Breastfeeding is recommended by the American Academy of Pediatrics. However, breast feeding is not always possible for all women, and the choice whether to breast feed or use formula is a personal one. Roughly 60-65% of infants in America are breastfed as newborns, and over 73% of them transition to infant formula between birth and 6 months of age. Breast milk is believed to strengthen an infant's immune system and is also linked to lower incidence of childhood obesity.
The American Academy of Pediatrics, the American Medical Association, the American Dietetic Association and the World Health Organization call recommend that breastfeeding is best for babies, as it helps defend against infections, prevent allergies, and protect against a number of chronic conditions. Breast milk contains antibodies that can lower the occurrence of ear infections, diarrhea, respiratory infections and meningitis. It contains lactose, protein and fat, which are easily digested by a newborn baby. However, babies may need vitamin D supplements if they are exclusively breast fed, and breast milk reflects the mother’s diet, so mothers need to monitor their diet carefully to ensure that all the nutrients are there.
The FDA regulates formula companies to ensure that they include all known necessary nutrients in formula. They also contain some nutrients that breastfed babies can only get from supplements, such as vitamin D. Parents should look for an iron-fortified formula, as iron deficiency can affect brain development.
Soy-based vs. Cow's milk-based infant formula
It is estimated that about 20 percent of formula-fed infants are fed soy protein-based formula during their first year of life. most pediatricians will recommend cow's milk-based formula over soy-based formula for most babies. But doctors will recommend soy formula if they believe an infant should avoid cow's milk protein and/or lactose (milk sugar) or if the baby simply doesn't tolerate milk-based formula. There are lactose-free milk-based formulas available now, but some parents, including vegetarians, still prefer soy-based formulas.
Iron-fortified and low-iron formula
The infant formulas currently available in the United States are either "iron-fortified"—with approximately 12 milligrams of iron per liter—or "low iron"—with approximately 2 milligrams of iron per liter.
The American Academy of Pediatrics (AAP) recommends that formula-fed infants receive an iron-fortified formula as a way of reducing the prevalence of iron-deficiency anemia.
If infants are fed a low-iron formula, a health care professional may recommend a supplemental source of iron, particularly after 4 months old.
Babies that are formula fed are more likely to suffer from digestive problems, as breast milk is easier to digest. They also do not receive antibodies from their mothers, which means they are less protected against infection and illness. However, when preparation directions are followed, infant formula is healthy for babies with typical dietary needs.
However, doctors say that happy, unstressed mothers are the best mothers, and so bottle feeding a baby may be preferable to breast feeding if the mother is experiencing difficulties. If the mother takes in too much alcohol, caffeine or mercury from fish, this can be harmful to a breast-fed baby. Medications may also pass into the breast milk. Some mothers may also find breast feeding painful.
In 2011, Walmart recalled a batch of infant formula after an infant died from a bacterial infection. This was a voluntary recall as a precautionary measure.
Scientific research comparing breastfeeding with formula feeding
The American Association of Pediatricians recommends exclusive breastfeeding for the first 6 months and breastfeeding with solid foods for the first year of an infant's life.
Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice. The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant.
According to a study by the American Academy of Pediatrics, children who were exclusively breast fed for the first few months had lower blood influence levels and different growth patterns from formula fed babies, but these differences had disappeared by age 3..
However, a study published in March 2017 found that there was no statistically significant difference in cognitive or noncognitive development of kids who were breastfed compared with those who were not. The study did find that kids were less hyperactive at age 3 if they were breastfed for at least 6 months but by the age of 5 there was no statistically significant difference in kids of either group.
According to a study in 2006 by BMJ, breast-feeding had little impact, if any, on a child’s IQ. The study concluded that while earlier studies had found IQs to be higher for breastfed children compared with formula-fed children, this difference could be explained by other factors such as the mother's IQ. The study found that "one standard deviation advantage in maternal IQ more than doubled the odds of breast feeding," suggesting that mothers with higher IQs are more likely to breastfeed.. The conclusions of the study match another 2003 study that also found no difference in mental and verbal abilities of breastfed vs formula-fed toddlers.
A more recent study found a slightly higher than average IQ for breastfed infants even if the breastfeeding lasted for only a few months after birth.
A 2011 study in France found that exclusive breastfeeding during the first weeks of life induced a specific pattern of growth and a specific metabolic profile, which appeared to differ in formula-fed infants. These differences tended to disappear with age.
Storage of breast milk vs formula
Breast Milk Storage
Containers: Breast milk can be stored in capped glass or hard plastic containers. There are special plastic bags available for storing breast milk but they are not advisable for longer duration of storage. Do not store breast milk in disposable bottle liners or plastic bags designed for general household use.
Storage: Place the containers in the back of the refrigerator or freezer, where the temperature is the coolest. If you don't have access to a refrigerator or freezer, store the milk in a cooler or insulated bag until you can transfer the milk to the refrigerator or freezer. Do not add warm breast milk to frozen breast milk because it will cause the frozen milk to partially thaw.
Duration: Milk can be stored at room temperature for up to six hours. If kept in an insulated cooler with ice packs, it can be stored for up to 24 hours. When refrigerated, breast milk can be stored for 5-8 days in the fridge, 3-6 months in the freezer or 6-12 months in a chest freezer.
Storing infant formula
Infant formula does not have a very long shelf life. Ready-to-use bottles must be consumed within 2 hours of being opened. Unopened bottles and can typically have a shelf life of 3-6 months. Powdered infant formula can be stored longer. However, once water is added to the formula, it must be consumed within 2 hours.
Traveling with formula or breast milk
While liquids and even water are not allowed through airport security, there are exceptions for both breast milk and formula. The TSA agent at the security checkpoint may ask the accompanying adult to sip a drop of breast milk before allowing it through.