Breastfeeding vs Bottle Feeding Formula
The benefits of breastfeeding vs bottle feeding formula, physical benefits of breastfeeding for mom & baby.
- Type 2 diabetes
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- SIDS (sudden infant death syndrome)
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Recommended Links to Learn More about Breastfeeding vs. Bottle-feeding
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- Breastmilk: Every Ounce Counts
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Home / Parenting / Feeding your baby: Breast milk or formula?
Feeding your baby: Breast milk or formula?
There are pros and cons to both breastfeeding and formula feeding. This guide breaks down the benefits and challenges of each.
Some families know right from the start what they’ll feed their babies — breast milk or formula — while others struggle. Most child health organizations advocate breastfeeding, and “Breast is best” is a commonly used phrase. There’s no doubt, breastfeeding is a wonderful way to nourish a newborn — breast milk provides numerous benefits. Mayo Clinic experts agree.
However, medical providers also realize that not all women are the same, and people’s life situations are different. Depending on your circumstances, certain factors may lead you to choose infant formula instead of breast milk. Or you may opt for a combination of both breast milk and formula. Some women simply aren’t able to breastfeed.
If you’re worried that you’re not being a good mother or putting the needs of your child first if you don’t breastfeed, don’t. Such negative thinking isn’t good for you or for your baby. Feeding, regardless of how it’s delivered — breast milk or formula, breast or bottle — promotes intimacy. Know that both options will provide your child the nutrition he or she needs to grow and thrive.
Questions to ask
If you haven’t had your baby yet and you’re debating between breast milk and formula, you might consider these questions:
- What does your medical provider suggest? Your medical provider will likely be very supportive of breastfeeding unless you have specific health issues — such as a certain disease or disease treatment — that make formula feeding a better choice.
- Do you understand both methods? Many women have misconceptions about breastfeeding. Learn as much as you can about feeding your baby. Seek out expert advice if needed.
- Do you plan to return to work? If so, how will that impact breastfeeding? Does your place of work have accommodations available where you can use a breast pump, if that’s your plan?
- How does your partner feel about the decision? The decision is ultimately yours, but it’s a good idea to take your partner’s feelings into consideration.
- How have other mothers you trust and respect made their decisions? If they had it to do over again, would they make the same choices?
Breastfeeding is highly encouraged by experts because it has many known health benefits for babies and moms. The longer you breastfeed, the greater the chances that your baby will experience these benefits, and the more likely they are to last.
Benefits for babies
Breast milk provides babies with:
- Ideal nutrition. Breast milk has just the right nutrients, in just the right amounts, to nourish your baby completely. It contains the fats, proteins, carbohydrates, vitamins and minerals that a baby needs for growth, digestion and brain development. Breast milk is also individualized; the composition of your breast milk changes as your baby grows.
- Protection against disease. Breast milk provides antibodies that help your baby’s immune system fight off common childhood illnesses. Breast-fed babies may have fewer colds, ear infections and urinary tract infections than do babies who aren’t breast-fed. Breast-fed babies may also have fewer problems with asthma, food allergies and skin conditions, such as eczema. Studies suggest that adults who were breast-fed as infants may have a lowered risk of heart attack and stroke and may be less likely to develop diabetes.
- Protection against obesity. Research indicates that babies who are breast-fed are less likely to experience obesity as adults. Formula-fed infants generally have a higher calorie intake than do babies fed breast milk. And breast milk itself appears to have components that help control hunger and energy balance.
- Easy digestion. Breast milk is easier for babies to digest than formula or cow’s milk. Because breast milk doesn’t remain in the stomach as long as formula does, breast-fed babies spit up less. They have less gas and less constipation. They also have less diarrhea, as breast milk appears to kill some diarrhea causing germs and helps a baby’s digestive system grow and function.
Benefits for moms
For nursing mothers, the benefits include:
- Faster recovery from childbirth. The baby’s suckling triggers your body to release oxytocin, a hormone that causes the uterus to contract. This means that the uterus returns to its pre-pregnancy size more quickly after delivery.
- Suppressed ovulation. Breastfeeding delays the return of ovulation and, therefore, menstruation, which may help extend the time between pregnancies. However, breastfeeding is not a guarantee against pregnancy. You can still become pregnant while breastfeeding.
- Possible long-term health benefits. Breastfeeding may reduce your risk of getting breast cancer before menopause. Breastfeeding also appears to provide some protection from uterine and ovarian cancers.
- Convenience. Many mothers find breastfeeding to be more convenient than bottle-feeding. It can be done anywhere, at any time, whenever your baby shows signs of hunger. Plus, no equipment is necessary.
- Breast milk is always available — and at the perfect temperature. Because you don’t need to prepare a bottle and you can nurse lying down, nighttime feedings may be easier.
- Cost savings. Breastfeeding can save money because you don’t need to buy formula, and you may not need bottles.
Admittedly, breastfeeding can also present some challenges and inconveniences. Drawbacks to breastfeeding for nursing moms include:
- Exclusive feeding duties. At first, newborns nurse every two to three hours, day and night. That can be tiring for you, and your partner may feel left out. But you can also express milk with a breast pump, if desired, which can let others take over some feedings.
- Certain dietary restrictions. If you’re breastfeeding, the general rule is to avoid drinking alcohol before nursing. The alcohol level in breast milk is basically the same as in your bloodstream. One standard drink — such as 5 ounces of wine or 12 ounces of beer — takes about two to three hours to leave the bloodstream (and therefore breast milk). If you do drink alcohol, wait at least a couple of hours before breastfeeding. “Pumping and dumping” — pumping after drinking alcohol and discarding the breast milk — doesn’t affect the amount of alcohol in breast milk. Blood alcohol levels will only go down with time.
- Sore nipples. Some women may experience sore nipples and, at times, breast infections. These may be avoided with the right positioning and technique. A lactation consultant or your medical provider can advise you on proper positioning.
- Other physical side effects. When your lactating, your body’s hormones may keep your vagina relatively dry. Using a water-based lubricating jelly can help treat this problem. It may also take time for your menstrual cycle to once again establish a regular pattern.
Some parents prefer to feed their infants formula rather than breast milk. This is a personal choice, and there are many reasons why new parents opt for formula. In a few cases, breastfeeding just isn’t possible.
If you choose not to or you aren’t able to breastfeed, be assured that your baby’s nutritional needs can be met with the use of infant formula. And your baby will still be happily bonded to you as a parent.
Pros and cons
Parents who formula feed usually feel the main advantages are:
- Shared feeding duties. Using a bottle with formula allows more than one person to feed the baby. For that reason, some nursing mothers feel they have more freedom when they’re bottle- feeding. Both parents may like bottle-feeding because it allows them to share more easily in the feeding responsibilities.
- Convenience. Some parents feel formula is more portable, especially on outings and in public places. They don’t have to find an out-of-the-way location to breastfeed.
Some of the challenges of formula feeding include:
- Time-consuming preparation. Bottles must be prepared for each feeding. You need a steady supply of formula. Bottles and nipples need to be washed. If you go out, you may need to take formula with you.
- Cost. Formula is costly, which may be a concern for some parents.
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Breastfeeding or formula feeding: a mother’s choice.
Deciding how to feed an infant is a decision that should be made by a mother and her family. The benefits of exclusively breastfeeding an infant for the first six months of life are well established (World Health Organization [WHO], 2017); however, it may not always be feasible or a preferred option. For mothers who cannot or choose not to breastfeed, formula feeding is a great option that can support a healthy and thriving infant. This fact sheet will address common questions about breastfeeding and formula feeding to help mothers make an informed decision on how to feed their infant, whether it is by breastfeeding, formula feeding, or a combination of the two.
Human breast milk is the gold standard of infant nutrition. It provides nearly all of the essential nutrients and bioactive substances necessary for optimal development and it constantly changes based on the infant’s nutritional needs. Breastfeeding also has many unique benefits for both the mother and baby, described in Table 1. These benefits encompass infant nutritional needs, mother-baby bonding, and maternal health.
Breastfeeding should be initiated within 24 hours of birth in order to stimulate the breasts and increase milk production. Initiating breastfeeding can be challenging for some mothers, and a variety of factors influence whether or not a mother will continue breastfeeding past the first few weeks. Prior lactation education, support from family and hospital staff, concern for the newborn’s health, and cultural perceptions of breastfeeding are a few of the main factors that impact a mother’s decision to breastfeed. The most influential factor on this choice is the support received from partners; however, physicians, lactation consultants, and other health professionals can also make a significant impact on a woman’s desire to continue breastfeeding. In general, mothers and babies need continued support and encouragement in order to succeed in breastfeeding
Table 1. Benefits of Breastfeeding
There are several obstacles that may arise when breastfeeding which may also prevent mothers from continuing breastfeeding. Breastfeeding requires that mothers and babies stay in close proximity, which may be difficult for working mothers, even with the aid of a pump. Lack of support in the workplace or social perceptions of public breastfeeding may also make the task more difficult.
Breastfeeding can be physically challenging as well. Many mothers experience sore nipples, plugged ducts, mastitis or other infections, and breast engorgement. These painful issues can cause women to stop breastfeeding. Most complications can be prevented by breastfeeding on demand, using proper breastfeeding techniques, wearing a supportive bra, and completely emptying the breast of milk. More severe complications or infections that persist will require medical attention. It is important that a mother speak with her doctor or a lactation specialist if she experiences any uncomfortable symptoms.
Some mothers may also worry about producing enough milk. Only 5% of women have an insufficient milk supply; however, milk supply may dwindle if mothers are supplementing with formula or not breastfeeding on demand. Understanding the potential issues and how to overcome obstacles to breastfeeding is crucial in helping mothers continue to breastfeed.
Formula Feeding: Benefits and Drawbacks
Infant formulas are specifically designed to imitate human breast milk composition and they are the only safe alternative to breast milk for infants. Many families enjoy the convenience of formula since any caregiver can help feed the baby, as opposed to just the mother. This can help in situations where the mother is resting, is unable to feed the baby, or needs to return to work. It also provides an opportunity for other family members to bond with the baby during feedings. Many parents also feel that formula feeding helps their babies sleep through the night at an earlier age, meaning fewer nighttime feedings and more sleep for the mother.
A major drawback to formula feeding is the cost. Formulas cost an average of $1,500 per year. Mothers should also keep in mind that formulas cannot convey all the same health benefits as breast milk, as the non-nutritive substances such as antibodies and digestive enzymes cannot be replicated in formula. If a mother decides to use formula to feed her infant, healthcare providers should support her in her decision by helping her determine which formula provides the best option for her infant.
Choosing a Formula
Standard formulas are meant for babies who have no abnormal health or dietary problems. They are typically based on modified cows’ milk or soy milk, which are then fortified with vitamins, minerals such as iron, and essential fatty acids. Formulas are typically produced in three forms: powder, concentrated liquid, and ready-todrink formulas. Powdered formula is cheapest but requires the most preparation, while ready-to-drink formulas are most expensive but require no preparation.
There are a variety of alternative infant formulas available on the market for babies with specific health conditions, as standard formula may not be suitable for all babies. Table 2 describes the types of formulas and their different uses. These formulas vary in nutritional composition, caloric value, taste, digestion, and cost. Talk with your pediatrician before switching your infant’s formula.
Table 2. Types of Formula and Their Uses
What to Avoid
Regular cow or goat milks are not safe alternatives to breast milk or formula during the first year of life. Both goat milk and cow milk do not provide enough vitamin E, iron, or essential fatty acids for the baby and can overload the baby’s body with potassium, sodium, chloride, and protein. The high protein levels in both milks can cause babies to urinate more which can lead to severe dehydration.
Likewise, alternative milks such as coconut, almond, or soy do not have the adequate nutrients an infant needs for healthy growth and development. Once a baby begins their first solid foods, it is safe to feed them foods that contain milk and alternative milks.
A Mother's Choice
Breastfeeding is the gold standard for infant nutrition and best for most mothers and babies, but there are times when bottle-feeding is the best choice for some mothers and babies. Many mothers may perceive that how they choose to feed their babies is a moral decision, with breastfeeding perceived as “good” and formula viewed as “bad” because of current stigmas and social norms. It is essential for mothers to feel supported when deciding on an infant feeding strategy that balances personal, financial, and family factors. Reducing stigmas associated with either choice is vital for helping mothers feel at peace with their decision. Most importantly, mothers should know that either breastfeeding and formula feeding can provide babies with all the essential nutrients they need for adequate growth and development.
- American Academy of Pediatrics, S. O. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827–e841. doi.org/10.1542/peds.2011-3552
- Centers for Disease Control and Prevention. (2013). The CDC guide to strategies to support breastfeeding mothers and babies. U.S. Department of Health and Human Services.
- Dieterich, C. M., Felice, J. P., O’Sullivan, E., & Rasmussen, K. M. (2013). Breastfeeding and health outcomes for the mother-infant dyad. Pediatric Clinics of North America, 60(1), 31–48. doi.org/10.1016/j.pcl.2012.09.010
- Giugliani, E. R. (2004). Common problems during lactation and their management. Jornal De Pediatria, 80(8), 147–154. doi:10.2223/jped.1248
- Godfrey, J. R., & Lawrence, R. A. (2010). Toward optimal health: the maternal benefits of breastfeeding. Journal of Women’s Health, 19(9), 1597–1602. https://doi.org/10.1089/jwh.2010.2290
- Le Huërou-Luron, I., Blat, S., & Boudry, G. (2010). Breast- v. formula-feeding: Impacts on the digestive tract and immediate and long-term health effects. Nutrition Research Reviews, 23(01), 23 doi.org/10.1017/S0954422410000065
- Martin, C. R., Ling, P.-R., & Blackburn, G. L. (2016). Review of infant feeding: Key features of breast milk and infant formula. Nutrients, 8(5). doi.org/10.3390/nu8050279
- Meedya, S, Fahy, K & Kable, A. (2010) Factors that positively influence breastfeeding duration to 6 months: A literature review. Women and Birth, 23(4),135–145. doi.org/10.1016/j.wombi.2010.02.002
- Radzyminski, S., & Callister, L. C. (2016). Mother’s beliefs, attitudes, and decision-making related to infant feeding choices. The Journal of Perinatal Education, 25(1), 18–28. https://doi.org/10.1891/1058-1243.25.1.18
- Rudzik, A. E. F., & Ball, H. L. (2016). Exploring maternal perceptions of infant sleep and feeding method among mothers in the United Kingdom: A qualitative focus group study. Maternal and Child Health Journal, 20(1), 33–40. https://doi.org/10.1007/s10995-015-1798-7
- Samour, P. Q., & King, K. (Eds.). (2012). Pediatric nutrition (4th ed). Jones & Bartlett Learning.
- United States Department of Health and Human Services [USDHHS] Office of the Surgeon General, A. S. for H. (ASH). (2011, January 19). Breastfeeding: Surgeon general’s call to action fact sheet [Text]. Retrieved July 9, 2019, from HHS.gov website: https://www.hhs.gov/surgeongeneral/reports-andpublications/breastfeeding/factsheet/index.html
- World Health Organization (2018). Counseling women to improve breastfeeding practices. Retrieved from https://apps.who.int/iris/bitstream/handle/10665/280133/9789241550468-eng.pdf?ua=1
- Ziegler, E. E. (2007). Adverse effects of cow’s milk in infants. Nestle Nutrition Workshop Series.Paediatric Programme, 60, 185–196; discussion 196–199. doi.org/10.1159/000106369
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Harvard Health Blog
The real link between breastfeeding and preventing obesity
- By Claire McCarthy, MD , Senior Faculty Editor, Harvard Health Publishing
While we know that breastfeeding has many health benefits for mothers and babies, the studies have been a bit fuzzy when it comes to the link between breastfeeding and preventing obesity in children . Some studies show a clear link, but in others that link is less clear. A new study published in the journal Pediatrics may help explain the fuzziness. It showed that what really helped prevent obesity was getting breast milk directly from the breast .
That’s not to say that drinking expressed breast milk from a bottle isn’t healthy. After all, it’s the food that was explicitly designed for infants — and in the study, babies that got breast milk from a bottle did have lower rates of obesity at 12 months. Some of that benefit is thought to be related to the microbiome that breast milk helps create. Babies who drink breast milk are more likely to have certain bacteria in their digestive tracts that help prevent obesity.
But the babies that had the lowest risk of obesity in the study were those that got only breast milk directly from the breast for the first three months of life. Why would that be?
To be able to breastfeed directly from the breast for three months, you have to be able to be with your baby constantly for three months. Mothers who can do that either have access to paid maternity leave or have enough resources to take an unpaid leave — or to stay at home with their babies and not work outside the home at all. Studies have shown that mothers who breastfeed longer are more likely to have higher incomes, more education, and private insurance .
These, then, are mothers who are also more likely to have access to and be able to afford healthy foods, to live in areas where there are safe places to exercise — and to be able to pay for sports and other forms of exercise as their children grow. It’s not just about how these babies are fed, but also about the context in which they are born and raised.
The way in which they are fed, though, is important. Babies who feed directly from the breast are less likely to be overfed. When they are full, they stop sucking, or switch to a “comfort” kind of sucking that doesn’t produce milk. When babies are fed from bottles, parents and caregivers are more likely to push them to finish the bottle; feeding becomes a bit less about appetite and more about volume and schedule.
Learning to eat only when you are hungry and stop when you are full is a really good skill when it comes to preventing obesity. That’s why the American Academy of Pediatrics has encouraged parents to learn and use “ responsive feeding ,” that is, responding to the cues of babies and children of both hunger and being full. The motto is, “You provide, your child decides.”
What this study helps us see is that the link between breastfeeding and obesity prevention is part of a bigger picture we need to pay attention to if we want to fight the obesity epidemic. It shows us that we need to:
- Do everything we can to help mothers stay at home with their babies for at least three months, which will require paid maternity leaves. The United States is way behind the rest of the world in this .
- Help all parents, regardless of how they feed their infants, learn about responsive feeding, and thus help their babies learn to eat when they are hungry and stop when they are full.
- Understand obesity risk as part of a bigger societal issue — truly, as a social justice issue. All children need — and deserve — access to healthy foods and exercise, and there is more we can do to make this happen.
About the Author
Claire McCarthy, MD , Senior Faculty Editor, Harvard Health Publishing
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
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Effect of breastfeeding compared with formula feeding on infant body composition: a systematic review and meta-analysis
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Chris Gale, Karen M Logan, Shalini Santhakumaran, James RC Parkinson, Matthew J Hyde, Neena Modi, Effect of breastfeeding compared with formula feeding on infant body composition: a systematic review and meta-analysis , The American Journal of Clinical Nutrition , Volume 95, Issue 3, March 2012, Pages 656–669, https://doi.org/10.3945/ajcn.111.027284
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Background: Early-life nutrition may influence later body composition. The effect of breastfeeding and formula feeding on infant body composition is uncertain.
Objective: We conducted a systematic review and meta-analysis of studies that examined body composition in healthy, term infants in relation to breastfeeding or formula feeding.
Design: PubMed was searched for human studies that reported the outcomes fat-free mass, fat mass, or the percentage of fat mass in breastfed and formula-fed infants. Bibliographies were hand searched, and authors were contacted for additional data. The quality of studies was assessed. Differences in outcomes between feeding groups were compared at prespecified ages by using fixed-effects analyses except when heterogeneity indicated the use of random-effects analyses.
Results: We identified 15 studies for inclusion in the systematic review and 11 studies for inclusion in the meta-analysis. In formula-fed infants, fat-free mass was higher at 3–4 mo [mean difference (95% CI): 0.13 kg (0.03, 0.23 kg)], 8–9 mo [0.29 kg (0.09, 0.49 kg)], and 12 mo [0.30 kg (0.13, 0.48 kg)], and fat mass was lower at 3–4 mo [−0.09 kg (−0.18, −0.01 kg)] and 6 mo [−0.18 kg (−0.34, −0.01 kg)] than in breastfed infants. Conversely, at 12 mo, fat mass was higher in formula-fed infants [0.29 kg (−0.03, 0.61 kg)] than in breastfed infants.
Conclusion: Compared with breastfeeding, formula feeding is associated with altered body composition in infancy.
The relation between breastfeeding and body composition is of considerable relevance to human health. Particular interest surrounds the potential role of infant feeding in influencing body composition, overweight, and obesity in later life. Systematic reviews that examined associations between early feeding and later-life obesity or BMI have been inconclusive ( 1 , 2 ). This is perhaps unsurprising given the considerable between-study heterogeneity and the importance of confounding in long-term observational studies. Any effect of breastfeeding on adult weight and body composition might be mediated through, or share common biological pathways with, effects on infant body composition, and the accumulation of fat mass relative to body weight is maximal in infancy ( 3 ). Therefore, we considered it relevant to question whether an effect of infant feeding on body composition can be identified in the preweaning and early postweaning period when any relation might be expected to be more pronounced, and the influence of potential confounding factors are more limited.
Growth patterns differ between breastfed and formula-fed infants, and by 12 mo of age, formula-fed infants weigh, on average, 400–600 g more than breastfed infants ( 4 , 5 ). Attempts to measure the effect of infant feeding on body composition have been limited by the variety of techniques used and small sample sizes, and individual studies have reported conflicting results with respect to both the direction and magnitude of effect ( 6 – 8 ). Body composition changes rapidly and nonlinearly over the first year of life ( 9 ), and therefore, comparisons between individual studies have also been complicated by the range of postnatal ages at which measurements have been made.
In this study, we present a systematic review and meta-analysis of longitudinal and cross-sectional studies that were performed in infancy and examined body composition in vivo in relation to breastfeeding and formula feeding.
A systematic review of published studies that reported outcomes of healthy, term (37–42 wk of gestation) infants (0–12 mo of age) was undertaken in accordance with guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses ( 10 ). A protocol was developed (by CG) and reviewed by all authors. The outcomes studied were fat mass (kg), fat-free mass (kg), and the percentage of fat mass. We included studies that used a model of ≥2 compartments with determination of at least one compartment by using one of the following in-vivo techniques: TBK 4 , TOBEC, isotope dilution, ADP, DXA, MRI, or computerized tomography. Studies in which body composition was derived through the measurement of skinfold thickness were excluded because of the poor ability of this technique to predict body composition in infancy ( 11 , 12 ). Types of exposure were breastfeeding (exclusive or predominant) and formula feeding (exclusive or predominant) as defined in each study. No limit was applied with respect to the duration of the feeding method in either group. For inclusion, formula should have been a standard, commercial cow milk–based product, comparison of breastfed and formula-fed groups must have occurred at the same time points, and at least one measure of body composition must have been performed in the first postnatal year.
A search was conducted in PubMed ( http://www.ncbi.nlm.nih.gov ) for studies published before 24 March 2011 in any language by using the following MEDLINE Medical Subject Headings terms, with limitation to human studies: [(breast feeding) OR (infant formula) OR (infant nutritional physiologic phenomena)] AND [(body composition) OR (bioelectrical impedance) OR (total body electrical conductivity) OR (air-displacement plethysmography) OR (absorptiometry, photon) OR (total body potassium) OR (magnetic resonance imaging) OR (tomography, X-ray computed) OR (isotope dilution)].
A literature search was conducted (by CG and assisted by JRCP), and relevant studies were identified by evaluating the abstract or obtaining a full copy of the article if no abstract was available. Reference lists of articles retrieved were hand searched for studies appropriate for inclusion. Whenever possible, forward citations of studies retrieved during the literature search were traced. Review articles and commentaries were excluded after hand searching reference lists.
Data on the study design, location, population, exposure classification, technique of body-composition measurement, outcome, and potential sources of bias were extracted (independently by CG and KML and checked by MJH and SS). Study quality was assessed in relation to the following study biases: blinding to the feeding group by investigators who measured outcomes, definition of feeding groups (in particular, the extent of contamination bias that arose from formula feeding in the breastfed group), and method of assessment of feeding status (prospective or retrospective). In studies in which body-composition data were not presented in a form suitable for a meta-analysis, efforts were made (by CG) to contact the author to obtain these data. Authors were asked to provide means and SDs for fat/adipose tissue mass, fat-free mass, and the percentage of fat mass by feeding group. If no response to 2 requests was received, or if the author was unable to provide additional data, the study was excluded from meta-analyses. When only sex-specific values were presented, these values were pooled by using a standard formula for the combination of mean and SD data ( 13 ).
A meta-analysis was carried out of studies that reported differences in outcomes (fat mass, fat-free mass, and the percentage of fat mass) between formula-fed and breastfed groups at the following time points: 1–2, 3–4 (representing the preweaning period), 6 (weaning), 8–9, and 12 (representing the postweaning period) mo. The mean difference (95% CI) between outcomes in the formula-fed and breastfed groups was calculated at each postnatal age point. When a study examined the same population at 2 postnatal ages and both ages fell within one predefined point, which, therefore, rendered both ages eligible for inclusion (eg, when data were collected at 3 and 4 mo), data from the later age was included in the meta-analysis. When data were obtained from one population at the same postnatal age by using 2 alternate methods, the method with the smallest SD was included in the subsequent meta-analysis. To examine the robustness of these assumptions, analyses were repeated by using the alternate values to determine whether this led to a different conclusion.
A fixed-effects meta-analysis was undertaken with RevMan 5 software (The Cochrane Collaboration) by using the inverse-variance method. This method was performed separately for each postnatal age point. Heterogeneity was assessed by using the chi-square test for Cochrane’s Q statistic ( 14 ) and by calculating I 2 ( 15 ). When heterogeneity was present ( P < 0.05; chi-square test), a random-effects meta-analysis was carried out. In this case, the pooled difference was the estimate of the average effect across study populations because studies were assumed to have different underlying effects. In contrast, for fixed-effects analyses, studies were assumed to have the same underlying effect, which was estimated by using the pooled difference. Results were illustrated by using forest plots. Funnel plots were used to investigate asymmetry.
Subgroup analyses were planned of studies that were performed by using the same body-composition technique, when ≥3 studies reported results at comparable postnatal ages, and of sex-specific values. A subgroup analysis of results by sex may be subject to selection bias because studies may only report results by sex if a difference is observed. Therefore, a subgroup analysis by sex was only carried out if the meta-regression showed sex differences to be significant, and if data were available for the majority of studies at the relevant time point.
The literature search is outlined in Figure 1 . The search strategy identified 702 publications; an additional 8 articles were located after bibliographic review of retrieved articles ( 16 – 23 ). One article was unavailable (in full or abstract form) for review ( 24 ). After screening of abstracts, the full texts of 35 articles were reviewed to assess eligibility. Twenty studies were excluded after full-text review for the following reasons: only breastfed infants were included, with no comparative formula-fed group ( 25 ); body composition was determined by using skinfold thickness only ( 21 , 26 – 30 ); articles were review articles ( 4 , 31 – 34 ); the feeding method was not provided ( 19 , 22 , 35 , 36 ); percentages of fat mass or adiposity data were not provided ( 37 – 39 ); and study cohorts ( 40 ) were part of a larger, included cohort ( 41 ).
Flowchart of the search strategy used in this review set out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The relevant number of papers at each point is provided. BF, breastfed; FF, formula fed; SFT, skinfold thickness.
Fifteen studies remained for inclusion in the systematic review ( 6 – 8 , 16 – 18 , 20 , 23 , 41 – 47 ) ( Table 1 ). For the meta-analysis, attempts were made to contact authors of 7 studies for additional data ( 6 , 16 , 41 – 43 , 45 , 47 ); 5 authors replied ( 6 , 16 , 41 , 42 , 47 ), but one author was unable to provide data ( 47 ). There was considerable heterogeneity with respect to study design. The majority of studies used a longitudinal design, although 3 studies were cross sectional ( 17 , 41 , 46 ). A wide range of techniques were used to measure body composition [ie, TBK ( 47 ), isotope dilution ( 8 , 23 , 41 , 44 , 46 ), TOBEC ( 7 , 17 , 46 ), DXA ( 43 , 45 ), MRI ( 20 ), ADP ( 16 , 18 , 42 ), and a multicomponent technique that incorporated isotope dilution, TBK, and DXA ( 6 )]. No studies were shown to assess body composition in infancy by using computerized tomography. Measurements were performed at a range of time points during the first year ( Table 1 ).
Details of studies included in systematic review 1
ADP, air-displacement plethysmography; AGA, appropriate for gestational age; AT, adipose tissue; BCM, body cell mass; BF, breastfed; BM, breast milk; BMC, bone mineral content; CSS, cross-sectional study; DXA, dual-energy X-ray absorptiometry; ECW, extracellular water; FF, formula-fed; FFES, fat-free extracellular solid; FFM, fat-free mass; FM, fat mass; LS, longitudinal study; SGA, small for gestational age; TBK, total-body potassium determination; TBM, total body mass; TBW, total body water; TOBEC, total-body electrical conductivity.
With respect to study quality, no study reported whether measurements were performed by investigators blinded to the feeding group. The feeding method was prospectively defined in all studies except one study ( 17 ), although the definitions used for feeding groups varied in studies ( Table 1 ). Information provided on weaning ( Table 1 ) indicated that feeding at time points ≥6 mo was no longer predominantly breast-milk feeding even in those groups designated as breastfed groups. Therefore, for time points ≥6 mo, the breastfed group represented originally breastfed infants. In 8 of the 15 studies included, age-specific values were used for hydration and density of fat-free mass ( 3 ). Individual study values for fat mass, fat-free mass, and the percentage of fat mass that were represented by feeding group are shown in Table 2 .
Summary table of body-composition data from individual studies included in the systematic review 1
BF, breastfed; FF, formula-fed; TOBEC, total-body electrical conductivity.
Mean ± SD (all such values).
Body composition at 1ndash2 mo
There were no significant mean differences in fat mass, fat-free mass, or the percentage of fat mass between the formula-fed and breastfed groups ( Tables 3 – 5 ; see Figure 1 under “Supplemental data” in the online issue) at 1–2-mo postnatal age. One study ( 45 ), in which no significant difference was shown in the percentage of fat mass at 2 mo, did not report SDs (and these data were unavailable from the authors) and was, therefore, excluded from the meta-analysis. For meta-analyses, data of fat mass and the percentage of fat mass from Butte et al ( 46 ) that was obtained by using isotope dilution had a narrower SD than did values obtained by using TOBEC for the same cohort; therefore, isotope-dilution data were included; for fat-free mass, data derived by using TOBEC were included. When Anderson ( 16 ) and de Bruin et al ( 7 ) reported values at 1 and 2 mo, the 2-mo values were included. The repetition of analyses by using alternate values for the studies by Butte et al ( 46 ), Anderson ( 16 ), and de Bruin et al ( 7 ) did not alter the significance or direction of results.
Mean difference in fat mass between FF and BF infants 1
BF, breastfed; FF, formula-fed.
All values are means; 95% CIs in parentheses.
Mean difference in fat-free mass between FF and BF infants 1
Mean difference in the percentage of fat mass between FF and BF infants 1
BF, breastfed; FF, formula fed.
Body composition at 3ndash4 mo
Formula-fed infants had significantly lower fat mass, significantly higher fat-free mass, and a significantly lower percentage of fat mass than did breastfed infants at 3–4 mo age ( Tables 3 – 5 ; see Figure 2 under “Supplemental data” in the online issue). Despite contact with the author, SDs were unavailable from one study ( 47 ) (which also reported a significantly higher fat-free mass and lower percentage of fat mass in formula-fed girls, but not boys, at 3 mo) and was excluded from meta-analyses. Data determined by using TOBEC by Butte et al ( 46 ) had narrower SDs than did data determined by using dilutional techniques; therefore, TOBEC data were included in our meta-analysis. The repetition of analyses by using alternate values for the study by Butte et al ( 46 ) did not alter the significance, direction, or magnitude of results.
Pooled mean differences and 95% CIs for fat mass (kg) between formula-fed and breastfed infants by age. A fixed-effects meta-analysis was undertaken with RevMan 5 software (The Cochrane Collaboration) by using the inverse-variance method. This analysis was performed separately for each postnatal age point. When heterogeneity was present ( P < 0.05; chi-square test), a random-effects meta-analysis was carried out. The meta-analysis technique used, P value, and number of subjects at each point were as follows: 1–2 mo: fixed effects, P = 0.49, n = 95; 3–4 mo: fixed effects, P = 0.04, n = 446; 6 mo: fixed effects, P = 0.03, n = 111; 8–9 mo: fixed effects, P = 0.70, n = 122; and 12 mo: random effects, P = 0.07, n = 112.
Body composition at 6 mo
Formula-fed infants had significantly lower fat mass and percentage of fat mass than did breastfed infants at 6 mo. No significant differences were detected in fat-free mass ( Tables 3 – 5 ; see Figure 3 under “Supplemental data” in the online issue). Despite attempts to contact authors, additional data were unavailable for 1 study ( 43 ), which was excluded from meta-analyses. The study ( 43 ) reported a significant positive association between breastfeeding at 6 mo and the percentage of fat mass at 6 mo measured by using DXA. This association was present for the truncal percentage of fat mass but not for the peripheral percentage of fat mass.
Pooled mean differences and 95% CIs for fat-free mass (kg) between formula-fed and breastfed infants by age. A fixed-effects meta-analysis was undertaken with RevMan 5 software (The Cochrane Collaboration) by using the inverse-variance method. This analysis was performed separately for each postnatal age point. When heterogeneity was present ( P < 0.05; chi-square test), a random-effects meta-analysis was carried out. The meta-analysis technique used, P value, and number of subjects at each point were as follows: 1–2 mo: fixed effects, P = 0.85, n = 95; 3–4 mo: fixed effects, P = 0.01, n = 446; 6 mo: random effects, P = 0.48, n = 111; 8–9 mo: fixed effects, P = 0.005, n = 122; and 12 mo: fixed effects, P = 0.0008, n = 112.
Body composition at 8ndash9 mo
Formula-fed infants had significantly higher fat-free mass than did breastfed infants at 8–9 mo. No significant differences were detected in fat mass or the percentage of fat mass ( Tables 3 – 5 ; see Figure 4 under “Supplemental data” in the online issue).
Pooled mean differences and 95% CIs for the percentage of fat mass between formula-fed and breastfed infants by age. A fixed-effects meta-analysis was undertaken with RevMan 5 software (The Cochrane Collaboration) by using the inverse-variance method. This analysis was performed separately for each postnatal age point. When heterogeneity was present ( P < 0.05; chi-square test), a random effects meta-analysis was carried out. The meta-analysis technique used, P value, and number of subjects at each point were as follows: 1–2 mo: fixed effects, P = 0.67, n = 135; 3–4 mo: random effects, P = 0.03, n = 586; 6 mo: fixed effects, P = 0.02, n = 211; 8–9 mo: fixed effects, P = 0.51, n = 122; and 12 mo: random effects, P = 0.16, n = 301.
Body composition at 12 mo
Formula-fed infants had significantly higher fat-free mass than did breastfed infants at 12 mo. No significant differences were detected in fat mass or the percentage of fat mass ( Tables 3 – 5 ; see Figure 5 under “Supplemental data” in the online issue).
Funnel plots of studies at 3–4 mo ( see Figure 7 under “Supplemental data” in the online issue) showed no visual evidence of asymmetry. There was no evidence of funnel-plot asymmetry for analyses at other time points ( see Figures 6 and 8–10 under “Supplemental data” in the online issue), although the small number of studies made this difficult to evaluate reliably.
Pooled differences over the first 12 mo
Pooled differences in fat mass, fat-free mass, and the percentage of fat mass between the formula-fed and breastfed infants by postnatal age are shown in Figures 2 , 3 and 4 , Figures 2 , 3 , and 4 , respectively.
Meta-analysis of results measured by using a single technique
Body composition was measured by using the same technique in ≥3 studies at 3–4 and 6 mo only. At 3–4 mo, ADP was used to measure the percentage of fat mass in 3 studies ( 16 , 18 , 42 ); meta-analysis showed a significant reduction in the percentage of fat mass [mean difference (95% CI): −1.72% (−3.47%, 0.03%) ( P = 0.05); fixed effects, heterogeneity I 2 = 0%, P = 0.75) in formula-fed compared with breastfed infants ( see Figure 11 under “Supplemental data” in the online issue). At 3–4 mo, 5 studies that used isotope dilution reported results for the percentage of fat mass ( 8 , 23 , 41 , 44 , 46 ), and 4 studies that used isotope dilution reported results for fat mass and fat-free mass ( 8 , 23 , 41 , 46 ). Meta-analysis revealed no significant differences for the percentage of fat mass [−1.36% (−3.98%, 1.25%) ( P = 0.31); random effects, heterogeneity I 2 = 61%, P = 0.04; see Figure 12 under “Supplemental data” in the online issue], fat mass [−0.11 kg (−0.25, 0.03) ( P = 0.13); fixed effects, heterogeneity I 2 = 57%, P = 0.07; see Figure 13 under “Supplemental data” in the online issue], fat-free mass [−0.01 kg (−0.16, 0.14 kg) ( P = 0.89); fixed effects, heterogeneity I 2 = 0%, P = 0.42; see Figure 14 under “Supplemental data” in the online issue]. At 6 mo, by using isotope dilution, 3 studies reported results for the percentage of fat mass ( 8 , 23 , 44 ); the meta-analysis of these studies showed no significant difference [−0.33% (−2.39%, 1.72%) ( P = 0.75); fixed effects, heterogeneity I 2 = 45%, P = 0.16; see Figure 15 under “Supplemental data” in the online issue].
Sex-specific effects on body composition
Studies that reported body composition by sex are summarized in Table 1 . Only 2 studies provided comparable data; De Bruin et al ( 7 ) reported data at 1, 2, 4, 8, and 12 mo, and Butte et al ( 6 ) report data at 0.5, 3, 6, 9, and 12 mo. We combined these studies by using meta-regression to examine sex differences at 0.5–1, 3–4, 8–9, and 12 mo so that each cohort only contributed to each time point once. There was no evidence of a significant sex difference from the meta-regression at any time point.
In this systematic review and meta-analysis that included 15 studies and >1000 infants, we identified significant differences in body composition between healthy, term breastfed and formula-fed infants ≤1 y of age. We showed that formula-fed infants had higher fat-free mass throughout the first year of life than did breastfed infants but changes in fat mass over this period were more complex. Formula-fed infants had lower fat mass than did their breastfed counterparts at 3–4 and 6 mo. By 12 mo, this effect was no longer apparent, with a trend toward reversal and higher fat mass in formula-fed infants. These findings are biologically plausible. Circulating leptin is higher in breastfed infants than in formula-fed infants ≤4 mo of age but not later in infancy ( 53 ) in keeping with the greater fat mass in breastfed infants at 3–4 and 6 mo but not at 12 mo. In addition, greater protein intake ( 54 ) and higher resting energy expenditure ( 8 ) in infancy have been well described in formula-fed compared with breastfed infants, which are consistent with our finding of higher fat-free mass in the formula-fed group throughout this period. Although we showed no evidence of a difference in effect between boys and girls, this absence may reflect a lack of power because only 2 studies reported sex-specific results. The variance in difference between feeding groups in fat and fat-free mass was most marked at 6 mo. We considered the possibility that this might have been attributable to data from Motil et al ( 8 ). Ten breastfed (7 boys) and 10 formula-fed (2 boys) infants were recruited in this study, but body-composition data were provided for only 16 infants (sex distribution was not provided). However, the exclusion of these data did not alter the direction of results.
Our meta-analysis was based on studies that used different methods to assess infant body composition. The extent to which these methods are comparable must be considered. Butte et al ( 55 ) showed significant differences in fat mass estimated by using TOBEC, TBK, DXA, and 2 H 2 O isotope dilution. However, there was no evidence of nonsystematic variation ( 55 ), which supported the validity of our analysis that examined the difference in body composition between feeding groups rather than the absolute body composition. In addition, we attempted to address this issue by performing subgroup analyses of studies that reported values measured by using the same technique at a comparable postnatal age. Sufficient studies (≥3 studies) were only available for a minority of time points. In 4 of 5 cases in which this subgroup analysis was possible, we showed differences of the same magnitude and direction as the analyses in which methods were combined. This result supported our analysis of results obtained by using different in vivo body-composition–measurement techniques.
A major limitation of body-composition studies that use indirect techniques in pediatric populations is the rapid maturation of body tissues during childhood ( 3 ). Thus, the assumptions inherent in the derivation of fat or fat-free mass may not be stable throughout childhood. Therefore, it is reassuring that all studies included in our meta-analysis used reference standards that are appropriate for infants. Significant differences in body composition exist in relation to sex in adults ( 56 ). Although differences in infancy appear less pronounced ( 57 ), we intended to examine the effect of sex but were unable to do so because of the limited number of studies that reported outcomes by sex. Studies of infant feeding are liable to important study-level biases such as recall bias if breastfeeding is assessed retrospectively ( 58 ), and contamination bias related to formula feeding in the breastfeeding group. With a single exception ( 17 ), breastfeeding was assessed prospectively in all included studies, which limited the recall bias; however, the definition of feeding groups varied widely, and no study reported the use of WHO criteria for exclusive breastfeeding, which suggested that a contamination bias may represent an important source of heterogeneity. The choice of infant feeding is also subject to a number of important confounding influences, such as prematurity and maternal diabetes, that may also affect body composition. We attempted to limit this possibility through the use of strict inclusion criteria. An additional issue was that the limited number of studies at time points other than 3–4 mo would have resulted in limited power to detect important differences. This issue was of particular relevance at 12 mo, at which, in contrast to our findings at 3–4 mo, there was a suggestion that formula-fed infants had higher fat mass than did infants who were breastfed. Finally, the use of the percentage of fat mass as a proxy for adiposity in body-composition studies has been criticized for methodologic and statistical reasons ( 59 , 60 ); thus, we included measures of fat and fat-free mass as well as the percentage of fat mass. The representation of fat mass by using alternatives such as a fat-mass index to adjust for body size ( 59 ) has been recommended, but we were unable to include such an alternative in our analyses because such data were only available in 3 articles ( 20 , 41 , 42 ) and were not at assessed at comparable time points.
To our knowledge, the pattern of body-composition development over the first year of life that we identified is a novel finding that raises intriguing hypotheses in relation to possible evolutionary drivers and causal biological mechanisms. Key differences exist in macronutrient content and bioactive factors between breast milk and formula. The protein content of formula is higher than that of pooled breast-milk reference samples. However, a hallmark of breast milk is that composition varies widely between mothers and within mothers across feeds by time of day and duration of lactation ( 61 ) and even between different mammary lobes within the same breast ( 62 ). Differences also exist in feeding behaviors between suckled and bottle-fed infants because suckled infants are more likely to initiate and terminate feeding sessions ( 63 ). Because infants who freely suckled at the breast appear to self-regulate intake ( 64 ), this effect raises the important question of the true extent to which macronutrient intake differs from that of formula-fed infants. The large number of potentially bioactive hormones ( 65 ), proteins ( 66 ), cytokines ( 67 ), and growth factors ( 68 ) in breast milk add additional dimensions to differences far beyond those attributable to the macronutrient content.
The higher fat-free mass seen in association with formula feeding is of note. Fat-free mass reflects a heterogeneous group of tissues including bone, muscle, organs, and connective tissue, and hence, the biological implications are uncertain. Future work should aim to distinguish the specific components of fat-free mass influenced by infant feeding. The higher fat mass in early infancy that we showed to be associated with breastfeeding, which is replicated across mammalian species ( 69 ), can be assumed to represent an evolutionary mechanism to support the infant during the precarious weaning period. If we accept the presumption that breast milk represents the ideal nutrition for infants, our finding that formula-fed infants are insufficiently adipose in the preweaning period suggests that infant formulas are not supporting the normal trajectory of adipose tissue development. The apparent switch from higher adiposity in breastfed infants at 3–4 mo to greater adiposity in formula-fed infants at 12 mo would also support the possibility of a programming effect of early infant feeding on intermediary metabolism or appetite regulation. Research involving animal models showed that subtle changes in early feed composition led to alterations in adiposity that preceded deranged glucose metabolism ( 70 ). Accumulating evidence from long-term cohort studies indicates that body composition in childhood tracks into adult life ( 71 ). The data presented in the current study suggest that initiating events may well arise earlier in infancy and result from early feeding choices. Although the differences in fat mass we described are small (of the order of 90 g at 3–4 mo of age and 180 g at 6 mo of age), our findings add to the developing understanding of the possible contributions of breastfeeding and formula feeding on risk of obesity in childhood and adult life. What is now required is long-term follow-up of adequately powered cohorts to identify the outcomes associated with these early differences.
We acknowledge all authors who contributed data to this meta-analysis.
The authors’ responsibilities were as follows—CG: initiated and designed the study; CG, KML, JRCP, and MJH: conducted the literature review; CG and SS: analyzed data; CG and NM: discussed the study and wrote, revised, and prepared drafts of the manuscript, including the final version of the manuscript; NM: had primary responsibility for the final content of the manuscript; and all authors: read, revised, and approved the final manuscript. CG has received support from Pfizer Nutrition to attend an educational conference, but declared no other conflict of interest. MJH has received support from Danone International to attend an educational conference, but declared no other conflict of interest. NM has received consultancy fees from Ferring Pharmaceuticals, but declared no other conflict of interest. KML, SS, and JRCP declared no conflicts of interest.
No funding support was received for this study.
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dual-energy X-ray absorptiometry
total-body potassium determination
total-body electrical conductivity.
- body composition
- breast feeding
- fat-free mass
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Psychological factors in breast feeding versus bottle feeding in the Third World
- PMID: 12264266
PIP: The increasing use of bottle feeding rather than traditional breastfeeding among mothers in developing countries is causing great concern. The feeding bottle is a powerful symbol of westernization, and it can be very difficult for mothers caught in the transitional period between traditional culture and western culture to understand that the feeding bottle can be, under improper hygienic conditions, dangerous to the health of the baby. The importance of breastfeeding in developing countries lies not only in its nutritional value, but in its effect on fertility, since, in many societies, among them the Yoruba of Nigeria, women used to avoid intercourse during breastfeeding. These traditional customs are breaking down, especially among urban and more educated women, or among those holding jobs; a study conducted in Nigeria reports that more education and modern occupations are dramatically changing feeding patterns; in 1976 80% of moderately educated women, i.e. above primary school level, had stopped breastfeeding by the time their children were 1 year old, compared to only 18% of uneducated women. Moreover, many mothers believe that artificial formula is better than breast milk for babies, and view it as medicine, or as being good for children's health. It seems that a reversal to the practice of exclusive breastfeeding will be impossible in most developing countries.
- A better start. Dupont J. Dupont J. IDRC Rep. 1982 Jul;11(2):15-6. IDRC Rep. 1982. PMID: 12264470
- Psychological factors in breast feeding versus bottle feeding in the Third World. Berry N, Mccullough M. Berry N, et al. Bull Br Psychol Soc. 1982 Sep;35:355. Bull Br Psychol Soc. 1982. PMID: 12264707
- Early termination of breastfeeding among Philippine urban poor. Guthrie GM, Guthrie HA, Fernandez TL, Estrera N. Guthrie GM, et al. Ecol Food Nutr. 1983;12(4):195-202. doi: 10.1080/03670244.1983.9990716. Ecol Food Nutr. 1983. PMID: 12265406
- Role of breast-feeding in the prevention and treatment of diarrhoea. Huffman SL, Combest C. Huffman SL, et al. J Diarrhoeal Dis Res. 1990 Sep;8(3):68-81. J Diarrhoeal Dis Res. 1990. PMID: 2243179 Review.
- Qualitative Studies of Infant and Young Child Feeding in Lower-Income Countries: A Systematic Review and Synthesis of Dietary Patterns. Bazzano AN, Kaji A, Felker-Kantor E, Bazzano LA, Potts KS. Bazzano AN, et al. Nutrients. 2017 Oct 18;9(10):1140. doi: 10.3390/nu9101140. Nutrients. 2017. PMID: 29057842 Free PMC article. Review.
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Although “breastfeeding” has been the clear answer for decades, the importance of exclusive breastfeeding as the primary driver of health benefits for infants has emerged more recently. 1,2 The strongest evidence for exclusive breastfeeding is in the prevention of common infectious diseases and sudden infant death syndrome. 1,–3 That exclusive …
Ultimately the decision to breastfeed vs bottle feed is made by the parents, but parents should strongly consider breastfeeding as a very health-conscious option. Because there are many health and relational benefits of breastfeeding, it is strongly suggested by all medical communities. The Benefits of Breastfeeding vs Bottle Feeding Formula
Breastfeeding may reduce your risk of getting breast cancer before menopause. Breastfeeding also appears to provide some protection from uterine and ovarian cancers. Convenience. Many mothers find breastfeeding to be more convenient than bottle-feeding. It can be done anywhere, at any time, whenever your baby shows signs of hunger.
Breastfeeding requires that mothers and babies stay in close proximity, which may be difficult for working mothers, even with the aid of a pump. Lack of support in the workplace or social perceptions of public breastfeeding may also make the task more difficult. Breastfeeding can be physically challenging as well.
By Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing. While we know that breastfeeding has many health benefits for mothers and babies, the studies have been a bit fuzzy when it comes to the link between breastfeeding and preventing obesity in children. Some studies show a clear link, but in others that link is less clear.
breast feeding infant fat-free mass Issue Section: Growth, development, and pediatrics INTRODUCTION The relation between breastfeeding and body composition is of considerable relevance to human health. Particular interest surrounds the potential role of infant feeding in influencing body composition, overweight, and obesity in later life.
Breastfeeding is also more convenient. You can breastfeed almost anywhere and anytime your baby is hungry. You do not need to make formula before feeding, worry about clean water, or carry it with you when you go out or travel. And you save money on formula, which can cost $1,000 or more a year. Breastfeeding is the natural, healthy choice for ...
Although greater convenience, necessity of working outside the home, or insufficient milk lead some mothers to bottle feed, misleading and aggressive promotional campaigns of the infant feeding companies have been very effective in persuading mothers of all income levels to choose bottle feeding.
PIP: The increasing use of bottle feeding rather than traditional breastfeeding among mothers in developing countries is causing great concern. The feeding bottle is a powerful symbol of westernization, and it can be very difficult for mothers caught in the transitional period between traditional culture and western culture to understand that ...