When deciding how to feed your baby, knowing what’s in breast milk or formula, the difference in cost, and the impact they have on health and sleep, can help you make an informed choice.
Let’s start by comparing breast milk to formula. There are ways in which formula is similar to breast milk: they both provide energy, hydration and nutrients, so your baby will grow whichever milk he is given.
But despite advances in how baby milk powder is formulated and manufactured, it doesn’t come close to matching the health benefits of your breast milk. Human milk has evolved over millions of years to be the perfect food for human babies. It’s much more complex than other mammals’ milk, as it builds our more complex brains and unique digestive and immune systems.
In contrast, cow’s milk, from which most formula is made, meets the specific needs of calves. It’s not safe for human babies to drink, so has to be processed intensively when made into formula for infants.
“Did you know the salt [sodium] content in cow’s milk is pretty much at toxic levels for babies?” says Professor Peter Hartmann, an internationally renowned specialist in breastfeeding and milk production, based at the University of Western Australia.
“In fact, in the early 1980s, cow’s milk was known to be toxic to laboratory animals such as rabbits or rats. These days, if any compound is toxic to a laboratory animal it’s not pursued in drug studies. So, by today’s standards, they wouldn’t have been allowed to make formula! Meanwhile mother’s milk has very low concentrations of sodium.”1
What’s in breast milk?
From colostrum that coats and seals your newborn’s stomach lining, to mature milk that helps your baby grow strong, each drop of your breast milk contains thousands of beneficial components, including:
- antibodies to protect against illnesses2
- hormones that promote bonding and regulate appetite3
- stem cells that may support organ development and repair4
- white blood cells that fight infection5
- beneficial bacteria that protect your baby’s digestive system6
- prebiotics called oligosaccharides that support a healthy gut7
- long-chain fatty acids to help develop your baby’s brain, nervous system and eyes8,9
- enzymes to support his digestive and immune systems2
- nucleotides and hormones that help develop healthy sleep-wake patterns10
One of the benefits of breast milk over formula is that it’s a living fluid. It adapts to your baby’s changing circumstances. So if your baby becomes ill, your body makes extra white blood cells and antibodies that travel into your milk and help fight infection.5
“The protective properties of mother’s milk are fundamental and unique to the evolution of lactation,” explains Professor Hartmann. “But we don’t yet have the data to understand the full extent of all the protective elements and what they do, as breast milk is so complex.
“Take oligosaccharides – there are more than 200 of them.11 They’re the third most abundant component of breast milk – yet we have little idea about what they do! They possibly have very complex structures because it gives them affinity for particular proteins, and when the oligosaccharide and the protein come together they have biological effects.
“Really, if you don’t know about it you shouldn’t muck around with it! Breast milk’s the normal thing.” Read more about breast milk in What’s in your breast milk?
What’s in formula milk?
Ingredients vary by brand and country, but typical baby formula milk is made of processed skimmed cow’s milk with added emulsifiers and stabilisers to help the oils and water mix when you make up the feed. It may also contain:
- lactose (a natural sugar found in milk) and/or other sugars such as corn syrup, fructose or maltodextrin
- plant-based oils, such as palm, rapeseed, coconut, sunflower and soybean oil
- fatty acids, usually derived from fish oil
- vitamins and minerals from plant and animal sources
- a couple of enzymes and amino acids
- probiotics (in some formulas)
NB Different types of baby formula, such as goat’s milk, hypoallergenic and soya formulas, may have a different mix of ingredients.
“Scientists have shown there are more than 1,000 proteins in breast milk12 – and the best formula companies are looking at increasing just one or other of them,” explains Professor Hartmann. “What’s more, people have only just been able to synthesise some of the many oligosaccharides found in breast milk. So copying a couple of proteins and oligosaccharides is not going to get you breast milk!
“As far as cow’s milk is concerned, excess protein has to be added to bring the number of amino acids up to the level that baby needs,” he continues. “But that excess protein will be metabolised and broken down into components that can be converted into fat.
“That’s one of the problems with formula – babies do too well on it. Parents often think they’re doing fine because they’re growing like mad – but actually that may not be good for the long-term health of formula-fed infants.13 So formula companies are now trying to bring down protein levels in their milk to prevent babies from getting too fat.”
Breastfeeding vs formula: Health benefits
Look at the bigger picture when deciding whether to give your baby breast milk or formula. Breast milk isn’t just a food. It has an important protective function, reduces your baby’s likelihood of diarrhoea, gastroenteritis, ear infections, colds and flu, and thrush14–16 and halves his risk of sudden infant death syndrome (SIDS).17
You may have heard that breastfeeding your baby improves his chances of doing well at school,18 but did you know it’s been linked to better behaviour,19 eyesight20 and teeth alignment21 too? Your breastfed baby also has less risk of becoming obese, and his lifelong chances of getting type 1 and 2 diabetes,22,23 and certain cancers24,25 will be lower. Read more about breastfeeding benefits for babies.
Breastfeeding also burns up to 500 calories a day,26 which may help you lose weight more quickly after the birth. And the longer you breastfeed, the lower your own risk of developing breast,27 uterine28 and ovarian cancers,29 heart disease,30 and type 2 diabetes.22 Read more about breastfeeding benefits for mums.
Breastfeeding vs formula: Practical advantages
Breastfeeding is usually easier on your purse. One estimate is that families who breastfeed exclusively save USD 1,200 to USD 1,500 during their baby’s first year.31
And while breastfeeding may not stop your baby waking at night, it will save time during feeds and help you both get back to sleep faster, so you can expect an extra 40 to 45 minutes’ rest each night.32
In fact, breastfeeding saves you more time in general, as you don’t need to do as much washing up, sanitising, boiling water and prepping bottles of formula – your milk is always ready at the right temperature.
In addition, the foods you eat flavour your milk so your baby experiences new tastes at every feed, and may enjoy a wider variety of foods when you start introducing solids.33 Breastfeeding could even encourage healthier eating, as research shows breastfed babies of mums who have fruit and vegetables regularly enjoy eating these foods more than babies of mums who don’t.34 Formula, meanwhile, always tastes the same, and even using different brands can’t recreate the complex flavours of your milk.
Finally, have you considered the environmental benefits of breast milk? With no intensive farming, factory emissions, transportation or packaging involved, breastfeeding is better for the planet as well as for you and your baby.
For more information on what’s in breast milk, read our free ebook The Amazing Science of Mother’s Milk now.
- Cribb VL et al. Contribution of inappropriate complementary foods to the salt intake of 8-month-old infants. Eur J Clin Nutr. 2012;66(1):104.
- Lönnerdal B. Nutritional and physiologic significance of human milk proteins. Am J Clin Nutr. 2003;77(6):1537S-1543S.
- Savino F et al. Breast milk hormones and their protective effect on obesity. Int J Pediatr Endocrinol. 2009;2009:327505.
- Hassiotou F, Hartmann PE. At the Dawn of a New Discovery: The Potential of Breast Milk Stem Cells. Adv Nutr. 2014;5(6):770-778.
- Hassiotou F et al. Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clin Transl Immunology. 2013;2(4):e3.
- Pannaraj PS et al. Association Between Breast Milk Bacterial Communities and Establishment and Development of the Infant Gut Microbiome. JAMA Pediatr. 2017;171(7):647-654.
- Bode L. Human milk oligosaccharides: every baby needs a sugar mama. Glycobiology. 2012;22(9):1147-1162.
- Deoni SC et al. Breastfeeding and early white matter development: A cross-sectional study. Neuroimage. 2013;82:77-86.
- Birch E et al. Breast-feeding and optimal visual development. J Pediatr Ophthalmol Strabismus. 1993;30(1):33-38.
- Sánchez CL et al. The possible role of human milk nucleotides as sleep inducers. Nutr Neurosci. 2009;12(1):2-8.
- Moukarzel S, Bode L. Human Milk Oligosaccharides and the Preterm Infant: A Journey in Sickness and in Health. Clin Perinatol. 2017;44(1):193-207.
- Beck KL et al. Comparative Proteomics of Human and Macaque Milk Reveals Species-Specific Nutrition during Postnatal Development. J Proteome Res. 2015;14(5):2143-2157.
- Michaelsen KF, Greer FR. Protein needs early in life and long-term health. Am J Clin Nutr. 2014;99(3):718S-722S.
- Howie PW et al. Positive effect of breastfeeding against infection. BMJ.1990;300(6716):11-16.
- Duijts L et al. Prolonged and exclusive breastfeeding reduces the risk of infectious diseases in infancy. Pediatrics, 2010;126(1):e18-25.
- Ladomenou F et al. Protective effect of exclusive breastfeeding against infections during infancy: a prospective study. Arch Dis Child. 2010;95(12):1004-1008.
- Vennemann MM et al. Does breastfeeding reduce the risk of sudden infant death syndrome?. Pediatrics. 2009;123(3):e406-e410.
- Straub N et al. Economic impact of breast-feeding-associated improvements of childhood cognitive development, based on data from the ALSPAC. Br J Nutr. 2016;1-6.
- Heikkilä K et al. Breast feeding and child behaviour in the Millennium Cohort Study. Arch Dis Child. 2011;96(7):635-642.
- Singhal A et al. Infant nutrition and stereoacuity at age 4–6 y. Am J Clin Nutr, 2007;85(1):152-159.
- Peres KG et al. Effect of breastfeeding on malocclusions: a systematic review and meta‐analysis. Acta Paediatr. 2015;104(467):54-61.
- Horta B et al. Long‐term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta‐analysis. Acta Paediatr. 2015;104(467):30-37.
- Lund-Blix NA. Infant feeding in relation to islet autoimmunity and type 1 diabetes in genetically susceptible children: the MIDIA Study. Diabetes Care. 2015;38(2):257-263.
- Amitay EL, Keinan-Boker L. Breastfeeding and Childhood Leukemia Incidence: A Meta-analysis and Systematic Review. JAMA Pediatr. 2015;169(6):e151025
- Bener A et al. Does prolonged breastfeeding reduce the risk for childhood leukemia and lymphomas? Minerva Pediatr. 2008;60(2):155-161.
- Dewey KG. Energy and protein requirements during lactation. Annu Rev Nutr. 1997;17:19-36.
- Victoria CG et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490.
- Jordan SJ et al. Breastfeeding and Endometrial Cancer Risk: An Analysis From the Epidemiology of Endometrial Cancer Consortium. Obstet Gynecol. 2017;129(6):1059-1067.
- Li DP et al. Breastfeeding and ovarian cancer risk: a systematic review and meta-analysis of 40 epidemiological studies. Asian Pac J Cancer Prev. 2014;15(12):4829-4837.
- Peters SAE et al. Breastfeeding and the Risk of Maternal Cardiovascular Disease: A Prospective Study of 300 000 Chinese Women. J Am Heart Assoc. 2017;6(6).
- U.S. Department of Health & Human Services [Internet]. Surgeon General Breastfeeding factsheet; 2011 Jan 20 [cited 2018 Apr 04].
- Doan T et al. Breast-feeding increases sleep duration of new parents. J Perinat Neonatal Nurs. 2007;21(3):200-206.
- Menella JA et al. Prenatal and postnatal flavor learning by human infants. Pediatrics. 2001;107(6):E88.
- Forestell CA, Mennella JA. Early determinants of fruit and vegetable acceptance. Pediatrics. 2007;120(6):1247-1254.