I have heard it said many times that “breastfeeding is the most important thing that a mother can do for her baby.” This article is dedicated to that truth.
The American Academy of Pediatrics has issued a policy statement on this issue that reads: “Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice.”
It seems odd that we need a policy statement to state the obvious. Yet, with large percentages of women choosing not to nurse for various reasons, maybe the truth about formula is not reaching mothers.
For those mothers who have chosen not to breastfeed, please take this article as a chance to learn and consider breastfeeding future babies. I am not trying to offend any woman, for I know the sensitivity of this topic.
What is the history of formula? As early as 2000 BC, there is documentation of animal milk being used to feed babies.
When wet-nurses, women who breastfeed children other than their own, were not available, mothers would turn to any milk source for survival of their baby.
More recently, in 1867, scientists began to analyze breast milk in order to produce a substitute.
Different forms of powdered and liquid formulas emerged over the next century causing a steady decline in breastfeeding until the 1970’s.
Breastfeeding was on the rise again until direct to consumer advertising began in 1988.
Data from the Center for Disease Control for 2011 show that infant breastfeeding rates are at 37 percent in North Carolina. Only 8.2 percent of infants in North Carolina are exclusively breastfed for the first six months, as recommended by the AAP.
This is a big public health issue. In a 2006 North Carolina breastfeeding study, the barriers to breastfeeding were noted more often in less educated, single, lower socioeconomic status mothers, smokers and obese women.
Since its inception, the goal with formula has been to replicate breast milk.
The brand name Similac comes from “similar to lactation.”
Look at the changes this formula has undergone over the years to try to match breast milk quality.
In the last decade alone we have seen the addition of omega 3 fats, prebiotics, nucleotides and more. The explicit goal of the formula companies is to produce a formula that is as healthy for infants as breast milk. The data show that they cannot.
What do we know about the benefits of breast milk over formula?
Is there a comparison? No!

Let us look at the cost of formula use.
A one year supply of generic infant formula costs roughly $1,600 per baby. If your infant needs a specialty formula, the cost can be more than $3000. Breast milk is free.
The annual cost of formula to American families is greater than two billion dollars. The federal government spends more than 550 million dollars on subsidized WIC formula for the poor.
As our government struggles with covering its budget, here is a place to save money.
Families have to spend extra hard-earned dollars on bottles, nipples, and formula paraphernalia. Environmentally, we have to dispose of all of the cans and bottles.
The energy needed to transport formula around the country could be reduced. Economically, this is a no-brainer!
Additional health care dollars are saved because breastfed babies have fewer trips to the doctor. Because breast milk helps prevent infection, breastfed infants catch fewer infections than formula fed infants.
More importantly for parents, that means less stress and late nights with a sick child!
Breastfeeding also provides an emotional connection between mother and child. Moshe Szyf’s work on nurturing and stress shows us that positive nurturing of newborns helps them to reduce future stress responses.
What better way to reduce the future stress of children than with natural breastfeeding.
In the first few months of life, newborns have an underdeveloped immune system leaving them vulnerable to infection.
Breast milk provides an immediate source of immunity against infections. Many studies have shown that exclusively breastfed babies have fewer gastrointestinal and respiratory infections.
This protective effect stems from the innate immune, anti-infectious, and immune modulating properties of human milk. Specific antibodies and cellular elements secreted by the mother into her breast milk cannot be found in formula.
Human milk adapts to the child’s nutritional needs as the infant grows. Formula cannot do this.
Milk starts out thin and watery and loaded with proteins and antibodies that protect against infection.
As the child ages, breast milk thickens, sweetens and becomes rich in fat, carbohydrate, protein, minerals and vitamins. The system is dynamic like our lives.
Breast milk provides an immediate source of beneficial bacteria to the newborns’ naïve intestines.
The colonization of the intestines occurs soon after birth and is associated with reduced allergic and autoimmune disease.
Many studies show that the bacterial flora in our intestines is set in motion at birth and that cow’s milk formula induces a dramatically different set of microbes that are not as nice to us. (Other major contributors to the promotion of abnormal bacterial flora of our intestines are delivery by caesarian section, early use of antibiotics, early use of antacids, poor quality American style diet, and stress).
The intestinal bacterial flora is likely to be the most important new frontier in human health and will be the target of many therapies for cure and health. It starts at birth.
In the last five years, we have seen an explosion of cow milk protein intolerant children that present to us within weeks of birth with colic, eczema, green and loose stools and gastrointestinal reflux.
The treatment is removal of cow’s milk protein. Why would a supposedly healthy protein need to be removed so often because of intolerance?
The answer is that babies are not little calves; the cow’s milk base is not suited to the child at such a naïve and young age.
Let’s look at the disease reduction by exclusive breastfeeding:
1. Reduces the risk of illness from most forms of bacterial disease.
2. Reduced rates of sudden infant death syndrome by 30 percent.
3. A 50 percent reduction in necrotizing enterocolitis, a life-threatening intestinal disease of preterm infants.
4. Reduces hospital readmission rates for preterm infants during their first year of life
5. Better neurodevelopmental outcomes.
6. Infant mortality rates are reduced by 21%.
7. Provides protection against the development of allergies, especially with a strong family history of allergic disease.
8. Reductions in inflammatory bowel disease and celiac disease.
9. Reductions in autoimmune diabetes and some forms of cancer.
10. And on and on.

If there were a drug that would do all of this, would there be a parent on earth that wouldn’t give it to their child? I think not.
Salisbury Pediatric Associates and Rowan Regional Medical Center have embarked on a new breastfeeding initiative called Best Fed Beginnings.
The program is designed to change the entire culture of the hospital’s staff to promote and support exclusive breast-feeding in those mothers who choose to breastfeed.
Led by Connie Hoffner, the team consists of nursing staff, physicians and consultants that are working to increase breastfeeding success.
The goal is successful breastfeeding with positive encouragement at every level.
If we succeed, we will begin to reverse the trend of formula induced dysfunction and return to a time honored tradition of natural feeding and improved health outcomes.
I would like to end this column with a blessing for all mothers and a hope that this helps those who will soon give birth to raise a beautiful and healthy child.

Dr. Chris Magryta is a pediatrician at Salisbury Pediatric Associates.