Historically, formula feeding and breastfeeding have each been popular during different time periods.1 Often, popularity was driven by commercial efforts to convince new moms of the optimal way to feed their babies. In the 1940s and 1950s, synthetic formula was new to the market. Advertising campaigns for both new moms and physicians put a heavy emphasis on formula feeding. And guess what? Formula feeding became the popular thing to do, and global breastfeeding rates declined.
“Breast is Best” is a mantra introduced to the global public by the World Health Organization (WHO) in the 1990s to convince more women to breastfeed their babies instead of formula feeding.2 The WHO recommends that infants breastfeed exclusively for the first six months of life.3 “Breast is Best” might offer a catchy alliteration, and the intentions behind the slogan are good, but it sometimes does more harm to expectant and new mothers than good.
“Breast is Best” Can Cause More Harm Than Good
Anxiety & Depression
The pressure to breastfeed is a significant driver of anxiety and depression that I have seen amongst my village of moms. Moms put themselves under immense pressure to make it work, myself included. We want what’s best for our children, and when we feel like we are failing at giving them what is said to be “the best,” it can feel like we are failing at our first encounter with motherhood. I spent four months in excruciating pain before a proper diagnosis of oral ties with my first son. I dreaded feeding him at every opportunity. Because of my pain, I could not bond with him in his early infant days.
Many women struggle with breastfeeding. They desperately want to give their babies breastmilk as it has been promoted as “the right thing to do.” And we do not doubt its incredible benefits. But mothers may struggle to get their baby to latch and then pump and bottle feed after an unsuccessful nursing session. That can take a ton of time, including washing pump parts and bottles just to turn around to start the process all over again. The obsession with providing breastmilk can fuel their anxiety, guilt, and depression. Having these feelings can even hinder their experience of bonding with their new baby. If this is the case, is breast actually best when it damages the mental health of the mom?
I happened to deliver both of my children at a baby-friendly hospital. These hospitals are defined as those that “give mothers the information, confidence, and skills necessary to successfully initiate and continue breastfeeding their babies and give special recognition to hospitals that have done so. In cases where patients have a medical indication or have made an informed decision to use formula, the safe preparation and feeding of formula is provided to mothers.”
Notice the emphasis is on breastfeeding. Formula is an acceptable alternative but only if “medically indicated” or if the mother asks for it. I went into my delivery with my son, knowing that I wanted to breastfeed. But if that was not in the cards for us, I was perfectly fine going to formula.
The emphasis on exclusive breastfeeding without expert lactation care at my hospital presented many challenges. My newborn had challenges waking to feed. Due to his undiagnosed oral ties, he did not transfer colostrum effectively. On his second morning of life, the nurses on the shift laughed at me and said, “You’re in for it later with cluster feeding.” I was a brand new mom, and I had no idea what cluster feeding was. And the excruciating pain that I was in wasn’t helping.
No one called in a lactation consultant to help me. My baby was crying, I was crying, and if it weren’t for the most wonderful postpartum nurse in charge of our care that night, I would not have known to give him formula. My poor baby was just starving! In this situation specifically, the baby-friendly hospital initiative, which supports exclusive breastfeeding as a primary goal, did not support me and my newborn. Thankfully, with the help of formula supplementation and an expert IBCLC (not affiliated with my hospital), I was able to breastfeed my son until he was a toddler.
Fed is Best. Period.
If you struggle with breastfeeding and need to supplement with formula, or if you want to go straight to formula for any reason, or no reason at all, there is nothing wrong with that. Fed is best for your baby and you. Breastfeeding doesn’t have to be the default method for feeding your baby! There are many advantages to formula-feeding as well. And, of course, breastfeeding is also a wonderful process if it works well for you and your baby.
There has been so much pressure put on moms to breastfeed, originating with that campaign from the WHO. And I believe it has caused some damaging results to maternal mental health. Don’t forget that no one will ever ask your son or daughter when they go to kindergarten or graduate from high school whether or not they were formula or breastfed. I have seen firsthand in myself and others the damage that the “Breast is Best” campaign has done. I firmly believe that any way you choose to feed your baby is the best way to feed your baby!