Breast-feeding Vs Formula-feeding – Is one better than the other?


A woman is given the ability to feed when her baby is born, but why is there still some misconceptions on breastfeeding? Is breastfeeding good or is feeding formula to your baby better for him/her? Let’s find out from Dr. Sharifah Aida Alhabshi, Consultant Pediatrician from Columbia Asia Hospital Petaling Jaya.

GetDoc: What are the benefits of breastmilk over formula milk?

Dr Aida: There are many benefits of breastmilk. As we all know, mothers are encouraged to exclusively breastfeed their babies from birth to six months and continue up to 2 years old to gain maximal benefit from the breastmilk.

Breastmilk provides adequate nutrition for a baby especially the first six months of their life ensuring good health and growth. It is easily digestible hence preventing the baby from being constipated or having any diarrhoea.

Breastmilk also provides natural antibodies to babies and protect them from illnesses such as ear infections or cold and also offers protection against eczema (atopic dermatitis) and reduces the risk of cow's milk protein allergy.

Apart from benefits of the breastmilk, we also need to consider the benefits we can gain from breastfeeding. Breastfeeding in itself gives added value to both mother and baby. It helps in establishing the bond between the mother and the baby. It stimulates continuous production of the milk. And reduces the risk contamination of the milk as we need not worry about sterilising bottles and water source to dilute the milk etc.

On the other hand, preparing infant formula relies on stringent steps from the amount of the milk powder to water ratio, temperature of the milk, sterilising the bottle etc.

So if you can breastfeed, it would be a better thing for your baby, there are more benefits attached to it when compared to infant formula.

GetDoc: Are there any benefits of formula feeding over breastfeeding?

Dr Aida: Although breastmilk is the best nutrition option for an infant, infant formula can come in handy especially when there is inadequate supply of breastmilk. It can be given as a 'top up' to the breastmilk and reducing the risk of dehydration to the baby.

For mothers who decided not to breastfeed or unable to, infant formula is the option they can have.

GetDoc: Can a breastfeeding mum top up with formula milk?

Dr Aida: It is the mother’s choice and willingness, ultimately. I'll go with the saying "Although breastfeeding is the best, a well fed baby is better". If the mother choose to exclusively breastfeed her baby but is having issue with supply, there is no problem to top up; do not allow your baby to go hungry. Top up can be given as infant formula or even from a donor's expressed breastmilk.

GetDoc: A formula-fed baby gains more weight than a breast-fed baby – is this true?

Dr Aida: No, not really. In the first 2-3 months of life, there are not much difference in the weight gain for both breast-fed nor formula fed babies. However, by  about six month old, formula-fed babies have a higher tendency to put on more weight and grow more rapidly while breast-fed babies tend to be leaner. This group of babies do catch up with the weight by 2 years of age and have lower risk of becoming obese.

GetDoc: Does formula milk cause constipation?

Dr Aida: Formula-fed babies have the tendency to have firmer and sometimes harder stools compared to breast-fed baby.

GetDoc: How can one tackle this?

Dr Aida: Most of the time is to ensure proper amount of water to powder milk ratio. Parents need to follow the instructions given on the cover of the formula. Sometimes, a baby reacts differently to different brand. Best is to consult their doctor in order to ascertain the cause of constipation.

GetDoc: Is it necessary to give the baby water when formula feeding?

Dr Aida: It is not necessary to give water feeds for babies less than 6 months of age. Babies below 6 months old are are purely on the milk diet. Most will feed average every 2 to 3 hourly. As long as the formula is prepared with the correct amount of water, there is no need to give any additional water to the baby separately.

GetDoc: Why is formula preferred over other milk such as cow’s milk for the infant?

Dr Aida: Infant formula has been studied and tailored to be safer and more suitable for infant consumption as compared to fresh cow's milk. When it comes to fresh milk, it has a higher protein content that makes it difficult to digest and may be taxing on the infant's immature kidneys. It is also lacking in certain micronutrients that is essential for growth. Unpasteurised fresh milk may impose health threat to the baby as well.

GetDoc: WHO recommends mothers breastfeed their children up to the age of 2 years. Does this apply to formula feeding as well? When should we stop formula for babies?

Dr Aida: So far, there is no specific recommendation regarding infant formula duration by WHO. Personally, I would recommend continuing infant formula among children who are picky eaters as an additional supplements while improving the child's diet intake. This is because infant formulas are fortified with minerals like iron, calcium and zinc that is important for their growth. Nonetheless parents should consider weaning them off their bottle before the age of 2 and while keeping to 2-3 glasses of milk a day.

GetDoc: There is a lot of awareness these days with regards to breastfeeding but when considering the mother, she may also go through depression having to feed the baby constantly and also deal with other chores in the house. What advice would you give in such a scenario?

Dr Aida: Breastfeeding is the best way to feed your baby. Although theoretically sounds easy, it needs practice and positive thinking. Once you get it right, it will be a second nature to you.

During the first few days, mothers are usually exhausted after delivery and they have this innate expectation to do everything right the first time. Here are some advice:

  1. Get yourself educated on breastfeeding and breastfeeding techniques. Attend breastfeeding workshop or classes before your baby is born.

  2. Talk to your partner on your plan to exclusively breastfeed your baby. His support is important during the adjustment period and unburdened you from the other chores.

  3. Learn coping mechanism and relaxation techniques. It can be tiring to take short naps and feeds baby every 2-3 hourly. Anxiety and stress may suppress milk production and make latching on difficult.

  4. Ask for help. Talk to your paediatrician or lactation consultant whenever you need to. You may attend postnatal breastfeeding workshop for hands-on learning experience.

  5. Feed on baby's demand. Do not skip baby's meal time, it may reduce milk production.

 GetDoc: As a doctor, what would you recommend for new mothers – breastfeeding or formula feeding?

Dr Aida: Breast is best! Yes definitely breast feeding is what I would recommend. It is doable, it is natural. It needs a lot of hard work but it is not impossible. But do remember, a well-fed baby is a healthy and happier baby.

To know more about breastfeeding or if you need any clarifications regarding formula feeding, head on to GetDoc to make an appointment with Dr Sharifah Aida Alhabshi, Consultant Pediatrician from Columbia Asia Hospital Petaling Jaya.

Hridya Anand

by Hridya Anand

A biochemist by education who could never put what she studied to good use, finally found GetDoc as a medium to do what she loved - bring information to people using a forum that is dedicated to all things medical. View all articles by Hridya Anand.


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