All content of this blog is my own opinion only. It does not represent the views of any organisation or association I may work for, or be associated with. Nothing within this blog should be considered as medical advice and you should always consult your Doctor.

When you can prove formula is "nearly as good" - we'll talk!

Formula is nearly as good
"The research isn't that compelling for breastfeeding, it's probably not about the milk but the parenting style of a breastfeeding mother." 
There's only "a few small benefits" to breastfeeding
Happy mum = Happy Baby OR A baby is better with a happy mum and bottlefed, than with a mum stressed trying to breastfeed.
If I read things like this once per week, I must read them twenty times. I even had an email recently asking me if I really believed breastmilk was so much better than formula, the studies can't account for all the variables.  I also want to make it clear I believe in informed choice about infant feeding, you can't beat yourself up for what you didn't know.

So I decided it was time to reply :)

Firstly - even the guys making breastmilk substitutes don't claim they are close to breastmilk. (they're not allowed to for legal reasons because it isn't true)  They may claim "closer to breastmilk" - and indeed they may be closer than they were last month, or last year; that does not equate to close.  As I always say, I'm closer to owning a Bentley than I was ten years ago - doesn't make me anywhere near close!  Similarly there are literally hundreds of constituents in breastmilk that are not in substitutes.

Moving onto the "research isn't compelling".  We seem to be in a position of looking to prove "breast is best" ie prove breastmilk is better and has benefits.  Why on earth are we trying to prove the milk of our own species is better than milk from a cow?  A mammal that bears little resemblance to a human, or it's milk to ours. In fact it isn't at all comparable and needs massive modification to even be tolerated by humans; this makes no sense?!

The trouble with research is that it will never "prove something beyond doubt", that is not it's purpose.  As many point out because for ethical reasons we can't use control groups and feed one group breastmilk and one group substitutes, research has to focus on people who have already made this choice.  Therefore some argue that it's the parenting style of those who choose to breastfeed that may differ and may confer "the benefit".  Even when studies adjust for variables, some will still argue it doesn't portray a "convincing enough picture".

Indeed it may not, because control groups in the UK/US of infants who have been exclusively breastfed for 6 months are so hard to find, that researchers often either lump together "any breastmilk" or "no breastmilk" or exclusively breastfed for a shorter period of time eg 3 months.  Both these factors may well skew the data - and dilute the outcome of breastfeeding, because exclusivity is known to be important to protect in many areas, and until the gut closes at around 6 months, any substitute may influence outcome.  This means realistically any studies that could control like for like would be more likely to show a more compelling outcome for breastfeeding.

But the fact remains - human infants are meant to consume human milk, we should not be trying to prove it "has benefits".  Instead substitutes should prove they are as good as breastmilk, that they don't increase risk of illness or disease, that there are no risks to using them.

Following my post about SIDS & guilt - I read a reply from one lady on a forum that stated I was wrong, that breastfeeding reduced the risk of SIDS, but not breastfeeding didn't increase it.  Just think about that statement for a moment....if an infant receiving breastmilk has a better outcome than one who doesn't - then it's also perfectly accurate to say that an infant not receiving breastmilk has a worse outcome than one who does...

As for the "it's parenting style that makes a difference to outcome" - this may sound perfectly reasonable, until you look at all the constituents of breastmilk.  Protein that cause cell suicide in over 40 types of cancer, stem cells that develop into many different cell types in the body, serving as an internal repair system.  Lymphocytes that kill infected cells directly or mobilise other components of the immune system, enzymes, immunologlobulins and a whole lot more, that actively seek out and destroy harmful pathogens, sweeping them from the body and regulating immune response.  Anti infective factors, hormones, growth factors, anti-inflammatories and more.  This poster has lists to compare of what is breastmilk and formula.

Thymus gland as sized at birth shown by rubber model on baby's chest.We KNOW this stuff is there, beyond any research discussing outcome - we know fundamentally of the massive differences.  So - how about people get to work proving that going without all this stuff, doesn't cause a whole host of problems?  The Thymus (central organ in the immune system) has been found to be up to half the normal size in artificially-fed infants.

Now do we really think that parenting style is most likely to be the big key?  or might those hundreds of active constituents perfectly made to fight disease actually be playing quite a part?  which logically makes most sense to you?

What's also striking is that we also know how specific constituents work to protect baby in certain ways - and the research exploring outcomes tallies with what is missing.  The conditions we know the constituents of breastmilk protects against, we find in much higher levels in non breastfed infants.  To state there are only a few "benefits", is not only misleading but incorrect - there are no benefits to feeding a mammal the milk of his own mother, only risks of not doing so.  There are over 101 reasons to breastfeed.

When those who attack breastfeeding can present good solid evidence there are no risks to missing out on a passive immune system, we'll talk - until then what else is there to say?


  1. I love this post! I hate hearing those statements as well. Yes, I don't want to make people feel bad, but I am not going to create an excuse for others to use either.

    I love when people say depression would increase with the stress of breastfeeding. I have had depression since I was 14. When K2 came, I had PPD, then I was diagnosed with PTSD (a year ago). You know what? I am bad, but breastfeeding was the only thing that made me feel (as weird as that sounds). Breastfeeding saved my life, had I not been, I would have given up long ago, because there was no 'need' for me.

  2. Parenting styles are an important part of why BF babies tend to experience better health in adulthood. But.... IME there's a correlation between BF and other health-ful choices. That is, if a mum experiences success in her BFing, it tends to lead to other good healthy choices in other arenas. Not that she can't, or wouldn't have, if she'd FF: just that BFing increases the likelihood of other healthful choices.

    Is the causation direct (from the milk) or indirect (from the changes in the relationship triggered by BFing)? Does it matter?

    It all starts with BFing. It is the root, and the centre of the circle and the beginnings of great things.

    Every woman should be supported to BF.

  3. Lucky me attend the UNICEF conference in Harrogate at the beginning of Dec. Dr Lars Hanson presented a fascinating talk on the immunology of breastmilk ( you've briefly talked about it in your post ). I wish every women/man knew the miraculous properties of breastmilk. Formula will never, ever, ever be close to breastmilk. I love your comparison with the Bentley; it's true!

  4. Yeah right what we build and fuel the most complex chemically sensitive molecular structure in the known universe and central in all our perceptual and cognitive function will make no difference. Our nearest living relatives (with less advanced brains) breastfeed for several years. Breastmilk specifically honed over millions of years of evolution is rich in precisely the required hormonal and bio-chemical profile to build an advanced neural system. But hey ho what a crazy idea and anyway where is the evidence that building our brains from sh*t results in profound stupidity???

  5. the last part of this really rang true with me. i didnt know any better and believed that there wasnt that much difference between breast milk or formula. i thought it was just vitamins and minerals which could be added to the milk that were in breast milk. i combine fed my 1st son for 5 months before going fully formula and my 2nd i exclusivley fed for 6 weeks. now its true they havent suffered any repurcussions, yet, but since breastfeeding my 3rd son (whos 9 months and still breastfeeding)and finding out all the truth about the differences and the risks of formula i feel awful that i gave up so easily in the past and terrible that i believed the lies that it was almost as good. and i'm also very thankful that they have been so well so far and that they at least got some breast milk.

  6. I've only skimmed because I know that I 100% agree. It frustrates me that we have to demonstrate unquestioned benefits to bfing, and that even then we often get the answer, "Ah, but that's just because bfing mothers tend to be better off, more intelligent and make healthier choices in all areas." Why do we have to fight so hard to justify bfing?

    Why can't we look at it from the other direction - these are the risks of formula that are demonstrated by research, even after taking account of any maternal factors. And these are just the risks that we know about so far.

  7. Its funny how we always get the arguments that breastfed babies are smarter because their mothers are better off and smarter etc, when the research still holds true for places like the Phillippines where the children most likely to be breastfed are the offspring of lower income less educated parents..

  8. Great information. I agree completely, and from a scientific point of view it makes no sense to dispute the fact that breastmilk is best.

  9. I don't understand why you have put the nutritional benefits of breastfeeding and the emotional/psychological state of the mother in the same basket, when to my mind they are two separate issues.

    It is unhelpful to suggest that mothers should breastfeed at all costs, even at the expense of their mental health. I have had excellent support in continuing to breastfeed, but I am more than my breasts. I have found that my approach has had to be holistic, respecting both my baby's needs and my own.

    I am combination feeding and this is what works for us, having experienced issues with tongue-tie and dietary intolerances since day one. If anyone would like to question my commitment to breastfeeding, I would be happy to bore them with the details of the changes I have made to my diet so that my baby feeds well and without pain.

    Of course breast milk is superior. However, in my view, there is more to it than that.

  10. QUOTE I don't understand why you have put the nutritional benefits of breastfeeding and the emotional/psychological state of the mother in the same basket, when to my mind they are two separate issues.

    I'm confused as to what you mean, could you explain more please?

    I have never suggested mothers breastfeed at the expense of their mental health - MANY women I see (bearing in mind we are the last to be called in as we're independent) are extremely vulnerable mentally, with many feeling as though they're "going mad" - and it's us that spend the hours helping them debrief all the guff advice they were given. We support mums whatever their journey/choices, but most aren't mix feeding through choice, but because nobody has managed to get to the bottom of their problems!

    Breastmilk is only superior if we hold formula as the norm for comparison, but it isn't really is it?

  11. Thanks for your response.

    I understand that my earlier comment focuses on one point which is clearly not the main purpose of the article, however the issue is very personal to me and stems from my experience.

    I refer to your opening quotes of "happy mum = happy baby" etc and the link to "Over 101 reasons to breastfeed". The list includes phrases such as, "Breastfeeding acts as a natural tranquiliser for mum", "Breastfeeding is a self confidence booster for mum" and "Non-breastfed babies require more doctor visits".

    My experience has been the polar opposite. I had a traumatic labour and struggled to bond with my baby as a result. Due to issues such as tongue tie (discovered at 12 weeks) and food intolerances (discovered at 5 months) feeding was a nightmare which lasted two hours out of every three. I was advised to express after every feed to build my milk supply, which I duly did. I went through the motions whilst struggling with my apparent lack of love for my baby (which my husband had in bucket loads). My baby was still very slow to gain weight, which was a cause of concern for both us and the midwife.

    Being taught how to breastfeed was essential, however, it was the breastfeeding itself which was compounding the issue. Six months on and I can see that I was struggling with PTSD, which unfortunately was not picked up by my GP, my health visitor or the breastfeeding support counsellor despite numerous appointments with them all. It was the darkest time of my life and the only advice I was given was to get out of the house more.

    We introduced formula out of desperation, as an addition to breastfeeding, and things improved. I was devastated at the time but came to accept it.

    In essence, I feel that the psychological state of the mother is often downplayed, and comments such as the ones I quoted earlier (which I feel should be worded more carefully) stirs it all up again. If you personally are on the lookout for symptoms of PND or PTSD, or similar struggles, whilst supporting women to breastfeed, then that is fantastic and I wish I had you around when I most needed it to help me make sense of it all.

    I've ordered "The Politics of Breastfeeding" as it was recommended to me, which I'm looking forward to reading with an open mind.

  12. Hiya
    Nope you're right it isn't the point of the article, that sentence at the top needs removing as I did a dedicated post on the happy mum/baby phrase.

    Perhaps the link should say breastfeeding "when going well" proffers the following, as mums struggling are not likely to receive these perks as discussed here

    We presented around the above subject to a breastfeeding conference recently, to try and raise awareness of not only psychological impact on mum and the dyad of delayed and ineffective support - but also the impact of slower than expected weight gain and the links with this and maternal depression.

    3 months is a LONG time to be struggling with feeding issues, and a further two months to realise the implications to the gut again is unacceptable - this should have been discussed during follow up following division if things didn't resolve.

    Because we're independent we spend a couple of hours with mums, and yes often nobody has really sat down and LISTENED to mum, and what she is saying, how she feels and so on. I hope the comments here reassure you we always approach things sensitively


  13. Thank you for such a gracious response. Reading back over my earlier comments I can see that it was cathartic for me, but I'm sorry you bore the brunt of it! I had never put my story down on paper, as it were, until now. Thank you for 'listening'!