It has been five years since I first wrote this article and the case for breastfeeding as the best choice for a baby has only become stronger. This is not an article to demonize those that have chosen to use formula to feed their child. It is simply an educational tool to help mothers to be fully educated prior to deciding.

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 1970s.

Breastfeeding was on the rise again until direct to consumer advertising began in 1988. Data from the Center for Disease Control for 2014 show that the rate of some form of infant breastfeeding at 6 months of age was at 48% in North Carolina. Only 21% 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, however, kudos to them for constantly improving their product for those who use it.

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 $1600 per baby. If your infant needs a specialty formula, a common problem today, 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 almost a billion dollars annually on formula!

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 healthcare dollars are saved because breastfed babies have fewer trips to the doctor. Because breast milk helps prevent infection, breastfed infants catch fewer infections than their formula fed brethren. More importantly for parents, that means less stress and late nights with a sick child as well as reduced work absences!

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’ naive 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).

Breastmilk also has a prebiotic source of food to feed our new bacterial friends. 8% of breastmilk is a non digestible carbohydrate that is fermented by bacteria for the babies gut health.

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 ten years, we have seen an explosion of cow milk protein intolerant and allergic 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 proteins, especially alpha 1 casein.

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 many a child at such a naive and young age based on our current immune system’s makeup.

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%.

3)    50% 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.

I would like to end this article 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. M

Dr. Magryta is a physician at Salisbury Pediatric Associates. Contact him at newsletter@salisburypediatrics.com