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Evidence based formula feeding vs breastfeeding


tinselfoil hat

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tinselfoil hat

I had a baby 3 days ago and breastfeeding has been hard. From the very first feed I had two grazed bleeding nipples so switched to pumping and giving expressed milk in a bottle on the first night to heal my nips.


My nipples are still so sore and don’t seem to be healing. Despite using the fancy hospital pump on the lowest setting they’re still grazed and bleeding and maybe even look a bit worse.


I want to formula feed. This hurts. I never enjoyed breastfeeding with DD1 and I love watching their precious faces while they bottle feed. But I want to do what is best for my daughter. I know fed is best, then breast. I am particularly concerned with all the immunity gained from breastfeeding and don’t want DD to miss out on that.


I’d like some evidence based information about breast vs bottle. Its probably my tired baby brain but can’t seem to find much that isn’t pushing an agenda. I have an appointment with a lactation consultant tomorrow but I know she’s going to be biased towards breastfeeding since that’s her job and passion. I just want to understand the benefits of sticking with this, as motivation to keep going or if they’re not that different to know that formula is still a very good choice.


Please help me EB. Does anyone have any resources or research they can recommend?


Thank you

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I can't offer any BF vs FF advice but if you haven't seen them get some hydrogel nipple patches. Rite aid and a few other brands do them. If I have any grazes or damage ai find they heal my nips overnight!

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VeritasVinumArte

I feel for you OP. This is going back over 15 years but I found it very hard to find unbiased information when I was in a similar position to you.


Goodluck with it all!

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Do what works for you. You don’t need evidence to justify your choice if you formula feed. Baby has already gained some immunity during the pregnancy and from the colostrum.


You could “cocoon” with baby until she’s old enough to start her vaccinations as a way to protect her. Basically you only let members of your immediate household hold her and you avoid going out around other people. You and the family form a protective immunised cocoon around her.


As a formula feeding mum I say go for it. You don’t need to suffer pain and bleeding in order to have a healthy and happy baby, and you don’t need to exhaust every possibility of breastfeeding to switch to formula feeding.

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I think the health benefits of breastfeeding vs formula (properly made up according to the manufacturers directions) can be difficult to prove.


A quick google search has bought up this study. The number of hospitalisations is presumably factual, however it doesn't state which country the study was conducted in and that is very important eg water quality may be lacking.


https://pubmed.ncbi.nlm.nih.gov/27070106/#:~:text=Results%3A%20The%20prevalence%20of%20children,respectively%2C%20p%20%3C%200.001).


No links but one benefit of breastfeeding that isn't cited very often, is that it is better for the environment - ie no fuel for transport, no metal packaging, no fuel used for boiling water for making the formula, no plastic bottles etc. Breastfeeding is also cheaper than formula feeding.


Having said that, I comped with one of mine and I didn't particularly care about money or the environmental impact of FF when my baby was screaming non stop and neither of us had slept in 24 hours.

Edited by Feebi
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Go with what is going to make you happy. Fed is best. Fed. Mum’s mental health plays a part in all of it too. And yes while BF might be better technically, formula is fine. Many many babies thrive on formula.


Honestly out of all the kids I know you would have no clue which one was BF or FF. (And I was told allergies would be better with BF. The kid BF until 15months? He my kid with allergies. I did mix feed as I just couldn’t make enough milk. Big kid was FF by 3 months fully. Little kid hates hated hates hates the bottle but had to be given formula to supplement.)

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Fed is best. If you do want to try breastfeeding for a bit longer, I used nipple shields with both of mine, and they significantly reduced injuries.

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Do you have any lasinhol...lanisol?? (Somebody help me i can never remember how to spell the damn stuff) anyway, whatever you decide to do, getting some of that on your nipples will help them heal. If you continue breastfeeding put it on after a feed. Worked wonders for me.

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Emily Oster’s books are based on evidence. I found this from her about breastfeeding: https://www.google.com.au/amp/s/amp.theguardian.com/lifeandstyle/2019/jun/20/is-breast-really-best-i-looked-at-all-the-data-to-find-out


Basically, in a first world country, things like the mother’s education are more likely to have an impact.


Also, the AMA has previously issued advice about the pressure to breastfeed being a potential contributor to PND, so the pressure is real.


Good luck with your choice OP. Sending you hugs.

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Chicken Pie

Do what works for you. You don’t need evidence to justify your choice if you formula feed. Baby has already gained some immunity during the pregnancy and from the colostrum.


You could “cocoon” with baby until she’s old enough to start her vaccinations as a way to protect her. Basically you only let members of your immediate household hold her and you avoid going out around other people. You and the family form a protective immunised cocoon around her.


As a formula feeding mum I say go for it. You don’t need to suffer pain and bleeding in order to have a healthy and happy baby, and you don’t need to exhaust every possibility of breastfeeding to switch to formula feeding.

This

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Kiwi Bicycle

See if you can FF and EBM as an option? Benefits of both, might give your nipples time to heal, don't totally miss out on any immunity aspects of BF. Mixed feeding is totally an option also. Doesn't have to be one or the other ( unless bub decides to have a preference of course).

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As an avid breast feeding mother and educator I still strongly believe that 'FED IS BEST' although I have to say that the evidence that breast milk for most babies is the better feed is pretty strong but that by no means that formula feeding is bad or wrong and it is definitely the better choice for many mums and babies.


Many hurdles that you are experiencing you can get over but if you don't want to 'get over them' because you really do not like BF then I say just reach for the bottle, tell anyone trying to coax you into not giving up your choice firmly and your baby will not come to any harm as a result....in fact it can improve your bonding if you actually start enjoying feeding instead of resenting it.

Good luck OP, I know there are some fierce opinions out there which can be quite daunting.

Edited by STBG +2
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Oh OP that sounds really tough. While breastfeeding is will have the edge on formula feeding on most outcome measures, I think it’s important to also look at it from a holistic point of view. There is strong evidence around the impact of maternal mental health and well-being on child development, so if breastfeeding is likely to cause longer term stress and unhappiness (vs something that will resolve very quickly) then I’d also take that into account when making the decision!

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I formula fee, pumped and bottle fed and used nipple shields. That was fine for me, work out what is best for YOU and your baby. I’m a big advocate of fed is best.

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I can’t answer re evidence sorry, but I second what pp have said about nipple shields and also the hydrogel discs. I was in a similar situation with bleeding and pain every feed (I think it was an undiagnosed tongue tie) and they enabled me to continue BF DD.

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Just want to put another vote in for the hydrogel discs and nipple shields to protect and help you heal in these early days. My lactation consultant also prescribed a cream that helped a lot. With my first, breastfeeding was very difficult, with pain and bleeding, until 8 weeks. Then we turned a corner and it was fine after that. I think sometimes they need time for their little mouths to grow and be able to latch properly.


Please don't feel pushed into breastfeeding though. Your health and wellbeing matters too, so much, and your baby will still thrive on formula.


Good luck.

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Hi there. Congrats on the newborn. I'm sorry the first few days have been hard. I will second Lansinoh. I used it after every single feed for 8 weeks. Every single feed.


I'm terms of a more balanced view on the evidence, I found this article interesting.


https://www.google.com/amp/s/amp.theguardian.com/lifeandstyle/2019/jun/20/is-breast-really-best-i-looked-at-all-the-data-to-find-out


This excerpt has the main benefits the author found with stronger evidence:


Breastfeeding seems to improve digestion in the first year, lowers rashes for infants and is especially important for preterm babies. It also seems likely that it has some impact on reducing ear infections in young children and lowers the risk of breast cancer for the mother.


Also I found some research that breastfeeding a cumulative 24 months can help reduce early menopause for the mother. In my case (my mum went through menopause at 43-44 and I am already in premature ovarian decline in my 30s) this is important. But that's because my risk factor is high for this


Don't forget combo feeding is also an option if you aren't 100% sure yet what to do

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Just wanted to add that I was bottlefed as a child and breastfed. My younger sister was breastfed and us bottle feeding her baby.


You do what you have to do.

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Blueskies12

I don't have any research to share. I don't doubt the benefits of breast feeding.

I worked out that with my two children my priority became 'connection'- what worked best for us in aiding our ability to connect. I hated breast feeding too. I hated the pressure.

If you want to keep breast feeding, take it one feed at a time. Speak to the lactation consultant, but also follow your own instincts and heart. It's ok to do whichever way you want.

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Guest Chamomile

I can’t answer re evidence sorry, but I second what pp have said about nipple shields and also the hydrogel discs. I was in a similar situation with bleeding and pain every feed (I think it was an undiagnosed tongue tie) and they enabled me to continue BF DD.

 

Ask if the lactation consultant can check for tongue tie. This caused me huge pain at every feed until it was resolved.

It might give you a bit more info.

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I believe in doing what feels right for you. Resentment from the pain can cause bigger problems then using formula. I FF both of mine and made the conscious choice too for them and myself. In saying that there is the cocoon option which I think is a great idea, especially with covid around.


Do not be pressured or pushed into something you do not feel comfortable with.

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IamtheMumma

If you want to formula feed, send your partner out to get formula and bottles. Your body, your choice.


If you want bub to continue to get immunity from you, you can hand express a few mls each day (however often/little as you like) and feed it to bub.

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Do you have any lasinhol...lanisol?? (Somebody help me i can never remember how to spell the damn stuff) anyway, whatever you decide to do, getting some of that on your nipples will help them heal. If you continue breastfeeding put it on after a feed. Worked wonders for me.

 

Lansinoh


It's like magic on cracked nipples. But my hospital doesn't promote it for some bizarre reason. And nipple shields worn correctly were helpful for me.


Congratulations on your newborn. I hope the lactation consultant can help you achieve what you decide you want to.

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tinselfoil hat

Thank you everyone for the thoughtful and kind responses. I haven’t had a chance to read any of the resources nor reply properly because I’m now battling blocked ducts on both breasts :( mastitis would really seal the deal for me! I’ll try to read all I can before my LC appointment tomorrow. I am starting to realise pumping is untenable for me. Maybe nipple shields will be ok. Otherwise formula will be great.


Thanks again everyone. It means a lot.

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