Breast Bottle

The Babble Staff

In the 1950s, bottle-feeding was the norm. Now, as more and more benefits of breastfeeding are discovered, the pendulum has swung back. Some argue that formula is as good, or better, than mother's milk, but such talk is likely to give breastfeeding activists an aneurism. Amid all the talk of how superior the boob is to the bottle, it can be easy to forget that practical concerns sometimes make breastfeeding difficult or near impossible. Not all working mothers can pump, let alone breastfeed, at work. There may also be other complications: lack of milk, nipple pain, need for certain medications. A growing number of mothers who bottle-feed their babies are raising their voices in an angry chorus, asking why they should be made to feel guilty. The AAP states that "Human milk is the preferred feeding for all infants, with rare exceptions." Yet, as Dr. Cohen points out, breastfeeding may be the natural way, and it may decrease the rate of infections in children, but even breast-fed babies get sick.

How do you measure the peace of mind of having a healthy baby who is developing optimally? Where do you factor in the financial burden of formula prices and increased medical costs?

Public health agencies advocate for breastfeeding because of its well-documented health advantages to babies, but they fail to convey to individual mothers and families the potential emotional impact of this very crucial infant-feeding decision. In Western society, the decision about breast or bottle is still seen very much as a personal choice based on convenience. The potential stress of living with a child with recurrent illnesses, or the loss of the unique bond that comes from breastfeeding, are often omitted from the decision-making process.

There is much more to breastfeeding than the provision of optimal nutrition and protection from disease through mother's milk. Breastfeeding provides a unique interaction between mother and child, an automatic, skin-to-skin closeness and nurturing that bottle-feeding mothers have to work to replicate. The child's suckling at the breast produces a special hormonal milieu for the mother. Prolactin, the milk-making hormone, appears to produce a special calmness in mothers. Breastfeeding mothers have been shown to have a less intense response to adrenaline (Altemus 1995).

This calming effect is hard to measure in a society largely unsupportive of breastfeeding such as the United States, where breastfeeding beyond the early weeks is not the norm. Mothers who try to breastfeed in this climate often experience physical and emotional problems. These problems result from a lack of breastfeeding role models among family and friends, and are compounded by the easy availability of formula and a lack of access to knowledgeable and supportive health care professionals.

Even if a mother overcomes physical problems, she may still encounter negative comments, such as "Are you still nursing?" or "Your milk may not be strong enough — why don't you add formula?" Or her employer may make it impossible for her to continue breastfeeding on returning to work. Or she may be harassed for breastfeeding in public. No wonder that few mothers get to fully experience the relaxing effects of breastfeeding.

New motherhood is a time fraught with emotion. The baby blues are common, often exacerbated by lack of support and a sense of isolation. The role of breastfeeding in postpartum emotional upheavals has not been well studied, but breastfeeding mothers with depression need treatment just as much as any other mother. Such women present a unique challenge to health care professionals. Since medications may pass into breast milk, many physicians believe the safest solution is to wean the child. However, in most cases of depression, women do better if they continue to breastfeed. Unfortunately, too often physicians insist that mothers wean their child in order to take antidepressant medicines.

A review of the literature, however, has demonstrated that several antidepressants pose minimal, if any, risk to the nursing child. A mother who feels that her nursing relationship with her child is the only thing going right in her life can now continue to breastfeed while receiving appropriate medications for her depression.

One of the most powerful arguments many health professionals, government agencies and formula company manufacturers make for not promoting and supporting breastfeeding is that we should "not make the mother feel guilty for not breastfeeding". Even some strong breastfeeding advocates are disarmed by this "not making mothers feel guilty" ploy.

It is an argument which deflects attention from the lack of knowledge and understanding of most health professionals about breastfeeding. This allows them not to feel guilty for their ignorance of how to help women overcome difficulties with breastfeeding, which could have been overcome and usually which could have been prevented in the first place if mothers were not so undermined in their attempts to breastfeed.

If a pregnant woman went to her physician and admitted she smoked a pack of cigarettes, is there not a strong chance that she would leave the office feeling guilty for endangering her developing baby? If she admitted to drinking a couple of beers every so often, is there not a strong chance that she would leave the office feeling guilty?

Why such indulgence for formula? The reason of course, is that the formula companies have succeeded so brilliantly with their advertising to convince most of the world that formula feeding is just about as good as breastfeeding, and therefore there is no need to make such a big deal about women not breastfeeding.

Let's look at this a little more closely. Formula is certainly theoretically more appropriate for babies than cow's milk. But, in fact, there are no clinical studies which show that there is any difference between babies fed cow's milk and those fed formula. Not one. Breastmilk, and breastfeeding, which is not the same as breastmilk feeding, has many more theoretical advantages over formula than formula has over cow's milk (or other animal milk). And we are just learning about many of these advantages. Almost every day there are more studies telling us about these theoretical advantages. But there is also a wealth of clinical data showing that, even in affluent societies, breastfed babies, and their mothers incidentally, are much better off than formula fed babies. They have fewer ear infections, fewer gut infections, a lesser chance of developing juvenile diabetes and many other illnesses. The mother has a lesser chance of developing breast and ovarian cancer, and is probably protected against osteoporosis. And these are just a few examples.

All pregnant women and their families need to know the risks of formula feeding. All should be encouraged to breastfeed, and all should get the best support available for starting breastfeeding once the baby is born.

Dr. Jack Newman, MD, FRCPC
August, 1997

I'm going to repeat what everybody knows about breastfeeding: Breastfeeding is good, both psychologically and emotionally. The question many parents ask is: "How superior is breastfeeding to bottle-feeding from a health standpoint?" The answer is hard to quantify.

Mixed properly, formula contains the same amounts of water, protein, sugar, and fat as breastmilk, but it lacks the immunoglobulins and enzymes that breastmilk provides. On the other hand, formula is reinforced with vitamins and iron in quantities greater than those breastmilk supplies, even if these extra quantities aren't crucial. But if you're eating and nursing properly, you're providing just the right amounts of these same nutrients anyway.

Though breastfeeding is very good at transferring immunity, it obviously doesn't prevent all illnesses. [. . .] A few years ago, another study stirred up media attention by reporting that nursing decreases the frequency of ear infections. As a result, I occasionally get calls from parents (usually late at night) seeking an explanation for their child's sudden onset of ear pain. "How could his ears be infected? He was nursed for a full year!"

Another common misconception, that breastfeeding guarantees acceptance to an Ivy League school, springs from an inconclusive but highly publicized study that argued that IQ is slightly higher in breast-fed children. I cannot provide much anecdotal evidence on that one, as very few of my patients have applied to college yet. In any event, almost all the kids I see are geniuses; their mothers can vouch for that.

In summary, if you think nursing isn't for you, I recommend that you give it a chance. You may like it more than you think. If you've already given it a good try and disliked it (or if you don't even want to try), your baby still stands a very good chance of being healthy.

Some new mothers prefer not to breastfeed. They feel uncomfortable with the idea of nursing — for many reasons — and choose to forgo it. If you choose to bottle feed you can feel confident in your decision. The infant formulas available today provide perfectly adequate nutrition. And by cuddling and talking to your baby while feeding him, you can easily duplicate the feeling of warmth and closeness that breastfeeding provides.

You may be surprised, and encouraged to learn, that there are many advantages to bottle-feeding. As well as practical advice it is hoped you'll find comfort on this web site during, what can be, a very emotional time for a new mother as she learns to feed her baby.

Thankfully, most women who bottle-feed soon overcome any guilt they may feel and soon feel confident about feeding. The secret is support: support from this web site and other resources, such as; your midwife, doctor and health visitor; friends and family. Mothers are here to raise their children as best they can. Giving your child the best possible start in life encompasses so much more than feeding.

The "breast is best" pendulum has swung so far in favor of breastfeeding infants that parents who choose to (or have no choice but to) bottle-feed their babies feel stigma and guilt. Although just a half century ago, bottle-feeding was the norm in the United States, times and trends have changed and breastfeeding is the accepted "best practice" for infant feeding. Still, according to physicians, bottle-feeding is a healthy and satisfactory choice, and a reasonable substitute for breast-feeding. In other words, bottle-fed babies are healthy and develop just fine.

Infant formulas on the market are regulated in terms of their content. They are manufactured to resemble human breast milk as closely as possible. So, there is not significant difference in the constitution of different brands of formula. What a parent will find is that formula is available in cow-based or soy-based. Most physicians recommend trying the cow-based formula first. Then, if a reaction or allergy develops, try a soy-based formula. Check with your physician or pediatrician for suggestions. He or she may have suggestions based on your genetic history, or updated information on products available.