Pros and Cons of Formula Feeding and Breastfeeding

By Dr. Kenosha Gleaton, OBGYN

Deciding how you will feed your child can feel overwhelming (especially when you’re receiving solicited and unsolicited opinions). The truth is there are challenges and benefits to both formula feeding and breastfeeding. Here’s an overview of what you need to know. 

What to Know About Breastfeeding

Breastfeeding often begins within an hour after birth and can continue for as long as the body allows or as long as desired. [1] It’s possible to feed a baby breast milk through breastfeeding or bottle-feeding, which often requires pumping milk from the breast and storing it for later use. It’s common for parents to mix bottle-feeding and breastfeeding for more flexibility when it comes to sleeping and day-to-day schedules. 

The American College of Obstetrics and Gynecology (ACOG) does recommend exclusive breastfeeding for the first six months of a baby’s life and recommends breastfeeding continue until a year after delivery as new foods are introduced. [1] It’s estimated that only a quarter of women in the U.S. are able to breastfeed exclusively for six months, as a result of desired and undesired weaning. [2]    Read How and When to Wean from Breastfeeding → 

Pros of Breast Milk 

ACOG and other experts tend to recommend breastfeeding for at least a few months because there are many health benefits associated with breastfeeding. For example: 

Naturally Adapts to Meet a Child’s Needs

Breast milk naturally contains the right amounts of nutrients, including fat, sugar, water, protein, and minerals. [1] As the child grows, breast milk composition will change to keep up with nutritional demand. Plus many of the beneficial nutrients in your prenatal or postnatal vitamins are meant to aid in the development of your child while breastfeeding.

Easier to Digest

Breast milk is typically easier to digest than formula. This may result in less vomiting or diarrhea. Breast milk has also been shown to lower the chances of different digestive conditions. The whey protein, probiotics, and prebiotics from breast milk benefit digestive health and gut bacteria. [3] 

Maternal Health Effects

Studies show that breastfeeding may help with postpartum healing, decreasing the amount of bleeding experienced after birth and helping to shrink the uterus back to its normal size more quickly. [1] Breastfeeding may also reduce the risk of various cancers, including breast and ovarian cancer. The risk of postpartum depression may also be decreased in some people. [4] 

Infant Health Effects

Research suggests that breastfed infants have a lower risk of sudden infant death syndrome (SIDS). [1] Breastfed preterm babies are also less likely to experience short and long-term health problems. Lastly, breast milk contains antibodies that may help protect babies from different illnesses. This includes ear infections, respiratory illnesses, and allergies. [1] 

Bonding

Another reason many people enjoy or prefer breastfeeding is the intimacy of nursing a child. Some research suggests that breastfeeding may improve bonding between parent and infant. [5] This isn’t to say that you can’t have a close bond with an infant that isn’t breastfed, as there are other ways to promote bonding such as skin-to-skin contact, active talking, and eye contact. [1] 

Cons of Breastfeeding

Even though there are multiple health benefits associated with breastfeeding and breast milk, there are some challenges you may want to consider. 

Nipple and Breast Discomfort or Infections

Breastfeeding and pumping can cause nipple pain and discomfort. It’s estimated that up to 90% of breastfeeding parents will experience cracked nipples. [6] This can cause bleeding, and inflammation, and may increase the risk of infections and mastitis. Breastfeeding may also lead to problems such as vasospasm, milk blisters, eczema, and others. [1-2,6] Additionally, waiting too long between pumping or nursing can lead to engorged or uncomfortable breasts. [2] Some products, such as Natalist Nip & Lip Balm, can help soothe dry or cracked nipples. 

Difficult to Measure

Unless you’re exclusively bottle-feeding, it can be difficult to measure exactly how much your child may be eating. This information isn’t necessary for everyone, but can sometimes be helpful if you’re concerned about the infant’s growth or changes to their eating habits. 

Can Be Time Consuming

When exclusively feeding a child breast milk, the parent producing the milk has to be available for feedings or pumping regularly. This means pumping or nursing at work, in between errands, in the middle of the night, etc. especially because newborns tend to eat frequently, at least every two to three hours. [1] 

Limitations to Diet and Lifestyle

When breastfeeding, it is encouraged that consuming or using caffeine, alcohol, smoking, and some medications be limited or completely avoided. [1] Your healthcare provider can give you specific details on what is safe for breastfeeding or how to navigate pumping and nursing if you are going to be drinking alcohol or using certain medications. [1] You may also need to avoid certain foods while breastfeeding, such as seafood with high mercury levels. 

Difficulty Latching

Breastfeeding does not always come easily to infants or parents and may be difficult, painful, or stressful. [2] Many people require the help of a lactation specialist or healthcare provider to help with problems such as difficulty latching, tongue-tie, high palate, etc.  [1-2] 

What to Know About Formula Feeding

Infant formulas are breast milk substitutes in the form of liquids or powders. Formula is widely used to feed the majority of infants in the United States at some point during the first year of life. [7] The ingredients in the formula will vary depending on the brand and type of formula, but typically baby formula is made with cow’s milk and has added nutrients to mimic the concentration of vitamins and minerals found in breast milk. There are also soy-based formulas and protein hydrolysate formulas available if an infant has specific needs, allergies, or if there is simply a preference. 

Pros of Formula Feeding

Infant formula is widely used by many families as an occasional substitute for breast milk, or for long-term feeding. Here are some of the pros to using formula. 

More People Can Help with Feeding

While this could also be the case for bottle-feeding breast milk, using formula is a convenient option for families utilizing a caregiver or family member to help take care of the infant. The person that gave birth does not have to be around to help nurse or pump breast milk. This can also be helpful for nighttime feedings as either parent can assist with feeding. 

Easily Measured

It is much easier to measure how much you’re feeding your child when using infant formula. This can be helpful for ensuring your child is eating enough and keeping them on track for all their important growth milestones.

Diet and Lifestyle

Unlike breastfeeding, formula feeding is not impacted by maternal diet or lifestyle habits. This means that there is less to consider and plan around when taking certain medications, drinking alcohol, eating certain foods, etc. 

Feeding Frequency

Formula takes longer to digest than breast milk. While this fact alone may cause some challenges, such as increased diarrhea or vomiting, many formula-fed infants will eat less frequently. [1,3] This may mean fewer nighttime feedings and longer periods of time without having to prepare a bottle for your child.

An Accessible Option

Formula is a great option for many families if someone is unable to breastfeed due to a medical condition, illness, or disability. Formula allows a child to be fed whether or not the birth parent is around to raise or nurse them. Some people may also opt for formula simply because of a preference, or because breastfeeding was too challenging or caused cracked or sore nipples. [2] 

Shop Breastfeeding Safe Nipple Balm 

Cons of Formula Feeding

While formula feeding can be a flexible option for many, there are some challenges to be aware of. 

Not as Complex as Breast Milk

While formula can still provide many of the vital nutrients that infants need, baby formula is not able to provide the same antibodies that breast milk does. Breast milk also adapts to a child’s changing needs as they grow, whereas formula feeding does not. 

Expensive 

An important factor to take into account with formula feeding is the cost. Baby formula can be very expensive, especially if you are wanting to use soy or hypoallergenic formulas. It’s estimated that one year of formula may be around $1,500 or more. [8] When compared to breastfeeding, which is essentially free (not counting a breast pump or bottles), formula costs can add up quickly. 

Fewer Health Benefits

Breast milk is typically recommended because of the many health benefits seen in both the breastfeeding parent and the child. Studies have shown that breastfeeding may decrease the risk of various diseases and complications and may benefit the infant’s immune system. [1] While formula does include many vital nutrients, the risk of conditions is increased when used instead of breast milk. [9] 

Difficult to Digest

As mentioned, baby formula tends to be more difficult to digest than breast milk. This may lead to an upset tummy and cause gas, constipation, or diarrhea. [1,3] 

Requires Planning 

One of the more time-consuming and frustrating parts of formula feeding is having to plan ahead and prepare bottles. If you travel with your child or are often outside of the home, you will need to bring supplies to prepare bottles or store ready-made bottles. While formula does not have to be warmed, many infants prefer warm formula, which is another step to consider. Breastfeeding tends to be more convenient in a pinch as you can feed pretty much anywhere with little planning required. 

Using Both Formula and Breast Milk

A common scenario is for parents to mix both breast milk and formula. In some cases, exclusive breastfeeding may be started but is not sustainable due to work, sleep, social schedules, discomfort, or inability to continue breastfeeding regularly. Even though many experts recommend exclusive breastfeeding for the first six months, a majority of women are unable or don’t want to do so. [1-2] If you have specific concerns or questions about breastfeeding or formula feeding, speak to a healthcare provider. 

The Bottom Line

Breastfeeding and formula feeding are both acceptable and beneficial methods for feeding an infant. While attempting to breastfeed is recommended for at least a few months after giving birth, the reality is that not everyone is able to or wants to breastfeed. Formula feeding is a great option for many families that provides its own benefits, such as convenience and flexibility. Whatever your circumstances are, know that there are many different ways to bond with and feed your child. The most important thing is to follow your pediatrician's and other healthcare providers’ recommendations for keeping yourself and your child happy and healthy. If you are recently postpartum, you may benefit from taking a Postnatal Vitamin or using Nip & Lip Balm to soothe chapped, dry nipples. Shop Natalist Postpartum Products → 

References:

1.  Breastfeeding Your Baby. FAQ029. ACOG. May 2021. URL. 
2. Breastfeeding challenges. ACOG Committee Opinion No. 820. American College of Obstetricians and Gynecologists. Obstet Gynecol 2021;137:e42–53.
3. Breast Milk Is Best. Johns Hopkins Medicine. Accessed June 2023. URL. 
4. Hamdan A, Tamim H. The relationship between postpartum depression and breastfeeding. Int J Psychiatry Med. 2012;43(3):243-259. doi:10.2190/PM.43.3.d
5. Liu J, Leung P, Yang A. Breastfeeding and active bonding protects against children's internalizing behavior problems. Nutrients. 2013;6(1):76-89. Published 2013 Dec 24. doi:10.3390/nu6010076
6. Niazi A, Rahimi VB, Soheili-Far S, et al. A Systematic Review on Prevention and Treatment of Nipple Pain and Fissure: Are They Curable?. J Pharmacopuncture. 2018;21(3):139-150. doi:10.3831/KPI.2018.21.017
7. Institute of Medicine (US) Committee on the Evaluation of the Addition of Ingredients New to Infant Formula. Infant Formula: Evaluating the Safety of New Ingredients. Washington (DC): National Academies Press (US); 2004. 1, Introduction and Background. Available from: https://www.ncbi.nlm.nih.gov/books/NBK215843/
8. Rahmanan, A. Why Formula Costs So Much—Financially and Emotionally. Parents. September 14 2021. URL. 
9. Stuebe A. The risks of not breastfeeding for mothers and infants. Rev Obstet Gynecol. 2009;2(4):222-231.