Breastfeeding or Baby Formula: Which Feeding Method is Better?

Breastfeeding 

Breastfeeding means that a mother will produce breast milk for her baby and will either feed them at the breast or express breast milk into a bottle for another caregiver to feed with. 

There are also women who donate their breast milk to other families if a mother is struggling to produce enough milk. Usually, it is the mother who has given birth to their baby that will breastfeed their baby, however in same-sex couples, sometimes the other mum will induce lactation and feed their newborn too.  

Learn more: Bonny's Journey: From Breastfeeding Challenges to a Milk Donation Champion 

Benefits of Breastfeeding 

For many years now, the benefits of breast milk for both a mother and her baby have been shared, encouraging more mothers to breastfeed. The benefits go beyond nutritional advantages, let’s explore these.  

The World Health Organisation (WHO) recommends babies to be breastfed up to two years of age as a minimum. Some parents choose to breastfeed for a year and gradually wean onto other types of milk alongside solids. Breast milk can give your baby the following benefits, especially within the first hour of being born, and further benefits the longer they are breastfed for.  

• Complexity of breast milk can adapt to your baby’s growth and development needs (this is why you might notice a difference in consistency or colour if you pump). 
• Improved immunity to illnesses and infections due to the antibodies that are transferred from mother to her baby to boost their immune system. It can also protect them from developing other medical conditions such as asthma, obesity, allergies and diabetes.  
• Breast milk has been proven to be easier for babies to digest than formula milk, resulting in less bouts of constipation or diarrhoea.  
• Skin-to-skin contact during feeds for both parents can strengthen the emotional bond between you and your baby, especially for mothers who exclusively breastfeed. 
• Breastfeeding reduces the risk of SIDS (Sudden Infant Death Syndrome) 
• Breastfeeding helps to shrink the uterus and burns calories, which can help feeding mums return to their pre-pregnancy shape quicker. It’s also been proven to reduce the risk of certain cancers in women as well as high blood pressure, diabetes and cardiovascular disease.  

Breastfeeding mothers also have the luxury of convenience as they have “milk on tap”! Wherever you are, if your baby needs feeding, you can without having the prep that formula feeding requires. And better yet, it’s free.  

One last thing to note, if your baby is breastfed you will need to give them a vitamin-D supplement as this is the only crucial vitamin that your baby won’t receive from your breast milk.  

Learn more: Breastfeeding: Best Tips and Advice for Nursing Your Baby

Challenges of Breastfeeding 

Along with the many benefits that breastfeeding brings for a mother and her baby, there are some differences that can make this feeding journey feel more difficult. In the early days of your baby being born, there is a big demand on your time and your body to produce and feed your baby, to support their growth and development. This eases over time and throughout your breastfeeding journey, you will become accustomed to hearing terminology such as “cluster feeding”, where your baby can and will feed frequently for longer periods of time, as they experience a growth spurt. 

A common reason why some mothers struggle to continue with breastfeeding is due to the pain and discomfort that you can experience through different stages. In the first week, when your milk comes in, your breasts will feel engorged and sore which can cause discomfort when your baby latches on to feed. This lasts for a short time (2-3 days), and as your body adjusts to the amount of milk it needs to produce, it will start to even out the supply. Other common breastfeeding pain can stem from: 

• Sore nipples - use a nipple cream to alleviate any tenderness and allow the skin to heal. This is safe to apply before and after your baby feeds. 

• Engorgement - express milk with a hand pump or single electric breast pump. Some older remedies (which do work!) say to lay cabbage leaves on your breasts, a cold compress will also help relieve any discomfort. 

• Mastitis - if a milk duct becomes blocked, milk sits and cannot be expressed leaving it to “go off” and therefore causing an infection. Mastitis can be relieved by massaging the breast, and using warm flannels or warm showers, to help express some of the milk and unblock the milk ducts. A doctor can also prescribe antibiotics.  

• Poor latch - some babies need a little help to learn how to latch onto the breast correctly so that it doesn’t cause you any pain when they feed. A midwife, lactation consultant or a breastfeeding friend can help you with this. If a baby is born with tongue tie, it can be harder for them to latch properly. Using nipple shields can help to prevent any discomfort at your end as they learn this skill.  

Throughout your breastfeeding journey, whichever stage you may be at, there can be changes to your current circumstances that can affect your milk supply. For example, when a mother returns to work or if you are expecting another baby. Speaking from experience, when I reached 5 months in my second pregnancy whilst still breastfeeding my 2-year-old, my supply dramatically dropped (this is quite common). Naturally, my daughter weaned herself off the breast at this time because she couldn’t drink the same amount of milk she wanted.  

As women return to work from maternity leave, their milk supply will lessen over time as they spend less time with their baby, unless you are pumping to compensate for the feeds you are not doing yourself to help maintain your supply. An electric breast pump is an efficient way to express breast milk at work discreetly and safely. Your employer is legally responsible to provide suitable facilities and means for you to breastfeed or pump at work. 

And lastly, for some mothers the decision not to breastfeed is sometimes made for them already. Either due to medical reasons, a mother’s health, or a milk supply has not been established. As mentioned earlier, there are other options to feed your baby with breast milk if a mother is unable to herself, and awareness of this is increasing to build on these provisions for parents that want their baby to benefit from breast milk.  

Learn more: Common Challenges with Breastfeeding - What to do? 

Formula Feeding 

Formula is a human-made breast milk substitute suitable for babies. It is sold in ready-made bottles, powdered or high concentrate which is made up with cooled boiled water. Parents may choose to use formula instead of breastmilk because there are other factors at play which prevent them from breastfeeding or it doesn’t suit the family’s lifestyle, e.g. extended periods spent away from their baby.  

Benefits of Formula Feeding 

If you go to a supermarket, you will see many different brands and types of formula milk available. Some types of formula milk are prescribed by doctors if your baby has an allergy or intolerance (another reason why parents may favour formula milk to breast milk, as the mother would need to follow a diet in line with their baby’s dietary needs).  

Unlike breastfeeding where you feed on demand, formula feeding requires parents to follow a feeding schedule and prepare accordingly. If your baby is under a year old, they require their feeds to be made with cooled boiled water so that the feed is sterile and safe to drink. The bottles and teats will also need to be sterilised following the brands guidelines. Parents often favour formula feeding for its ease in preparation and flexibility in feeding schedules to be shared between parents and carers. 

Some argue that formula feeding is better for the other parent or carers to participate in because it doesn’t just rely on the mother to exclusively breastfeed. As well as formula feeding, there are lots of ways that parents and carers can join in with feeding such as burping baby during a feed, having skin-to-skin time to build a bond, and helping their partner prep so feeds are ready to go whatever your plans.  

Formula feeds are measured in ounces and it is clear to see how much your baby is drinking and whether you need to adjust their feeds slightly. If you have any concerns over their weight for example, it would be easy to explain to a paediatrician how much milk they have in a day. Whereas with exclusively breastfed babies, it can be harder to put a number on this.  

Challenges of Formula Feeding 

One of the slight snag points for parents who choose to use formula milk is the cost. A tub of formula in the UK can start from £9 and be as much as £20 per tub. So, the cost of formula can quickly add up for a newborn, and even more if you have multiple mouths to feed! Ways that families can save money towards feeding supplies is approaching food banks or shopping around online and via social media marketplaces to buy second-hand or cheaper baby bottles. Consider the different ways you can sterilise the equipment, for example a cold-water steriliser could cost less in energy consumption compared to a kettle or microwave.  

Although formula milk contains vital vitamins and nutrition for babies, it can never match the complexity that breast milk has. Formula milk contains vitamin-D, unlike breast milk, however it doesn’t include antibodies that can improve a baby’s immune system against illnesses like breast milk does. You may also find that formula milk takes longer for your baby to digest and it can make them feel windy or constipated due to the different makeup of milk. 

Although formula feeding offers flexibility, you need to be on the ball with the preparation. The last thing you want is a hungry baby and no clean sterile bottles! Work out a system and prep bottles with water the night before. As you make up a feed, you’ll need to check that the temperature is safe before baby drinks. Baby prep machines have become increasingly more popular to make these steps easier if you are willing to invest and have countertop space for them. 

Combining breastfeeding and formula feeding

Mixed feeding, also known as combi-feeding, is when you mix expressed breast milk with formula milk and feed it to your baby in a baby bottle. It can also mean alternating breast milk to formula milk for each feed that is due. There are specific guidelines for how the feed needs to be prepared so that it is safe for your baby to drink, to not cause them any discomfort.  

Parents find that by combining the two, they are reaping the rewards of both methods. Some of the reasons for parents choosing to combi-feed are: 

• You are a parent of multiples, e.g. twins, triplets, babies very close in age, etc. 
• Mum is struggling to maintain a milk supply or has a low milk supply. 
• It offers parents respite from feeding to get sleep. 
• Mum is returning to work and feeding responsibilities need to be shared. 

Examples of implementing a mixed feeding schedule can look like: 

• Breastfeed your baby first thing in the morning and at bedtime, and a carer to give formula milk during the day whilst you are at work.  
• If your milk supply is lessening, you can pump breast milk whilst you are away from your baby to store safely and use to make up with a formula feed. Having a stash of frozen breast milk can be really useful to mix with formula milk to combat the cost of baby formula.  
• Feeding your twins with expressed breast milk and baby formula throughout the day, either as a mixed bottle or around your pumping schedule so they can benefit from breast milk as well as parents benefitting from a flexible feeding schedule. 
• A breastfeeding mum is unwell, or generally needs more rest, try introducing a formula feed during the night to give them respite from breastfeeding. 

Babies can go longer between formula feeds than if they are breastfed on demand. This is something to bear in mind when mapping out a feeding schedule for the day and preparing bottles ahead of time. It’s also important to note, that with every expressed feed or formula feed your baby drinks, you will need to pump to maintain your supply otherwise you may notice this lessen over time. Of course, this would be a good option if you were aiming to wean your baby off the breast.   

Feeding any baby doesn’t come without its challenges every now and then, but the decision on how you feed them will hugely depend on your family’s lifestyle, mother’s health, and the support network you have around you. If you have any concerns about your own health or your baby’s with regards to feeding, consult with a healthcare professional quickly to get the support you need. 

Learn more: How to Combine Breastfeeding and Pumping: A Comprehensive Guide

Making an Informed Decision 

When making a decision such as this, there can be other factors at play which ultimately make your mind up for you. If you have a choice with no limitations, then you will make the right decision for your family.  

Health considerations for the mother and baby must be considered before deciding on a feeding method. Mothers with chronic illnesses such as thyroid conditions, polycystic ovary syndrome, or gestational diabetes will find it more difficult to breastfeed. Whereas infections such as HIV can make breastfeeding risky for a mother and baby. Therefore, choosing to formula feed instead can be a better and safer option in these circumstances.  

In addition to health, breast surgery and specific medications such as chemotherapy, can make breastfeeding unsafe. If you are unsure whether you are able to breastfeed, consult with your doctor and/or a lactation consultant who can support you with this decision and the best way forward. 

Postpartum depression can affect 1 in 10 new mothers which is a staggering ratio when you consider how many babies are born each year. In recent years studies have shown that breastfeeding mothers are less likely to experience prolonged postpartum depression, due to the levels of oxytocin that are released whilst feeding which help to regulate feelings of stress. If you have suffered from depression or low mood pre-pregnancy, it may be worth a conversation with your doctor to decide on the best feeding method if you have any concerns. 

Learn more: Postpartum Anemia Explained: Symptoms, Recovery, and Treatment

Which Method is Right for Us? 

Knowing more about each feeding method and the benefits that come with them, I hope you are able to make an informed choice as to which feeding method will work best for you, your baby, and your family. If you have further questions about some of the topics raised here, head over to the Mamahood Manuals or ask our panel of maternal health experts.