Infant Feeding: Breast or Bottle?

You are a new mother or are anticipating the birth of your child. As you prepare for your baby's arrival, there may be many questions you may have. One might be: Should I breastfeed?

Here are some points to consider when deciding to breastfeed or bottle-feed.

Benefits of Breastfeeding for the Baby

• Proper nourishment—Breast milk contains almost all of the nourishment that babies need during their first 6 months of life. However, vitamin D supplementation is needed because breast milk is low in this vitamin. Supplementation with vitamin D will need to be continued until your baby is getting enough vitamin D from other sources, such as vitamin D-fortified formula or sunlight. Talk to your baby's doctor before exposing them to sunlight. Overexposure is harmful. Starting at age 4 months, your baby will also need an iron supplement until they start getting enough iron from food sources, like infant cereal. If your baby is premature, they will likely need to take iron starting at 1 month of age.
• Immunity boost—Breast milk contains substances not found in formula that help protect babies from illness. These substances include antibodies, immunoglobulins, active enzymes, and hormones.
• Fewer illnesses—Compared with bottlefed infants, breastfed infants are less likely to develop:
  • Ear infections
  • Infections of the respiratory and gastrointestinal tracts
  • Diarrhea
• Possible protection against certain conditions—Breastfed infants may have some protection against sudden infant death syndrome, type 1 diabetes, type 2 diabetes, obesity, asthma, eczema, and leukemia.
• Boost to brain development—The nutrients found in breastmilk enhance how your baby's brain develops. Breastfeeding may even have a positive impact on your child's IQ and school performance.
• Easy digestion—Breast milk is easier for babies to digest.
• Bonding—The skin-to-skin contact involved in breastfeeding can enhance bonding between mother and baby.
• Jaw development—Sucking at the breast promotes good jaw development. It is harder to get milk from the breast than from a bottle.

Benefits of Breastfeeding for the Mom

Women who breastfeed their babies experience the following health benefits:

• Less postpartum bleeding
• More rapid shrinkage of the uterus to pre-pregnancy size
• Quicker return to pre-pregnancy weight—Milk production burns calories.
• Slower return of menstrual cycles
• Possible reduced risk of:
  • Breast cancer before menopause—Nursing a baby for at least 3 months may cause protective changes in breast cells.
  • Ovarian cancer
  • Type 2 diabetes
  • Postpartum depression

Both parents will likely appreciate the convenience of breastfeeding, including:

• Breast milk is available, sterile, and free.
• There is no formula to buy, measure, and mix.
• There are no bottles and nipples to sterilize. Plus, you don't need to carry these and formula wherever you go.

Drawbacks of Breastfeeding

• Stress for mom—You are the sole provider of nutrition for your baby, which can be very demanding and exhausting for some women. However, once a pattern is established, other family members can give you a break by feeding the baby a bottle of breast milk that has been pumped and stored in the refrigerator or freezer.
• Slow start—You may have difficulty getting the baby to properly latch onto the breast.
• Possible pain—Breastfeeding can be painful. You may have sore nipples, clogged milk ducts, and mastitis (breast pain).
• Medication precautions—Some medications can pass through the breast milk to your baby and may not be safe. Drugs can also interfere with how much milk you produce. Talk to you healthcare provider before taking prescription and over-the-counter medications, as well as herbs and supplements.

If you are unsure as to whether you want to breastfeed, you can try it for a few weeks and switch if it does not work out. Any amount of breastfeeding is beneficial for the baby. Once bottlefeeding is started, though, it is difficult to switch back to the breast.

The Benefits of Bottlefeeding

• Proper nutrition—Commercially prepared formulas (which are regulated by the US Food and Drug Administration) supply the appropriate combinations of proteins, sugars, fats, and vitamins to meet a baby's nutritional requirements; supplements are not usually necessary. But, if your baby is not eating enough vitamin D fortified formula, a supplement may be needed.
• Bonding—Although there is no skin-to-skin contact, cuddling while feeding can enhance bonding.
• Less dependence on you—Anyone can feed the baby. This makes it easier if you work or if you cannot or do not want to be the sole provider of the milk.

The Drawbacks of Bottlefeeding

• The possibility of allergy—Cow's milk formulas contain a different type of protein than breast milk, and some infants may be allergic to it or have trouble digesting it. These babies can be given soy milk formula, although some may be allergic to soy protein, too, and would require a hydrolyzed formula.
• A lot of preparation—Bottlefeeding requires a lot of organization and preparation; you will need to have enough formula on hand and have bottles and nipples clean and ready.
• A significant expense—In today's economic climate, many foods, including formula can be costly.
• Freshness not guaranteed—Formula can go bad, so you will need to check expiration dates and avoid damaged containers.

Revision Information

• Reviewer: Michael Woods, MD, FAAP
• Review Date: 12/2016
• Update Date: 12/14/2016