I was a first-time mom sitting in a hospital bed, frustrated that my baby wouldn’t nurse. The hospital staff kept coming in to ask how much my baby was eating. “He wouldn’t latch on,” I answered helplessly. “He keeps falling asleep.” The lactation specialist insisted that more skin-on-skin contact would do the trick, but even when we did that he fell asleep. I was confused–wasn’t my baby hungry? The staff scolded me for letting my baby sleep too long. “He needs to eat!” they insisted.
I was irritated by the lactation specialist. I quietly assumed she had no idea what she was talking about. In reality, I was insecure and proud. I thought nursing was supposed to be natural. Shouldn’t I be able to do this on my own? Why isn’t any of this working?
We tried different nursing positions, a nipple shield, and cheek stroking. Still nothing. I was engorged so I pumped and we offered him a bottle. He slowly sucked it, as though gravity gave him no choice.
Fast-forward a few weeks later–I sat in our living room with a manual pump. We didn’t have an electric pump yet and my son still didn’t understand nursing, so I used the manual around the clock. I looked down at a nearly-full bottle of milk, which had taken me 30 or 40 minutes to fill. Suddenly the bottle fell off–it hadn’t been screwed on tightly enough. All of the milk spilled onto the floor. I was bewildered. I worked so hard for that one bottle! Not only that, but somehow I needed to come up with something for my son’s next feeding. They say you shouldn’t cry over spilled milk…but I was so frustrated and so tired.
After I gathered my bearings, I thought of the container of formula in the cupboard. My OBGYN gave it to me during one of my prenatal appointments as a gift, but I never intended to use it. Nursing would be easy, right? All the other moms in my life were doing it. Weren’t they?
Literature said that breastfeeding was best. I was convinced that formula was for moms who didn’t have time for their babies or didn’t care about what was best for them. Formula was just the baby version of fast food. At the same time, I knew it was also expensive, so I couldn’t bring myself to throw the container out. Instead, it sat in a cupboard I hardly ever opened.
But in that moment, I was desperate. Breastfeeding was not the rewarding experience I had been told about. Either my baby was going to miss a feeding and all hell would break loose, or I could give him one bottle of McFormula.
We gave him the formula.
He didn’t explode.
The stress disappeared and I was able to get caught up with feedings. Eventually we got an electric pump. We continued to supplement with a bottle of formula because it was nice to have that break every day. Our system was finally working for us.
Needless to say, my experience changed the way I look at people who feed their babies formula.
This week I did some research. I wanted to know why experts tells us that “breast is best.” How is breast milk different from formula, apart from the obvious?
I also asked all of my mom friends for their stories. Do they feed their babies breast milk or formula? Am I the only one who struggled with breastfeeding? What are some other reasons that moms feed their babies formula?
Here’s what I found.
According to the FDA, only 38% of all the babies on the planet are exclusively breastfed. In the United States, 75% of babies start out breastfeeding, but only 13% continue through the first six months of life. 67% of babies in the U.S. rely at least somewhat on formula by 3 months of age (that’s 2.7 million babies!) Formula is WAY more popular than I ever imagined!
What is Formula Made of?
There are several different blends of formula, but the traditional variety is made from modified cow’s milk. Cow’s milk, when compared to human milk, contains higher levels of fats, minerals, protein, sodium, and potassium. Cow’s milk is also deficient in Vitamin E, iron and essential fatty acids. Manufacturers skin the milk and add supplements so that the formula more closely resembles human milk. Probiotics and prebiotics may also be added for gut health. Laws require that nutrients fall within minimum-maximum ranges that endure throughout the formula’s shelf life. Components that are added to the formula must have a proven track record of safe use.
The most affordable kind of formula comes in powder form, which is mixed with water according to directions. Other kinds include concentrated liquid, which is mixed with an equal amount of water, and ready-to-eat formula, which costs the most but requires no preparation.
If an infant cannot tolerate cow’s milk, other varieties may be tried, such as soy or hypoallergenic formula. There are also specialized blends for premature babies. Some countries dabble in goat, ewe, mare, donkey, and camel milk, but such formulas haven’t been studied well enough to be determined safe for infant consumption.
The Benefits of Formula-Feeding
- Formula is highly regulated to ensure that it is both safe and nutritionally adequate.
- Preparing formula is fast and easy. Mix, shake and serve. Some formulas don’t even require preparation.
- There are a variety of formulas on the market. Even if baby does not tolerate cow-milk-based formula, there is usually another kind that will be tolerated.
- Formula takes pressure off of mom to provide food for baby. This is especially helpful for parents of multiples, or if mom has a career outside of the home.
- Bottle-feeding provides more opportunity for dad and siblings to bond with baby.
- Babies who take formula often stay full for longer periods of time when compared to breastfed infants. (Special note: Some moms swear by a bottle of formula before bedtime during the sleep training phase.)
The Cons of Feeding Baby Formula
- It is expensive to exclusively feed an infant formula. According to The Simple Dollar, the average cost of formula for the first year of life is $1,733.75.
- Families may be tempted to pinch pennies by using less formula powder, which can result in nutrition deficiencies.
- Formula requires some preparation, and sometimes refrigeration. Bottle-washing is also necessary.
- Some babies do not tolerate certain formulas well. Parents may have to experiment, which can be a great source of stress.
- Some parents may not have access to clean water.
- When babies are little and eat frequently, parents might find it cumbersome to have to hold the baby’s bottle for long periods of time.
- Formula-feeders wrestle with guilt for choosing not to breastfeed, or for not having the capacity to breastfeed. They also might deal with shame from the breastfeeding community.
- Special note: More research is needed on the subject to determine whether or not differences matter, but the gut biome of a formula-fed baby is incredibly unique to that of a breastfed baby.
“I really wanted to breastfeed, but I only produced one ounce of milk. My doctor said some women just don’t produce enough milk. We switched to regular formula and realized that our son is lactose intolerant. Similac Pro-Sensitive is easier for him to digest.” –Luisa S.
“I am all for breastfeeding. My goal was to breastfeed until my son had teeth. I was unfortunate in the sense I couldn’t for as long as I wanted to. I stopped producing enough to satisfy. I tried many things to get my supply up, but nothing worked. So I had to supplement, which turned into full-on bottle feeding.” –Grace L.
“I was unable to nurse my 2 boys. My milk never came in so that was decided for me. Formula was fine. I definitely didn’t notice anything different in them compared to others who were nursed.” –Randi S.
“With both of my kids, it was like pulling TEETH to get my milk to come in. With my first son, I had a somewhat traumatic birth (the next time, I got the damn drugs) and therefore wasn’t in a place to try more than just a few weeks with him between nursing and pumping. He just wasn’t getting what he needed. We did both for a while and then switched completely to formula by a month. With my second son, again, so HARD to get my milk to come in but he was breastfed for about 6 weeks, with the last week or so being a combo and then my body was done again. My formula babies.” –Krystal R.
“I was working full-time. My husband was in school when we had our first child. Nurses harped on me every moment about breastfeeding. They never stopped to consider lifestyle and if it was even feasible for me at the time. I opted not to and never regretted it. Yes, sometimes formulas had to be adjusted, but the bonding time this allowed for my husband with the kids was priceless. Dads often don’t get that special time, as moms are the milk machine. Sometimes it’s easier to just feed the baby than to pump to allow Dad to. I feel like it’s okay either way but neither side should shame, degrade, scold or hold judgement to the other. We are all moms doing the best we can. All my kids were formula/bottle fed and all were fine. I don’t regret the choices, and I honor the choices of other moms.” –Marcy C.
“My daughter came a month early. Being in the NICU, they started her right away on the bottle since I didn’t see her for 3 hours after she was born. For each meal, she would drink as much formula as she could from a bottle but would get the remainder through a feeding tube. I pumped right after giving birth (full pumping session but I got a drop of colostrum) and then started combining breast and bottle-feeding since my supply was so low. I pumped for the first 4 weeks of her life but I was never able to get a satisfying amount. I transferred to 100% formula feeding since I was pumping every 3 hours and only getting 30 to 50 mL for the entire day. I would have loved to breastfeed her longer but my body just couldn’t do it…But on the flip side, I like seeing how much she is drinking.” –Kristen G.
Shopping for Formula
You should always talk to your pediatrician when starting or switching to a new formula. Typically, you’ll start with the traditional cow-milk-based formula unless you’re already aware of special needs. Here are some other varieties:
Hydrolyzed formulas= for babies with milk protein allergies, babies who don’t absorb nutrients properly (such as preemies), and babies with eczema
Soy-based formulas= for vegan babies and babies who cannot digest lactose
Hypoallergenic formulas= for babies who are allergic to cow’s milk and soy
Other items you’ll need to purchase:
- Bottles and nipples
- Bottle brushes
- Water filter or packaged water
- Drying rack
According to Baby Savers, the cost of name-brand powder formula is 14 cents per ounce. A 22-lb tub ($22 on sale) will get you about 155 ounces of formula. You can purchase generic powder for as low as 8 cents per ounce ($12 for the same-sized tub).
Name-brand ready-to-eat formula is 29 cents per ounce. A 16-pack of 8-oz bottles (128 ounces) will cost you about $38.27.
Your newborn baby will eat about 2.5 ounces of prepared formula per pound of body weight in a 24-hour day (so if your baby weighs 8 pounds, she’ll probably need around 24 oz of prepared formula per day).
Be sure to create a realistic budget for the regular purchase of formula before your baby is born.
What is Breast Milk Made of?
Human milk is a complex blend of carbohydrates, protein, fat, vitamins, minerals, digestive enzymes, hormones, and immune cells. Before a mother’s milk comes in, she will produce a thick and yellow substance called colostrum, which is rich in nutrients and antibodies.
Mature breast milk begins as a thin and bluish consistency (known as “foremilk”) and gradually increases in fat content (to create “hindmilk”) during a nursing session.
The Benefits of Breastfeeding
- A mother’s milk adapts to the needs of a growing baby. The milk provides adequate amounts of essential nutrients, even when the mother’s own nutrition is slightly deficient.
- When a mother is sick, or if she receives certain vaccinations such as the flu vaccine, she will transmit antibodies through her milk to her baby as prevention.
- As mom nurses, her body releases oxytocin, which helps mom to bond with her baby (think of it as an enhancer for maternal instincts). The oxytocin also has anti-anxiety and anti-depressive attributes that may help prevent postpartum depression.
- Another popular opinion is that breastfeeding helps with postpartum weight loss. (Special note: Although this may be true for some women, as breastfeeding does create a calorie deficit, other moms will feel pressured to eat more to make sure that baby is getting enough to eat.)
- Once a mother and child are securely established in nursing, mom’s hands will be free to multitask.
- Established breastfeeding requires no preparation and no equipment to bring along in the diaper bag (except for a nursing cover, if desired).
- Breastfeeding is budget-friendly. Aside from “startup costs” such as a nursing pillow, as-needed items such as nipple cream, and mom’s own nutritional needs, it doesn’t cost anything.
The Risks of Breastfeeding
- There are a few instances where breastfeeding is not recommended, such as when mom has infections like HIV or CMV, or if mom is on certain medications that will transmit through her milk.
- Some premature babies will not receive enough nutrients from breast milk and will require supplementation.
- Newborns sometimes have what is known as “lip tie” or “tongue tie,” which can make breastfeeding difficult. These situations are usually remedied with the help of minor surgery.
- Breastfeeding causes painful contractions during the first couple weeks of nursing, as the release of oxytocin helps mom’s uterus to shrink back to pre-baby size.
- Nipple pain is common, although nipples “toughen up” over time (unless baby isn’t latching properly). A poor latch can make nipples bleed.
- Clogged milk ducts and mastitis occur when baby continues to latch improperly, mom doesn’t nurse frequently enough (engorgement), mom’s bra doesn’t fit properly, or mom exerts herself too much (I learned the hard way that lifting weights isn’t advised).
- Because breast milk is broken down more easily than formula, baby will eat more often, which can mean less sleep for mom.
- Some moms endure stress from not being able to see how much milk baby is drinking.
- If mom does not express milk so that other members of the family can feed baby, from time to time she might experience feelings of having no freedom.
- Although it is required by law that mothers be able to nurse, public shaming is still an issue. Some moms are not comfortable nursing their babies outside of the home.
- Working mothers may find it difficult to express milk at work. They must remember to bring all their pumping equipment with them and have a cold place to store milk. Some mothers are perceived as inconvenient by their bosses because of how much time pumping takes.
- Moms who must pump around the clock do not have free hands to multitask during sessions like they would while nursing.
“Breastfeeding for me just made the most sense with my boys. I don’t enjoy washing bottles. When the twins were born I was pumping four hours and breastfeeding eight, making feedings alone twelve hours of my day. Most of that was because the twins’ prematurity and inability to keep up with my supply, since supply is rather important later on and is established fairly easy in their life. I will admit that the perk I see with bottle-feeding is that anyone can feed them and take care of them at that point. But, I love the bond I have with all my boys and that they are growing because God has graciously given me the ability to feed them and do it in the way that works well for us.” –Stephanie P.
“Four months of discomfort and mastitis twice…I kept pushing through, praying it would get better. Around the end of month four, something clicked and it was great after that. He was two when we completely stopped.” –Lauren M.
“I exclusively breastfed my first and am doing the same with my second. My first had a lip tie and tongue tie, which we didn’t cut until seven weeks and I wish we had done it sooner! I do pump so that I can go out on occasion…My son is not a picky eater. I attribute his love of broccoli and other veggies to breastfeeding, but maybe we were just lucky…My second child took a week of hard work to establish good nursing habits. It was a very tough week but I think worth it because personally I think bottles are more work (we don’t have a dishwasher).” –Tamara G.
“It was a great bonding experience and I enjoyed it a lot, but because I was so focused on breastfeeding I ended up not producing much more to pump, which meant we were stuck together 24/7. At times I wished for the sake of my mental health that I could have found a balance with pumping. We started solids at about 4 to 5 months, so that helped.” –Eileen F.
“It was really convenient, and very restful to sit and cuddle my babies. That being said, it also exhausted me physically to keep producing milk. An autoimmune disease I have makes my body tire easily.” –Lynn G.
“The main direct benefit I see with breastfeeding is the antibodies it gives our babies. However, it still does not always prevent them from getting sick. My son was breastfed until 16 months but was in daycare and always seemed congested. My daughter has been home with me for 8.5 months and had a runny nose for 3 days, other than that never has been sick.” –Libby B.
“I exclusively nursed (and pumped for) my children until they both stopped on their own (14 and 19 months). As someone who reads A LOT of medical research, I can tell you that you will find studies trying to disprove that ‘breast is best’ as well as a large number of studies showing various benefits. What is more important is that moms choosing either route do not have necessary support…This is where our focus should be. How do we support our moms and help them make educated decisions, and provide appropriate child-focused feeding support? In the big scheme of things, fed is best.” –Olya S.
Shopping for breastfeeding success
Here are supplies you’ll need if you decide to breastfeed:
- Nursing bras that fit well
- Nursing shirts (and maybe a dress for formal occasions)
- Nursing pads (for leaking)
- Electric pump (to be honest, I personally don’t believe manuals are worth the struggle–check to see if your insurance will cover an electric pump)
- Milk storage bags
- Nursing pillow
- Nipple cream
- Breastfeeding literature (seriously, there’s a lot to know–you should read before your baby gets here!)
- Vitamin D drops (if you live in a location that doesn’t get a lot of sunlight year-round)
- Nursing cover
I would also highly recommend swallowing your pride (if you’re like me) and seeking the help of a lactation consultant if you encounter issues (check to see if your hospital will have one available when you deliver).
Summary of the Pros and Cons
Stories of Moms Who Weren’t Exclusive
“With my firstborn, he nursed for 6 weeks and then I exclusively pumped for 6 weeks after that. He had laryngomalacia, which made it hard for him to nurse. He did much better with a bottle. After those first 12 weeks, he got both breastmilk and formula until he was 5 months, and then we switched to just formula…My daughter was breastfed for 6 weeks and then I had to stop cold turkey so I could go on blood pressure medication…My third child was exclusively breastfed for the first 1 ½ to 2 months and then we slowly started adding formula. I knew I wouldn’t be able to keep up my supply once I went back to work. It would have been very difficult for me to pump every 3 hours. She’s now 8 months and is formula fed during the day and nurses at night. It has actually worked out really well for us because I hate getting up to make bottles at night!” –Kacie S.
“With my first, I formula-fed from day one. She was 3 weeks early and 26 hours of labor ended in a c-section. I felt guilty for a really long time about it…With my second, I was determined to do everything I could to breastfeed. He had silent reflux so we ended up doing a combo of primarily breastfeeding and bottle-feeding during the day. We did that until he was 14-15 months old. He would have gone much longer but I was touched out…With my twins, I breastfed them for the first 6 or 7 weeks. It was a LOT. I would get done feeding the second one and then it would be time to start the next feeding. Luckily my husband was off the first 6 weeks with me, which helped a ton. He works overnights so ultimately we went to formula because having 4 kids alone overnight was intense enough. I needed to know who was eating and how much.” –Liz C.
“I am a firm believer in breastfeeding. I nursed for 14.5 months. I was ready to wean, but I miss the special bond I had with my son. When he was 9 months old, I had my gallbladder removed and had to pump and dump a lot because of the medications I was on. I had a good amount in the freezer but he still needed a couple of extra feedings. He was eating food at the time but I was grateful for the option that formula was available.” –Ashley S.
“I pumped so my husband could feed our daughter bottles. I felt they could use that bonding time, and I could use their time to get other things done for me or around the house. This only lasted about six weeks because my brother had emergency heart surgery and had to live on a hospital bed in our living room for a while. My sister-in-law was diagnosed with brain cancer and I was helping with her kids, and rides to and from radiation appointments. We switched to formula and it was fine. It never hindered my daughter’s eating or growth. She’s 15 now and she is rarely ill, having only ever needed antibiotics twice in her life.” –Sue B.
“I exclusively pumped for my first child for a year and produced A LOT of milk. I had frozen stashed everywhere. Boxes and boxes at my house, my in-laws…I even took over my dad’s freezer with boxes of frozen. I was religious about how often I pumped…I also decided to exclusively pump for my second until he was 7 months. That’s when we switched to formula. It was a tough decision to switch to formula when I had never had to use it before, but with 2 kids the task of pumping just became too much. I just didn’t have the time nor the energy to pump as often as I should have, and so my supply started to decrease. We have been doing formula for about a month now. I have mixed feelings about it. Sometimes I feel guilty that I didn’t just push through a few more months for him (especially when it’s time to buy more formula…so expensive!) but it has been way less stress on me, not worrying if I will have enough, or if I remembered to pack everything I need to pump every time I walk out of the house. The time I have back is great! As my friend Liz told me, ‘They all end up eating off the floor eventually anyways.’” –Chelsea P.
“I breastfed my oldest until he was 6 months, and at that point I decided to stop because I didn’t enjoy it at all. We used a nipple shield the whole time and I just didn’t feel that it was convenient. I never felt completely comfortable. We switched to formula at that point…With my youngest, he would not latch. I found out he has a lip tie and that’s what made it so difficult. I ended up exclusively pumping for him. I was able to pump enough to create a large freezer stash over 2,500 ounces by the time he was 8 months. I’m pregnant again and my body has stopped producing, so for about a month we’ve just been feeding frozen milk and things have been going well with that.” –Stephanie F.
“I have several scientific sources that show that when you account for demographics, outcomes for bottle-feeding versus breastfeeding are virtually the same. I’ve done both. My favorite is combo feeding. It’s the easiest for me and takes the pressure off of mom being the only source of food.” –Lauren C.
The Rest of My Story
Now I’ll tell you about my other two kids. My second-born was a champion at breastfeeding. After I delivered and the nurses cleaned her up, she latched right on and started drinking. My husband and I were amazed. Her breastfeeding journey was a piece of cake (save for one tango with mastitis when she was around 8 months old).
When my third child (second son) was born, I thought I had everything figured out. “My breasts were conditioned by that first year of pumping, and that’s why my daughter had no problems nursing,” I guessed. “Surely it’ll be easy to pick right up where we left off.” Another thought crossed my mind: “I didn’t read anything on breastfeeding before my first son was born. I know pretty much everything there is to know now. Piece of cake.”
Ha, ha, ha, ha, ha, ha, ha, ha. *coughs*
It was basically child #1 all over again.
This son wasn’t as sleepy, and he certainly wasn’t as tiny, but he had no idea what he was doing.
I looked at the lactation specialist. “Is it a gender thing? Are girls usually better at this sort of thing?”
She averted her eyes. “Yeah, girls are better at first.” She paused. “But boys will stick with you.”
Whether or not the gender stereotype is true, she was right about my boy sticking it out. After three weeks with a nipple shield, he finally figured it out. We ditched the shield and have been exclusively nursing for the past 7.5 months. It hasn’t been an easy ride (I had mastitis 3 times while my husband was in and out of the hospital for Crohn’s disease) but we’ve seen it through.
To be honest, even with my daughter I was counting down the days until her first birthday. I’ve never been in love with nursing. I love the bond, the smiles, and when they get goofy while nursing, but those kinds of things don’t go away once nursing stops. They just take on a different form. We can bond over storybooks. I can still make them laugh. And boy do they stay goofy in our family! I am dedicated to breastfeeding because it’s healthy, it’s cheap and my body can do it. At the same time, I agree that fed is best and I am in no position to judge other moms. Everyone’s story and situation is so different!
I think there’s a lesson here that applies to a lot of different facets of life, if we stop and think about it. Why do we so often impose our own personal decisions onto other people? Are we really that simple-minded? I think it often stems from insecurity, which everyone battles with. Make no mistake, I am not sitting on a high horse right now. I might not judge moms about what they feed their babies, but I’m still judgmental about other things. It’s wrong and I wish I didn’t do it. I try not to do it. I hope that other moms are mindful of it, too.
Did you notice that all of the moms who shared their story wanted to breastfeed their babies? Boy was I wrong in thinking that formula feeders don’t care. They sure do! Before kids, I had no idea how much of a gift it was to be able to nurse a child. Yes, it takes work. Sure, maybe some moms give up sooner than others. But I believe in grace. I believe in focusing on my own efforts as a mom and cheering on other parents for doing the best that they can.
I think in a perfect world, breastfeeding would be best. But we don’t live in a perfect world. In our world, moms don’t get enough time for maternity leave. Bosses don’t support them when they want to pump at work. Moms are judged for breastfeeding in public places. Babies are born too early and can’t latch. Moms don’t make enough milk. The list goes on.
The decision of what to feed your baby is a personal choice, not a universal one. Let’s stop pretending that our choices are best for everyone else.
New moms and dads: I hope this guide encourages you as you make important decisions for your family.
And for all the veteran parents reading this…
I’m rooting for you.