David Perlstein, MD, MBA, FAAP
Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Which is better, breastfeeding or formula-feeding?
Human milk is the preferred feeding for all infants. This includes premature and sick newborns, with rare exceptions. Pediatricians generally advise that full-term, healthy infants exclusively breastfeed when possible for the first 12 months of life and, thereafter, for as long as mutually desired. Advantages of breastfeeding include:
- breast milk is nutritionally sound and easy to digest;
- breastfeeding is believed to enhance a close mother-child relationship; and
- breast milk contains infection-fighting antibodies (immunoglobulins) that may reduce the frequency of diarrhea, gastroenteritis, otitis media (ear infections), and other respiratory infections in the infant.
Please see the Breast Feeding article for more information.
Some parents choose formula-feeding either because of personal preference or because medical conditions of either the mother or the infant make breastfeeding ill-advised. Parents need not feel guilty for choosing formula-feeding. Infant formulas are a time-tested, perfectly acceptable alternative to breastfeeding. Even though formula-fed babies do not receive infection-fighting antibodies from the breast milk, they still will have received a four- to six-month supply of these antibodies through the maternal bloodstream prior to delivery. Remember also that the majority of breastfeeding infants end up on a combination of breast- and formula-feedings before their first birthday.
Some common reasons for choosing formula-feeding include:
- There is an inadequate supply of maternal breast milk.
- The baby is sucking inefficiently.
- Parents are unable to quantify the amount of breast milk received by the baby. Some parents want to know exactly how much their baby is receiving at each feeding, and formula/bottle-feeding allows exact measurement.
- A significant reason for not breastfeeding is concern about transferring certain drugs the mother is taking due to a medical problem through the breast milk to the infant. Examples of medications that are considered unsafe for the baby include cimetidine (Tagamet), cyclophosphamide (Cytoxan), lithium (Lithobid), gold salts, methotrexate (Rheumatrex, Trexall), metronidazole (Flagyl), cyclosporine, and bromocriptine (Parlodel). Numerous other medications have not yet been adequately studied in the context of breastfeeding and the possible effects on the baby. Mothers may choose bottle-feeding rather than risk any potential effect on the baby.
- An increasing number of mothers must return to work shortly after their baby's delivery. Formula-feeding offers a practical alternative for mothers who may not be able to breastfeed due to work schedules. Formula-fed babies often need to eat less frequently than do breastfed babies because breast milk moves through the digestive system more quickly. Thus, breastfed babies may become hungry more frequently.
- A benefit of bottle-feeding is that the entire family can immediately become intimately involved in all aspects of the baby's care, including feedings. The mother can therefore get more rest, which can be critically important, especially if the pregnancy and/or delivery were especially difficult.
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