The Risks and Disadvantages of Formula Feeding

Facts About Breastmilk Substitutes Used in Bottle-Feeding Infants

Dec 19, 2008 Hayley Nichols

Formula feeding, or bottle-feeding, is often presented as a choice equivalent to breastfeeding. In fact, there are known and unknown risks associated with the practice.

Although breastfeeding is now widely acknowledged to be the ideal for babies, and the World Health recommendation is for a minimum of 6 months exclusive breastfeeding, the choice of how to feed a baby is often still framed as one between two equally valid alternatives.

In fact, breastmilk is not "ideal" but the normal, natural food for babies, adapted over millions of years to meet their unique nutritional and immunological needs. Formula, in comparison, has only been around for about 150 years, and its long-term results are still being studied.

World Health Organisation Recommendations for Infant Feeding

WHO recommendations are for an infant to be given only breastmilk for 6 months, and for breastfeeding to continue for two years of age or beyond. If a baby is not breastfed, formula is required for the first year of life. Many mothers are not fully aware of the risks of formula feeding and so are making a choice without the necessary information.

Nutrients in Formula Versus Nutrients in Breastmilk

All the nutrients in breastmilk are in perfect balance and the infant can also regulate its own intake, and therefore its weight gain, in a way that is impossible with formula-feeding, according to Successful Breastfeeding [Royal College of Midwives, 2002]. Deviating from this "gold standard" carries risks to the health of both mother and child.

Risks of Formula Feeding For Infants and Children:

The effects of formula feeding on infants and children continue to be studied, and several significant risks have been identified. There is an increased risk of:

• Mortality – this applies in Western countries as well as developing countries. For example, according to Lucas and Cole (1990), if all the preterm babies in British neonatal units were fed breast milk rather than formula, 100 deaths a year from necrotising enterocolotis would be prevented.
• Asthma and allergy
• Acute respiratory disease
• Childhood cancers
• Nutrient deficiencies: e.g., fatty acids, essential for brain development, and amino acids, essential for central nervous system development, as well as calcium and iron, are not in the correct proportions and/or as easily absorbed from formula as breastmilk.
• Infection from contaminated formula
• Diabetes
• Chronic diseases
• Cardiovascular disease
• Gastrointestinal infections
• Otitis media – inflammation of the middle ear
• Urinary infections
• Sudden infant death syndrome
• Necrotising enterocolotis – an infection or inflammation that causes destruction of the bowel or part of the bowel.

as well as

• Reduced cognitive development

Disadvantages of Formula Feeding For the Mother:

If a mother feeds her baby formula rather than breastfeeding, this has an effect on her health too. There is an increased risk of:

• Breast cancer – the risk of breast cancer is decreased by 4 % for each year of breastfeeding, according to D Hollander in Breast cancer Risk is Reduced By 4 % for Each Year of Breastfeeding [International Family Planning Perspectives, Vol. 28, 2002].
• Being overweight
• Ovarian cancer and endometrial cancer
• Osteoporosis
• Reduced natural child spacing, putting more pressure on the woman’s body and causing general stress, particularly in developing countries where resources are scarce
• Rheumatoid arthritis
• Stress and anxiety
• Diabetes

Normalisation of Formula Feeding

It is only in a small minority of cases that formula is medically necessary, according to the Royal College of Midwives, and a woman should be encouraged and supported to breastfeed for as long as she wishes. It is extremely rare for a woman to be physically unable to breastfeed, and most problems in breastfeeding are caused by a lack of support and accurate information.

However, formula feeding has become normalised through years of inaccurate information about breastfeeding, because of the vested economic interests of formula companies, and due to the sexualisation of breasts in our culture [Gabrielle Palmer, The Politics of Breastfeeding,New York University Press, 1993]. Fears about breastfeeding in public can be a significant deterrent to many women, but this can be overcome.

Organisations such as La Leche League offer localised support for breastfeeding mothers, and there are also helplines and groups where mothers can meet other breastfeeding mothers.

References:

Infant Feeding Action Coalition Canada Breastfeeding Information Resource Centre. Risks of Formula Feeding Brochure

A. Lucas and T.J. Cole (1990). Breastmilk and Necrotising Enterocolotis. Lancet 336: 1519-1523.

The copyright of the article The Risks and Disadvantages of Formula Feeding in Infants & Toddlers is owned by Hayley Nichols. Permission to republish The Risks and Disadvantages of Formula Feeding in print or online must be granted by the author in writing.

Formula Feeding Risks