formula can be avoided, and late night feedings do not require the preparation of bottles or formula.  The taste of the breast milk is greatly influenced by the types of food that are eaten by the mother, so breastfed babies tend to have a wider acceptance of a variety of solid foods when the time comes, as compared to babies that are simply accustomed to the taste of formula.

In wrapping up the pros associated with breastfeeding, studies strongly suggest that children who were only breastfed when they were infants tend to have slightly higher IQs than babies who were fed formula.  It was previously stated that breastfeeding can help to reinforce the bond between mother and child.  This skin-to-skin contact associated with nursing creates a different level of emotional connection that is not typically associated with bottle feeding.  This level of connection also serves to reinforce feelings of confidence and pride in the nursing mother because she is able to nutritionally provide everything that her baby needs all by herself.  It has also been proven that the act of breastfeeding itself can serve to burn calories and help shrink the uterus, providing a quicker return to the pre-pregnancy shape and weight, effectively reinstating a feeling of self-esteem and good body image.  Studies have also been conducted which reflect that breastfeeding can be beneficial to the mom, essentially lowering the risk of high blood pressure, diabetes, breast cancer, and cardiovascular disease.  There is also a decreased risk of ovarian and uterine cancer for breastfeeding mothers.

We must now take a moment to consider the challenges that are often associated with breastfeeding.   While the task of breastfeeding can be very easy for some mothers, there are some women for whom the routine is particularly challenging.  Women can find the entire experience painful and uncomfortable, in particular when the baby latches on to the nipple.  For most women that initial painful sensation lasts only about a minute, and usually the overall experience of pain while nursing lasts only through the first ten days or so, however, that is not always the case.  If pain is felt throughout the entire feeding process, and the soreness in the nipples or breasts persists, it may be necessary to see a doctor or a lactation consultant.  Typically, the experience of pain is a byproduct of improper positioning or nursing technique, however, pain can also be a clear indicator of some sort of problem, such as an infection.

Another challenge that is faced by breastfeeding mothers is the basic demands of a nursing schedule.  Babies that are breastfed tend to require more feedings, because the breast milk is digested faster than formula.  During the first few weeks of the baby’s life, it is entirely possible that the baby will need to be nursed every 2-3 hours.  Such a demanding schedule can be very impactful on a woman’s routine, in particular if they have returned to work.  This may also give rise to the need to pump and store breast milk, not only encroaching on work time, but limiting the ability to run errands or travel.  Nursing mothers also need to be mindful of their diets, unlike a mother who chooses to bottle feed, because elements of what the mother ingests can be passed along to the baby through the breast milk.  Much like during pregnancy, a woman needs to be careful with her alcohol and caffeine intake, as small amounts of each can pass along to the baby and have ill effects.  Should a nursing mother drink just a single alcoholic beverage, she should wait at least two hours before breastfeeding her baby to avoid passing along some of the alcohol.  Nursing mothers should also be careful when it comes to eating fish, because elevated levels of mercury in the fish can be harmful to the baby!

Lastly, the medical condition and current medical interventions of a mother can directly impact a decision to breastfeed a newborn baby.  Medical conditions that involve chemotherapy; or conditions like HIV or AIDS, which involve a specific medicinal treatment, can make breastfeeding unsafe for the baby.  Women who are suffering from a medical condition that may be impactful on the ability to nurse should consult their health care provider prior to breastfeeding.  Nursing mothers who have to take any form of medication while they are breastfeeding, even some over-the-counter medications and herbal medicines, should speak to a doctor or lactation consultant first to confirm if it is safe for the baby.  Women who have undergone breast surgery, such as a breast reduction, may have difficulty with their supply of milk, in particular if their milk ducts were severed.  If this is the case, they should also take the opportunity to visit a health care provider or lactation consultant to discuss the situation.

Now we should take a moment to consider the pros and cons associated with bottle feeding.  As stated previously, commercial baby formulas are a nutritious alternative to breast milk, and they contain the Vitamin D that is missing from breast milk.  Formula is the only realistic option if you choose not to breastfeed, as it is the closest approximation to breast milk that is commercially available, and it is created under sterile conditions to help ensure the safety, growth, and development of your baby.  We have mentioned several medical and physical factors that may contribute to a woman’s inability to breastfeed, but there are a number of women who simply make the decision that their lifestyle is better suited for bottle feeding.  The top three reasons that are typically cited by women who make the decision to bottle feed are convenience, flexibility, and diet.  Convenience is typically related to the fact that the responsibility for feeding is not solely that of the mother, and that a partner or a caregiver can just as easily offer a bottle.  It is equally true, however, that a nursing mother also could also prepare a bottle using pumped breast milk, but the pumping itself can be time consuming and can require some degree of a schedule.  Flexibility is connected to the lack of a need for a private setting to nurse, the ability to hand off a prepared bottle to a partner or caregiver and walk away if necessary, and the ability not to be constrained by a rigid feeding schedule.  Also bear in mind that formula fed babies tend to eat less often because the formula is harder to digest, creating even more flexibility in the necessary feeding schedule.  Diet can be a major factor because a bottle feeding mother does not have to monitor their eating and drinking and be concerned that they are passing anything along to the baby that is potentially dangerous!

Several of the challenges associated with bottle feeding were addressed previously when discussing the pros of breastfeeding.  First of all, commercial formula does not contain the antibodies that serve to fortify the immune system of the baby, making them slightly more susceptible to illness and/or infection.  Formula cannot match the complexity of breast milk, which has the ability to change to match the needs of each individual child.  Formula requires a level of preparation and additional supplies that are not necessary when breastfeeding, which in turn can result in unplanned visits to the grocery store to ensure that the necessary supplies are at hand.  It is also important that the additional supplies are cleaned and ready to go, requiring another level of preparation.  Formula fed babies tend to have more gas, and the composition of the formula can contribute to bouts of constipation, as compared to breastfed babies.  One of the most glaring challenges associated with bottle feeding is the expense!  Powdered formula tends to be the least expensive, concentrated formula is typically more expensive, and ready-to-feed formula is the most expensive.  There are also some specialty formulas, such as soy and hypoallergenic, that can be far more expensive than basic formulas.  Research has shown that the total cost for basic formula for the first year of a baby’s life can be approximately $1,500.
After taking all of the aforementioned information into consideration regarding breastfeeding and bottle feeding, it should be relatively apparent that the decision is not necessarily an easy one.  Oftentimes, a woman will make a committed decision prior to giving birth, and then change her mind as to the best approach after the baby arrives.  The decision is so uniquely connected to the lifestyle and individuality of the mother, that it is hard to know in advance how you will adapt to the demands of raising a newborn.  A mother should keep in mind that, even though the decision is hers alone to make, there may a distinct advantage to having a conversation with her health care provider or a lactation consultant regarding the options that are available to her.  It should also be noted that there is no need for a level of firm commitment to just one approach or the other, as some women will choose to nurse their babies and then supplement their diets with formula.  Ultimately, the decision should be based on two primary factors: what is best for you? And what is best for your family?


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By Jack Rambadt of Expecting Parents Alliance of America

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