Breastfeeding is hard.
From what I’ve been told, few women know this before they begin their journey. Although, I’m sure one can only know once they experience it. Yet, as a result, the difficulty can blindside a postpartum mom who is already undergoing a plethora of physiological changes.
There is no debating the benefits of breastfeeding your baby, despite the difficulties that may arise during the process. However, a lot of women struggle to breastfeed for a variety of reasons, and many ultimately decide to switch to formula.
As healthcare professionals, we know the research behind our recommendation to breastfeed exclusively for the first six months of your child’s life, and longer if you can. There has long been an understanding that breastfeeding is the gold standard when it comes to feeding your baby, objectively and scientifically speaking.
Science tells us that breast milk is superior to formula when it comes to the short- and long-term benefits to mother and baby.
Benefits for baby such as better cognitive development, less likelihood of developing illnesses, and development of the intestinal mucosa to name a few. Benefits for mom such as returning the uterus to normal size more quickly, and reducing the risk of certain diseases and cancers later in life.
Interestingly though, the idea that “fed is best” has gained popularity recently on social media. In a letter to parents and health professionals by a Christie del Castillo-Hegyi, she states that instructing mothers to exclusively breastfeed their babies is “dangerous.” She cites a research article about infant rehospitalization due to dehydration that can lead to neurological problems. She states that “exclusive breastfeeding at discharge is associated with an 11-fold higher risk of rehospitalization for underfeeding and dehydration,” and while this may be true based on the article, the conclusion of the study’s findings was that among those with access to good medical care, instances of neonatal dehydration were rare. I would encourage you to read her letter, it is informative and she cited reputable sources.
From what I can tell, this idea that “fed is best” has come about because many women feel shame or unfair judgement from other women (and men) who state that choosing to formula feed your baby makes you selfish, lazy, or a bad parent. While I personally disagree that formula feeding makes a woman a bad mother or harms her baby in any way, I believe by telling women ‘however you feed your baby makes no difference, because a fed baby is best‘ does a disservice to women (and their babies!) and leaves out important facts about the special benefits breastfeeding offers.
Think about it this way: If I am a new mom, and I have been told that there is no difference between formula feeding and breastfeeding my baby, how likely am I to stick with breastfeeding when it feels overwhelming and impossible? When the long, sleepless nights and the pain become seemingly unbearable? I would be unlikely to stick with breastfeeding, and instead I would go for the option that would relieve the hardship I am experiencing because I would not believe that there is anything special enough about breastfeeding to continue despite the challenges.
I want to be clear and reiterate–I am not in any way suggesting that every mother who formula feeds her baby is weak or lazy. In fact, I believe that most women arrive at that place because they believe they have exhausted all of their options and breastfeeding is simply not working for them. I am aware that in many cases that is a fact. Many women cannot breastfeed for medical reasons. Many women receive adequate post-partum support, see lactation consultants, and try every lactation cookie, supplement, etc. to try to remedy their various breastfeeding ailments. These are not the women that I want to address here.
If you are not able to breastfeed, pump, or receive donor milk because of a medical or financial issue, formula IS your next best option. However, as a future registered dietitian, I would be lying to you if I told you that formula and breast milk are the same; that there is no difference and it does not matter which you choose. Of course, your child getting adequate nutrition is always the ultimate goal–but that does not negate the benefits breastfeeding has over formula.
Instead of saying that “fed is best,” I would suggest being honest and up-front with moms. Tell them that breastfeeding is best, and that is why we as health professionals recommend it first and foremost. But also tell them that if they are not able to breastfeed for whatever reason, it IS okay to switch to formula, because science is awesome and we have come up with the next best thing to breast milk–formula! Do not tell them there is no difference. Tell them that there is a great alternative. Help them understand that although breastfeeding offers more health benefits to them and their baby, the best option for every woman, child, and family is not always breastfeeding. Reassure them that they are allowed to grieve the fact that they cannot breastfeed or are choosing not to. Do not tell them that it doesn’t matter. Tell them that, by becoming educated and having the right support, they will be able to make the choice that is best for them, their baby, and their life. I believe that is truly and deeply empowering.
In summary, what I am advocating for is better breastfeeding education and support all throughout the motherhood and parenting journey (because dads should be included in all parts of the process, too!).
Let’s not give women partial truths to comfort them, but rather educate and empower them to make the decisions that are best for them and their families.