Simply The Breast 🎶

In Wednesday’s newsletter, we asked you for your opinion on breast vs formula milk (for babies!), and got the above-depicted, below-described, set of responses:

• 80% said “Breast is best, as the slogan goes, and should be first choice”
• 20% said “They both have their strengths and weaknesses; use whatever”
• 0% said “Formula is formulated to be best, and should be first choice”

That’s the first time we’ve ever had a possible poll option come back with zero votes whatsoever! It seems this topic is relatively uncontentious amongst our readership, so we’ll keep things brief today, but there is still a little mythbusting to be done.

So, what does the science say?

[Breast milk should be the first choice] at least for the few few weeks and months for the benefit of baby’s health as breast milk has protective factors formula does not: True or False?

True! The wording here was taken from one of our readers’ responses, by the way (thank you, Robin). There are a good number of those protective factors, the most well-known of which is passing on immune cells and cell-like things; in other words, immune-related information being passed from parent* to child.

*usually the mother, though in principle it could be someone else and in practice sometimes it is; the only real requirements are that the other person be healthy, lactating, and willing.

As for immune benefits, see for example:

Perspectives on Immunoglobulins in Colostrum and Milk

And for that matter, also:

Colostrum is required for the postnatal ontogeny of small intestine innate lymphoid type 2 cells and successful anti-helminth defences

(Colostrum is simply the milk that is produced for a short period after giving birth; the composition of milk will tend to change later)

In any case, immunoglobulin A is a very important component in breast milk (colostrum and later), as well as lactoferrin (has an important antimicrobial effect and is good for the newborn’s gut), and a plethora of cytokines:

Cytokines in Human Milk

As for that about the gut, lactoferrin isn’t the only breast milk component that benefits this, by far, and there’s a lot that can’t be replicated yet:

Human Breast Milk and the Gastrointestinal Innate Immune System

As long as your infant/child is nutritiously fed, it shouldn’t matter if it comes from breast or formula: True or False?

False! Formula milk will not convey those immune benefits.

This doesn’t mean that formula-feeding is neglectful; as several people who commented mentioned*, there are many reasons a person may not be able to breastfeed, and they certainly should not be shamed for that.

*(including the reader whose words we borrowed for this True/False item; the words we quoted above were prefaced with: “Not everyone is able to breastfeed for many different reasons”)

But, while formula milk is a very good second choice, and absolutely a respectable choice if breast milk isn’t an option (or an acceptable option) for whatever reason, it still does not convey all the health benefits of breast milk—yet! The day may come when they’ll find a way to replicate the immune benefits, but today is not that day.

They both have their strengths and weaknesses: True or False?

True! But formula’s strengths are only in the category of convenience and sometimes necessity—formula conveys no health benefits that breast milk could not do better, if available.

For many babies, formula means they get to eat, when without it they would starve due to non-availability of breast milk. That’s a pretty important role!

Note also: this is a health science publication, not a philosophical publication, but we’d be remiss not to mention one thing; let’s bring it in under the umbrella of sociology:

The right to bodily autonomy continues to be the right to bodily autonomy even if somebody else wants/needs something from your body.

Therefore, while there are indeed many good reasons for not being able to breastfeed, or even just not being safely* able to breastfeed, it is at the very least this writer’s opinion that nobody should be pressed to give their reason for not breastfeeding; “no” is already a sufficient answer.

*Writer’s example re safety: when I was born, my mother was on such drugs that it would have been a very bad idea for her to breastfeed me. There are plenty of other possible reasons why it might be unsafe for someone one way or another, but “on drugs that have a clear ‘do not take while pregnant or nursing’ warning” is a relatively common one.

All that said, for those who are willing and safely able, the science is clear: breast is best.

Want to read more?

The World Health Organization has a wealth of information (including explanations of its recommendations of, where possible, exclusive breastfeeding for the first 6 months, ideally continuing some breastfeeding for the first 2 years), here:

World Health Organization | Breastfeeding

Take care!