Formula Milk in No Way Compares to Human Milk

“Something as simple as breastfeeding could save almost a million children a year.” -Jenny Morrow (Research found from the World Health Organization)

Feeding Preferences Considered

Newborn feeding options include breastmilk, donor milk or formula. You might hear that breast is best and know some benefits, but did you know that there are significantly detrimental effects that can occur from not breastfeeding? You’ll learn what’s in breastmilk vs. formula, it’s going to amaze you! Plus, we’ll cover the risks and benefits of infant feeding practices for women and their children.

 Impact of Infant Feeding on Maternal Health

  • Epidemiological data suggest that women who do not breastfeed face higher risks of cancer, cardiovascular diseases and weight gain.
    • Breast cancer
      Studies show that when you breastfed, this suppresses ovulation, leading to lactational amenorrhea (we discussed briefly above). In addition, lactogenesis leads to terminal differentiation of the breast tissue, which may reduce malignant transformation. These effects may mediate associations between breastfeeding and breast and ovarian cancer. Multiple studies have now examined the relationship between breastfeeding and breast cancer risk. A recent meta-analysis of 47 studies found that each year of breastfeeding was associated with a 4.3% reduction in risk of invasive breast cancer. Women who had never breastfed had a 1.4-fold increased risk of breast cancer, compared with women who had breastfed for a lifetime total of greater than 55 months (4 and ½ years). In short – if you breastfeed three children for two years each, this could reduce your risk of developing breast cancer by almost 30%!
    • Ovarian cancer
      Woman who developed mastitis while breastfeeding had the lowest risk of ovarian cancer. Researchers hypothesize that antibodies to MUC1, which develop during mastitis, may have a role in reducing the risk of ovarian cancer. In a case study, they found higher levels of MUC1 antibodies found among women who had breastfed and developed mastitis.
    • Cardiovascular disease
      Breastfeeding requires a substantial metabolic exposure; mothers who exclusively breastfeed burn over 500 calories a day to produce milk. This metabolic load may help mobilize the weight gained during pregnancy. Epidemiological studies suggest that favorable outcomes persist after weaning, with long term benefits for mothers. In the Nurses Health Study, never having breastfed was linked to a 1.3-fold risk of myocardial infarction, compared with lifetime breastfeeding for 2 years or more. Over an average of 7.9 years of post-menopausal participation in the Women’s Health Initiative, women with a single live birth who never breastfed were 28% more likely to develop cardiovascular disease than women who breastfed for 7-12 months.
    • Maternal diabetes
      Differences in metabolism between breastfeeding and formula feeding woman appear to persist into later life. The Shanghai Women’s Health Study found that women who had breastfed their children tended to have a 12% lower risk of diabetes mellitus than those who had never breastfed.
    • Maternal hypertension (high blood pressure)
      A Korean study found that lactation decreased mothers’ risk of developing hypertension by 8%. In the United States, using data from the Women’s Health Initiative, authors estimated that for every 29 women who breastfeed for more than 1 year, 1 case of post-menopausal hypertension would be prevented.
    • Maternal hyperlipidemia and metabolic syndrome
      Data from the Women’s Health Initiative also indicates that for every 40 women who breastfed more than 1 year, 1 case of post-menopausal hyperlipidemia would be prevented. The Study of Women’s Health Across the Nation found that each year of lactation decreased risk of developing the metabolic syndrome by 12%. In short – if you breastfeed three children for two years each, this could reduce your risk of developing the metabolic syndrome by almost 72%!

 Infant Feeding and Child Health Outcomes

  • Data suggest that children who do not breastfeed face higher risks of cancer, autoimmune disease, obesity, metabolic disorders, infections and SIDS.
    • Infectious morbidity
      Compared with breastfed infant, formula fed infants are more likely to develop an infection in the first year of life. This increased risk of infectious morbidity and mortality is explained, in part, by specific and innate immune factors present in human milk. Refer to the UF Breastmilk vs. Formula handout above to see how much formula is lacking compared to the composition of breastmilk.
    • Gastrointestinal infections
      Multiple studies suggest that formula fed infants face increased risk of gastroenteritis and diarrhea. In a meta-analysis of cohort studies, infants who were formula fed or fed a mixture of formula and human milk were 2.8 times as likely to develop gastrointestinal infection than those who were exclusively breastfeeding. Preterm infants are susceptible to necrotizing enterocolitis, for every 20 preterm infants who are breastfed, 1 case of necrotizing enterocolitis is prevented.
    • Otitis media (ear infections)
      Approximately 44% of infants will have at least one ear infection in their first year of life. The risk of otitis media among formula fed infants is twice that of infants who are exclusively breasted for more than 3 months.
    • Lower respiratory tract infections
      In a meta-analysis, infants who were formula fed faced a 3.6-fold increased risk of hospitalization for lower respiratory tract infection in the first year of life, compared with infants who were exclusively breastfed for more than 4 months. Lipids in human milk appear to have antiviral activity against respiratory syncytial virus, which causes the majority of respiratory hospitalizations for infants.
    • Infant mortality
      A study found that formula feeding was associated with a 1.3-fold higher risk of infant mortality compared with breastfeeding.
    • Sudden infant death syndrome (SIDS)
      Meta-analyses of case control studies suggest that formula feeding is associated with a 1.6-2.1-fold increased odds of sudden infant death syndrome, compared with breastfeeding. A recent German case-control study found that not being exclusively breastfed at 1 month of age was associated with a 2-fold risk of SIDS.
    • Obesity and childhood metabolic disease
      Epidemiological studies suggest that children who are breastfed in infancy are less likely to become obese or develop type II diabetes. Researchers have proposed several mechanisms to explain these associations, including differences in composition of human milk vs formula, feeding practices, associated lifestyle factors and self-regulation of intake by the infant. There is an appetite hormone called leptin in breastmilk that helps the infant know when their full. That’s why some breastfeeding sessions are 5 minutes, and some are 45 minutes in duration, baby is eating a snack or maybe Thanksgiving dinner. Infants that are formula fed tend to get the same volumes of food, feeding after feeding and are unable to regulate their appetite like breastfed infants.
    • Neurodevelopment
      A meta-analysis of 20 studies found that breastfeeding was associated with significantly higher scores for cognitive development than was formula feeding. Higher levels of cognitive function were seen in breastfed than in formula fed children at 6-23 months of age. Low birth weight infants (premature infants) had the highest scores for cognitive development and these babies seem to derive the greatest benefits. The cognitive development benefits of breastfeeding increased with duration for both term and preterm infants.
    • Exclusive breastfeeding and the immune system
      Early feeding has a central role in the development and maturation of the infant immune system. Compared with human milk fed infants, formula fed infants have higher pH stools and greater colonization with pathogenic bacteria, including Escherichia coli, Clostridium difficile and Bacteroides fragilis. The more favorable colonization with breastfed infants appears to be facilitated by bioactive factors in human milk. These oligosaccharides, cytokines and immunoglobulins regulate gut colonization and development of gut-associated lymphoid tissue and govern the differentiation of T-cells that have a role in host defense and tolerance. Formula fed infants also have a smaller thymus than breastfed infants. The thymus serves a vital role in the training and development of T-lymphocytes or T-cells, an extremely important type of white blood cell. T-cells defend the body from potentially deadly pathogens such as bacteria, viruses and fungi. These differences in immune system differentiation may underlie the higher incidence of allergic disease in formula fed children. Not breastfeeding may also increase disease risk through exposure to foreign antigens in the formula.
    • Childhood autoimmune disease
      • Asthma
        Multiple studies have examined the association between infant feeding and development of asthma. In a meta-analysis, a 1.7-fold risk of developing asthma among formula fed children with a positive family history of asthma, a 1.4-fold risk among those without a family history, compared with those who were breastfed for 3 months or more.
      • Atopic dermatitis
        In a meta-analysis, infants with a family history of atopic dermatitis who were formula fed or exclusively breastfed for less than 3 months have a 1.7-fold higher risk, compared with infants who were exclusively breastfed for greater than 3 months.
      • Type 1 diabetes
        Epidemiological studies have reported an association between exposure to cow’s milk antigen and development of type I diabetes, although results have been mixed. In a pilot study, exposure to cow’s milk-based formula was associated with higher prevalence of islet cell auto antibodies, providing tentative evidence for a casual association between cow’s milk exposure and type I diabetes.
    • Childhood cancer
      Several studies have examined associations between formula fed and childhood leukemia, based on the hypothesis that immunoactive factors in breast milk may prevent viral infections implicated in leukemia pathogenesis. Two meta-analyses found a 1.3-fold higher risk of acute lymphoblastic leukemia among formula fed children and a 1.2-fold higher risk of acute myeloid leukemia among formula fed infants, compared with children who were breastfed greater than 6 months.

 What the Top Agencies Recommend

How you feed your infant is a very personal decision. You’ve learned that formula feeding places mothers and infants at increased risk of a broad spectrum of adverse health outcomes, ranging from infectious morbidity to chronic disease. It’s just reality, formula milk in no way compares to human milk.

What the top agencies recommend: The World Health Organization and UNICEF have recommended for a decade that mothers breastfeed for at least two years. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first 6 months of baby’s life, followed by breastfeeding in combination with the introduction of complimentary foods until at least 12 months of age and continuation of breastfeeding for as long as mutually desired by mother and baby.

Bonus Tip: It’s good to know that even with the introduction of solids that are usually introduced around 6 months, baby’s main food source for the first year of life is either breastmilk, donor milk or formula. After the first year of life baby can continue to breastfeed or drink pumped breastmilk or if feeding baby formula, you’ll discontinue use of formula and baby can now be introduced to whole milk (such as cow milk or goat milk). Your baby will still take in 16 ounces or more of breastmilk and/or whole milk from the age of one to two years old.

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