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Breast Feeding vs Instant Formula

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Article by Claudette Wadsworth

Claudette Wadsworth Profile | Email | Website
Claudette Wadsworth Qualified Naturopath
Herbalist
Nutritionist

Natural Fertility Specialist
ThetaHealing Practitioner
40 Grosvenor Street
Bondi Junction
NSW
Australia 2022
(02) 9389 3689

Human milk is specifically adapted to the needs of the newborn and therefore breast milk is unquestionably the food of choice for the infant. According to the World Health Organisation, “breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants.”   It is also recommended that “exclusive breastfeeding for 6 months is the optimal way of feeding infants. Thereafter, infants should receive complementary food with continued breastfeeding up to 2 years of age or beyond."   Prior to 6 months of age, the lining of the digestive tract of the infant is not sufficiently developed to handle solid foods and early introduction leads to food allergies.

 

Breast milk not only continues to be nutritionally superior to any other formula or food for the infant but it is also vastly superior to formula in immunological, biochemical and cognitive benefits. Breast milk contains all nutrients required by an infant for the first 6 months of life, and should form the main nutritional source for the first year. It provides adequate protein, fats, carbohydrates (mainly beta-lactose with small amounts of oligo- and monsaccharides) and water as well as the necessary growth factors, vitamins, minerals, hormones, enzymes and long-chain polyunsaturated fatty acids (LCPUFAs). The nutrient composition of breast milk is influenced by the mother’s intake in pregnancy, particularly in the third trimester, and post-natally. Breast milk contains substances for the developing infant’s immune system including anti-inflammatory and anti-infective agents such as leukocytes, oligosaccharides and antibodies. The predominate immunoglobulin, secretory IgA, is approximately 10 times higher than the level found in cow’s milk or formulae.  Some of these immune system boosters are only present in substantial amounts in the later stages of lactation, demonstrating the importance of long-term breastfeeding.  Breast milk also changes in composition during a single feed whereas formula does not, eg. the hindmilk at the end of the feed is higher in fat which causes satiation in the infant.

 

Most drugs are only excreted to a small extent in breast milk and usually are well below the therapeutic dose for the infant. However, each case should be considered individually as the amount of drug passing into breast milk and remaining over time will vary and some drugs are contraindicated due to documented adverse outcomes in neonates as well as inhibiting or reducing breast milk production. Viruses and bacteria may appear in breast milk and therefore, HIV-positive mothers are advised not to breastfeed. 

 

Benefits of Breastfeeding 

Infant

•enhances maternal/infant bonding

•more easily digested and absorbed

•more resistance to bacteria, viral and fungal diseases, including respiratory, ear and gastrointestinal infections – the severity of illness is also reduced   

•reduced risk of SIDS

•reduced risk of allergy (especially if family history of atopy)

•reduced risk of necrotising enterocolitis in premature infant

•better cognitive and academic outcomes 

•less risk of developing Type 1 diabetes 

•reduced incidence of heart disease in later life 

•optimal growth and development , including speech, teeth and jaw development from sucking actionMother

•enhances maternal/infant bonding

•helps involution (retraction) of uterus

•uses fat stores from hips and thighs gained during pregnancy

•delays return of fertility

•reduces risk of breast and ovarian cancers and menopausal osteoporosis 

•convenient- no preparation, no time spent making up formulas

•hygienic – no disinfection, heating or washing up required

•economical – formula and accompanying equipment can cost up to $1 200 a year

•environmentally- friendly

•reduced unpleasant odour of stools due to complete protein digestibility

 

 

Breast milk will always be the “gold standard”, although if the mother is unable to breastfeed for some reason and it is necessary to resort to formula, there are better choices than others. Commercial formulas made from heat-treated non-fat milk are designed to provide necessary nutrients in a well-designed and absorbed form. However, there are over 400 nutrients in breast milk that are not found in any infant formula. Most infant formulas contain much higher concentrations of minerals and trace elements than those of breast milk as there is some concern about how well infants can absorb and  utilize these nutrients from formula.  Cow’s, goat’s, rice, soy milk, evaporated milk or sweetened condensed milk are not substitutes for formula as they are deficient of vitamins and minerals. Additional supplements or vitamins are not necessary for an infant as the formula should contain everything they require for growth. Standard formula is labelled “suitable from birth” and is for babies aged birth to 12 months. Follow-on formula is labeled “suitable only for babies over six months” is for babies 6 to 12 months. 

 

Formula can be made from whey, cow’s milk, goat’s milk, soy or rice. Cow’s milk formula is the most common, containing the proteins whey and casein. Whey is a more easily digested protein than casein with breast milk containing 60% whey, 40% casein; by contrast, cow’s milk is 20% whey and 80% casein. Infant formulas today try to closely mimic the ratio of whey to casein, although it is recommended to choose a formula based upon whey, rather than cow’s milk, which is a very common allergen. In infants with colic, whey-based formula fed infants have demonstrated reduced crying times.  Infant cow’s milk allergy is usually due to the protein or phenolic factors in milk, not to lactose intolerance. Lactose intolerance is unusual in babies as under the age of 3 as babies have a plentiful supply of lactase, the enzyme to break down lactose. However, the protein molecules in cow’s milk are much larger than those in human milk, making them difficult to digest for the infant. If an intolerance develops, it is recommended to change the formula or even alternate every couple of weeks. 

 

Hypoallergenic(HA) formula is cow’s milk formula where the protein has been partially broken down to make it more digestible and reduce the subsequent incidence of food allergies. This formula is becoming the most widely used formula and is preferable, especially if there is a family history of food allergies.  

 

Soy-based formulas are not recommended as there have been some studies demonstrating their adverse effects upon infant hormone receptor development. The isoflavones, including genistein and equol, which are found in soy demonstrate toxicity in oestrogen-sensitive tissues and in the thyroid. Soy formulas also contain higher amounts of aluminium and phytates which block the absorption of proteins and minerals, shown to cause delayed growth in children.  Lactose is not found in soy so other sugars not normally present in breast milk are added, such as sucrose and corn syrup which are heavily processed and highly allergenic. Research has shown that soy formula has no advantages in regard to colic, excessive crying, wind or sleep problems, wheezing or eczema.  Butterfat that is present in animal milk formula is replaced by vegetable oil that is often of poor quality, being more prone to oxidization and rancidity.

 

Goat’s milk formula is an alternative option with supposedly very low chemical contamination. The protein molecule in goat’s milk is much closer in size to that of human milk compared to cow’s milk, making it easier to digest. Rice-based formula is low allergenic, although it is lower in protein than animal milk and has little fatty acid content. 

 

The use of genetically modified (GM) ingredients in formula has not been prohibited by government regulations, although there are concerns about their digestibility and effects on the developing gastrointestinal tract so are not recommended. The soy based formulas are the most affected but other ingredients derived from soy such as lecithin are used in cow’s milk formula so potentially all formula may contain GM protein. Some manufacturers have chosen not to use GM ingredients and have stated it on the label.

 

In Australia, formula is not allowed to be advertised on the strength of its ingredients. However, there are some important nutrients, which normally would be present in breast milk, to look for when selecting or recommending a formula. 

 

Omega 3 fatty acids, especially DHA, are vital for the infant’s brain and eye development  but have only recently prompted formula producers to fortify their products with DHA and AA (arachadonic acid). Currently, DHA/AA enhanced formulas are available, although not mandatory. Unfortunately, the DHA added to formulas is often already oxidized (approximately 30%) and leaves out other unidentified fatty acids, but it is a step in the right direction. 

 

Probiotics are the ‘good’ bacteria, such as lactobacilli, that help the infant to digest, reducing the incidence of colic, infections and perhaps allergies.  Formulas that are also fortified with lactobacilli are definitely superior. Antibodies are also added to formulas but unlike in breast milk, they are inert , although preferable to none.

 

Two particular amino acids or proteins that have recently been added to formulas and should be looked for are cystine and taurine. Cystine enhances overall growth and taurine is used in brain development. 

 

Questions to ask mother

•Is she still breastfeeding? Exclusively or with formula as well? 

•Is the mother taking in medications that may come through the breastmilk?

•If she has stopped breastfeeding, for how long did the mother breastfeed? 

•Why did she stop?

•What formula is she using now?

•Does the infant suffer from constipation? Colic? Reflux? Allergy, eg. skin rash? Uncontrollable crying?

•Do either parents suffer from any allergies, eg. hayfever, eczema, asthma?

•Has she tried using a different formula? Was it still a cow’s milk formula or an alternative base? Which one? 

•Did the baby tolerate it better or symptoms improve or worsen since using the formula?

•Is the mother making up the formula exactly according to the instructions? Making it stronger than recommended will cause digestive upsets like diarrhea and severe nappy rash and to make it weaker will cause malnutrition. Scoops are not interchangeable between brands.

•Is the mother heating up the formula in the microwave? Breastmilk and formula should never be heated in the microwave as it changes the molecular structure, destroying nutrients.  Also the heat may not be evenly distributed by microwaving so the baby’s mouth can be scalded. 

•Is all unused formula discarded and not reused?

•How much is the infant drinking? 

•Is the mother overfeeding? The infant does not need a bottle every time it cries. Overfed formula fed babies have more digestive problems due to the difficulty in digesting formula. 

•How is the mother bottle feeding? An improperly tipped bottle will allow too much air into the infant’s stomach. The infant should not be bottle fed whilst in the pram or cot. 

 

Formula Equipment

•Use glass bottles preferably

•If using plastic, choose PET, HDPE, LDPE, or PP products

•Do not use any PVC part, eg. teats: recycle number 3 printed on them

•Teats should be as similar in shape to a mother’s nipple as possible: reduces amount of wind entering the infant’s stomach & reduces confusion between breast and bottle feeding if using both 

•Latex teats: cheaper, softer, more flexible but contains nitrosamines: known to cause cancer in animals; restricted to 60 parts/billion by National Health & Medical Research Council 

•Silicone teats: more expensive, less flexible, more durable, less toxic nitrosamines

•Slow-flow teats are best for newborns; medium flow teats from 8 weeks old; regular flow teats from fourth month

•Odd shaped bottles make them more difficult to clean and marketing gimics like ‘anti-colic’ devices usually do not prevent wind or colic anyway.

•Wide-necked bottles are preferable: cleaning & filling is easier, reduces amount of wind entering the infant’s stomach 

 

Checklist

•Breastfeeding is best, the longer the better, exclusively for 6 months, preferably up to 12 months or more

•Formula: whey-based or hypoallergenic cow’s milk formulae are best, goat’s milk formula also good

•Avoid soy-based formulas and formulas with GM ingredients

•Change formula if intolerance, digestive problems or allergies develop

•Best additions: DHA & AA fatty acids, probiotic: lactobacilli, antibodies, amino acids: cystine & taurine

•Avoid PVC teats and bottle parts

•Never microwave breast milk or formula

 

By Claudette Wadsworth

Naturopath, Nutritionist

Bondi Junction  02 9389 3689

CBD Sydney  02 9268 9000

www.claudettewadsworth.com.au

13 Mar 2013

Article/Information supplied by Claudette Wadsworth

Disclaimer - Any general advice given in any article should not be relied upon and should not be taken as a substitute for visiting a qualified medical Doctor.

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