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Breastfeeding or using formula to feed infants can be a fraught choice for parents. Getty Images
  • Parents may choose to use formula instead of breast milk for a variety of reasons including preference, access, or certain medical reasons.
  • But experts say they don’t want people to be swayed by marketing claims for formula.
  • A new study finds formula makers’ claims may confuse new parents about the benefits of breastfeeding.

An article recently published in the British Medical Journal (BMJ) argues that health and nutrition claims for infant formula are poorly substantiated — and even potentially harmful.

Parents should decide on whether or not breast milk, formula, or some combination of both is the right choice for them. But experts don’t want misleading marketing claims to confuse new parents.

Many studies show that breastfeeding offers mother and child significant health and psychological benefits. And many major medical groups in the United States recommend that mothers only give their baby breast milk until they’re at least 6 months old.

But also for some parents, using formula will be the right choice for them and the health of their infant.

So what do parents making the decision between breastfeeding or formula need to know?

Manufacturers began advertising direct to consumers in the 1980s. Something that became widespread (increasing by 74 percent) between 2011 and 2015, according to recent research.

This marketing often promoted nutrition-related and other claims implying formula was superior to breast milk.

“Our study shows how the marketing for these products not only contradicts recommendations by child nutrition experts, but also confuses parents about the most nutritious options for their young children,” said Jennifer Harris, PhD, MBA, lead study author and senior research advisor, marketing initiatives, at University of Connecticut Rudd Center, in a statement.

While these claims are newer, manufactured breast milk substitutes have been available in many forms since the 1800s — and by 1883, there were 27 types of powdered substitute available, according to an overview published in the Journal of Perinatal Education. The American Medical Association (AMA) formed the Committee on Foods to approve formula safety in 1929, which incentivized infant food companies to get the organization’s ‘Seal of Acceptance.’

An association with increased summertime infant deaths became one of the earliest controversies surrounding bottle feeding — but this was due to milk spoiling in bottles and a lack of understanding at that time regarding germs, states the overview.

Breastfeeding rates declined until the 1970s, when a new interest in breastfeeding started building.

Experts say that parents who are trying to decide between breastfeeding or formula shouldn’t be swayed by marketing ploys.

“The old adage of ‘breast is best’ is true — the primary reason is that formula doesn’t contain the gold mine of immunity boosting antibodies from mother,” Dr. Kecia Gaither, OB-GYN and director of perinatal services at NYC Health + Hospitals/Lincoln in New York City, told Healthline. “Studies have shown that there is a decrease in the incidence of SIDS in infants which have been breastfed.”

She explained that these antibodies can prevent the baby from getting sick with conditions like ear infections or digestive issues. “Breastfed babies are less likely to develop problems such as allergies or eczema that can occur with formula fed babies,” she continued.

The benefits may extend over a child’s lifetime.

“Breastfed babies are less likely to become obese later in life or develop diabetes,” said Gaither. A new study from South Korea finds breastfeeding can also reduce the mother’s diabetes risk.

Researchers found breastfeeding significantly increases glucose tolerance for almost 4 years after baby has been weaned to solid food. They said the milk-secreting hormone “prolactin” in breastfeeding mothers that promotes milk production also stimulates insulin-secreting pancreatic beta cells that regulate blood glucose.

For many parents, breastfeeding is not the right option. There are a variety of reasons a parent may decide breastfeeding is not the right choice, including preference and access.

A parent may not be able to produce any or enough milk, or an infant may not be able to latch properly.

“I supplemented with formula when I had my twins, in part because I didn’t produce enough breast milk for both of them,” said Dr. Jane van Dis, OB-GYN and medical director for Maven, a telemedicine platform. “I looked for formulas that were organic; I made sure to use glass bottles or BPA-free plastic.”

For other women, breastfeeding isn’t recommended if they’re receiving medical treatment or medication that makes milk unsafe. Some medical conditions can even prevent breastfeeding, such as mastectomy or breast reduction surgery.

“There are a few maternal medical conditions which prohibit breastfeeding and they include galactosemia in the infant, mothers who [have] HIV, mothers with untreated tuberculosis, active chickenpox, or herpes lesions on or near the nipple,” said van Dis. “Polycystic ovarian syndrome, as well as hypothyroidism, which are both endocrine disorders, can limit supply as well.”

Some women may not want to breastfeed because they find it uncomfortable, unpleasant, or they just don’t want to.

Additionally, some children adopted from birth or with two male parents may not have access to breast milk.

Whether breastfeeding or formula feeding, parents have options to keep their baby well fed and healthy.

According to Gaither, there are three basic compositions of infant formulas:

  • cow milk protein-based formulas
  • protein hydroxylate formulas

She explained that moms who are vegan or don’t want animal proteins in the child’s diet will prefer soy-based formulas. But for babies who can’t tolerate soy or cow milk protein-based formulas, a protein hydroxylate formula is the best option. Many formulas are also enhanced with omega-3 fatty acids, which aid in immune function and eye/brain development for the baby.

She added that some brands contain pre/probiotics, which help increase the concentration of healthy bacteria in the gut.

“Before deciding on any type of feeding for baby, be it breast or formulas — it’s best to speak to the pediatrician, and inquire as to whether any supplementation, such as vitamin D, may be necessary to add to the baby’s diet,” emphasized Dr. Gaither.

Health officials recommend feeding your baby breast milk for the first 6 months of life if possible, but the decision to breastfeed or use baby formula depends on many factors.

Formula manufacturers have been accused of exaggerating the benefits of infant formula, but there are situations when formula is the right choice for parents. But they should know what formula can and can’t do.

Experts say that before deciding on how you’ll feed your baby, it’s best to consult a pediatrician and ask whether the child’s diet will require any supplementation, such as with vitamin D.

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