Everything You Need To Know About Breastfeeding vs Formula

By Wendy, Lactation Consultant (IBCLC)

Although there is no denying the benefits of breastfeeding, there are so many reasons why a mom might need to add formula to the mix. Contrary to popular belief, supplementing with formula isn’t the end of the world. It also doesn't have to wreck your breastfeeding relationship, and you can still retain many of the benefits of breastfeeding.

Let’s talk about the best ways to balance formula and breastfeeding.

When is supplementing with formula necessary?

Most major health organizations recommend exclusive breastfeeding during the first six months of life. However, we all know that life sometimes has other plans.

Here are some common, valid reasons you might supplement with formula:

• You aren't able to produce a full supply of breastmilk.

• You are struggling with nipple pain, or your baby is battling with a tongue tie.

• You aren't able to pump when you return to work.

• You decide that full-time breastfeeding isn't for you.

What to know about breastmilk vs. formula

The World Health Organization (WHO) recommends supplementing your own pumped milk or donor milk if you cannot breastfeed exclusively. But we all know that those options are not always on the table, and formula becomes necessary. Although formula often gets a bad name, it is an excellent option for mothers who cannot make full-time breastfeeding work for whatever reason.

Still, it's essential to understand how formula is different from breastmilk so that you can make an informed choice about how to balance the two: 

• Both formula and breastmilk provide healthy, adequate nutrition for your baby to grow.

• Formula keeps your baby well-fed when you cannot produce a full supply and can act as a bridge to get you through a rough patch in breastfeeding.

• The main difference between formula and breastmilk is that breastmilk contains antibodies and other immunological factors that help your baby fight diseases and infections.

• Breastmilk has probiotic-like elements which help produce a healthy microbiome for your baby.

Can I give my baby formula and breastmilk?

 Yes! Many moms combo feed their babies both formula and breastmilk. If you do this, it’s helpful to keep a couple of points in mind:

•  It’s not a good idea to mix breastmilk and formula in a bottle during feeding. According to research published in Acta Paediatrica, this practice can diminish the breastmilk's nutritional value, including its calcium, protein, phosphorus, and zinc content. You are also more likely to waste breastmilk if your baby doesn't finish the bottle.

• If you are going to start introducing formula, you should know that your breastmilk supply will decrease if you don’t pump at regular intervals; it’s helpful to seek advice from a lactation consultant or counselor to find the right balance of pumping and supplementing for your particular case.

• Consider breastfeeding first thing in the morning and the middle of the night—your supply is naturally at its highest then, and this may be an excellent time to get a good feeding session in with your little one.

• When feeding your baby formula, try to do so in a "breastfeeding friendly" way: use a slow-flow, wide bottle nipple to encourage your baby to open wide, hold the bottle horizontally to slow down the flow, and give your baby frequent breaks.

• If you have to be separated from your baby for long periods, pumping for a few minutes at a time every few hours can help keep your supply up.

How much breastmilk is required to give baby immunological (and other) benefits?

Many moms want to know if there is a certain number of ounces of breastmilk a baby needs to get to derive all the benefits of breastmilk. The short answer is that any amount of breastmilk is incredible for your baby—and breastmilk contains all of its benefits for the whole duration that you are breastfeeding.

Furthermore, the immunological factors become more concentrated in the milk as you start breastfeeding less. For example, research published in Frontiers In Pediatrics found that breastmilk “after the 2nd year of lactation” contained “significantly higher” amounts of immunoglobulins like SIgA and IgG.

As for exact amounts, La Leche League explains that even when milk supply is low, there are many benefits to breastfeeding your baby, including providing them with essential "milk enzymes, hormones, fatty acids, proteins, and sugars which cannot be obtained from any other source.” La Leche League contends that even 50 ml of breastmilk can supply significant benefits for your baby. More research is needed in this area, but rest assured that “every drop counts.”

What formula is best for my baby?

There is no right answer to this question. Your best bet is to talk to your doctor about what formula might be right for your child. Finding the right formula might depend on your child's age, medical conditions they may have, and whether they have any trouble digesting a specific brand of formula. Many parents prefer to use an organic formula, but that may not always be within your budget. Making your own formula is usually advised against because it needs to meet specific strict nutritional standards for optimal infant growth and development.

The Bottom Line 

Realizing that you might need to supplement your baby with formula is an easy trigger for "mommy guilt." But there is nothing wrong with you if you need to use a formula. The truth is, breastfeeding is great, but your own health and sanity are important too, and if formula feeding is what you need to do, you shouldn’t feel guilty about that at all.