Why Is Breastmilk Favorable When Compared to Formula?

Abstract

The historical development of feeding infants includes wet nursing, feeding bottles and the use of formulas. Wet nursing was the safest and most common alternative to the breast milk of the natural mother before the invention of bottles and formula. The negative view of wet nursing by society, combined with improvements in the feeding bottle, the availability of animal milk and progress in the development of formulas, gradually led to the replacement of artificial feeding for wet nursing. In developed countries, the health outcomes differ substantially for mothers and infants who formulate feed compared to those who breastfeed. For infants, the incidence of infectious morbidity and the increased risk of childhood obesity, type 1 and type 2 diabetes, leukemia and sudden infant death syndrome are not associated with breastfeeding.

Keywords:  Formula, Breastfeed, Breastmilk, Lactation

Why Is Breastmilk Favorable When Compared to Formula? 

There are many well- known health benefits to breast feeding. It protects against many diseases and reduces mother and child health risks. It is protective against childhood and enhances cognitive development in newborn children. Breastfeeding can help reduce the risk of breast and ovarian cancers, diabetes and other mother diseases.The historical development of feeding practices for a full-time child immediately after birth includes wet nursing, feeding bottles and the use of formulas.  The key issues relating to child health and the development of common health problems among breastfed children versus formula-fed infants will be discussed in this paper. The difficulty for caregivers in poverty to provide formula to their infants will also be touched upon.

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Composition of Breastmilk

The use of a wet nurse, ” a woman who feeds a child of another,” was a common practice before the feeding bottle and formula were introduced. Wet nursing started in 2000 BC and continued into the 20th century. During this time, wet nursing developed from an alternative of necessity to a choice alternative. It developed into a “well-organized profession with contracts and laws to regulate its practice” (Stevens, Partick, Pickler, 2009). Despite objections in the Middle Ages and the Renaissance, wet nursing continued until in the 19th century the feeding bottle was introduced. With a viable alternative feeding method.

In Israel, children were considered a blessing as early as 2000 BC, and breastfeeding was considered a religious obligation. However, breastfeeding was not always possible because of the breastfeeding failure of the mother or the mother died while in childbirth. Around 950 BC in Greece, women with a higher social status often demanded wet nursing. Wet nurses eventually acquired a highly accountable position and had authority over slaves. The Bible also notes a number of examples of wet nurses, perhaps the most famous being Pharaoh’s hired woman Moses ‘ daughter, whom she found in the bulrushes. At the height of the Roman Empire, written contracts were formed between 300 BC and 400 AD with wet nurses to feed abandoned infants. The infants were usually thrown into rubbish piles by unwanted females. The wealthy bought the baby as a cheap slave for future use and the wet nurses, who themselves were slaves, fed the baby up to three years. Contracts provided a detailed account of the wet nursing service.

Medical authors such as Soranus of Ephesus, Galen of Pergamus and Oreibasius listed the qualifications for a wet nurse from approximately 100 AD to 400 AD. Some of these qualifications lead to test to be taken to find a suitable wet nurse. The fingernail test was used to evaluate the quality and consistency of breast milk was also described. When a drop of breast milk was placed on a fingernail and the finger moved, the milk was not supposed to be so watery that it flowed across the nail surface. The milk was not thick enough to stick to the nail when the fingernail was turned downwards. For the next 1500 years, the Soranus criterion has been used to determine the quality of breast milk. Galen of Pergamus taught the wet nurse how to relax the babies by swaddling, moving, rocking and singing. Roman doctor Oribasius wrote that the wet nurse should do some physical work in addition to her nursing duties. The physical work was to incorporate shoulder and chest movements in order to improve milk flow. Oribasius recommended grinding, weaving and walking. He also advised that a wet nurse should be a healthy woman aged twenty-five to thirty-five who had recently given birth to a male child.

During the Middle Ages, society regarded childhood as a special time of fragility and vulnerability. Breastmilk was believed to possess magical qualities, and that breastmilk could transmit both physical and psychological characteristics of the wet nurse. The belief led to protests against women being hired for the position of a wet nurse and, once more, a mother who nursed her own child was valued as a holy duty. During the Renaissance, wet nursing was the best alternative for children whose mothers were unable to supply food. In the Middle Ages, however, society during the Renaissance showed widespread disapproval of a wet nurse and a preference for breastfeeding mothers feeding their own children. In the mid-16th century, there were increasing concerns about wet nursing, along with statements expressing the importance of natural maternal breastfeeding.  Italian author Omnibonus Ferrarious, stressed that the mother was a better choice than a wet nurse for infant feeding except when the mother was ill or unable to breastfeed. Ferrarious worried that infants would love a wet nurse because she looked after them more than her own mother. In the early 17th century the French obstetrician Jacques Guillemeau supported the belief that the mother should give her milk to her child. In his work, Children’s Nursinghe stated four main objections to the idea of a wet nurse: the child may be switched to another place, the affection felt between the child and the mother decreases, the child may inherit a bad condition and,  the nurse may transmit to the child an imperfection of her own body which may then be transmitted to the parents. If the circumstances required a wet nurse, Guillemeau recommended a happy, healthy, well- behaved, observant, sober woman who was willing to feed. Despite the recommendations, during the Renaissance period wet nursing remained a popular, well- paid and highly organized profession. Therefore, it became a top choice for many poor women. A common practice among young women, unmarried or married was to have a child and then get rid of said child before seeking for a position of a wet nurse. In France, therefore, wet nurses were registered in a municipal employment office and laws were developed and enforced to regulate their employment. The law required a wet nurse to undergo a medical examination and prohibited her from breastfeeding another child until her own child was nine months old. The social class tended to dictate breast feeding practices during the same time period. It was unusual for noble women to feed because the practice was considered unfashionable and also the women were worried that their figures would be ruined. Breastfeeding also prevented many women from wearing the socially acceptable clothes of the time and it interfered with social activities like playing cards and being present during theater performances. The wives of merchants, lawyers and doctors also did not breastfeed because it was cheaper to hire a wet nurse than to hire a woman to manage the business of her husband or take care of the household in their stead. From the end of the 18th century till the 19th century, the practice of wet nursing moved from wealthy families to working families with lower incomes. When the industrial revolution started, whole families moved from rural areas to more major cities. The increased cost of living and poor wages forced many women to look for jobs and make a financial contribution to their families, making it very difficult for many mothers to feed and care for their children. According to law, poor wet nurses had to obtain a license from local authorities and report the death of any child receiving care given from them. The laws were ignored, and the high infant mortality rate of all infants had changed a little. Although at the end of the 18th century wet nursing continued to exist, the natural mother was still preferred to breastfeed and raise children. William Buchan, author of Domestic Medicine, showed open mistrust of wet nurses for their use of natural remedies. Opiates, drugs derived from opium which is usually used for pain relief, including anesthesia, being one of the home medicines which was referred to as “Quietness” by the wet nurses. Buchan wrote that the use of opiates as a child’s sleep aid was a critical error for wet nurses. Artificial feeding was a viable substitute for wet nursing in the 19th century. The progress in the feeding bottle and the availability of animal milk began to gradually but steadily affect the use of wet nurses the once highly organized wet- nursing profession was obsolete in 1900.

The Bottle1

Although wet nursing was the alternative method of feeding, evidence suggests that ancient times Untreated feeding bottles and cleanliness issues were written during the Roman Age, the Middle Ages and the Renaissance. Only during the Industrial Revolution did a refined, hygienic feeding bottle become available. Clay feeding vessels dating back to 2000 BC were found in newborn infant tombs. The vessels are oblong with a shape of a nipple. The objects were initially supposed to be containers for filling oil lamps. However, chemical analysis revealed casein from animal milk in the residue of the containers, suggesting that animal milk was used as an alternative to breast milk in ancient times. Several different devices have been used to feed infants with animal milk. Some of the devices found were made of wood, pottery and horns of cows. The most common source of feeding bottle during the Middle Ages was a thickened cow’s horn. By the 1700s, many infant feeding equipment was made from pe. Among these devices was the pewter bubby- pot. Invented in 1770 by Hugh Smith, a doctor at London’s Middlesex Hospital, the bubby pot was like a small coffee pot except the neck mostly from the bottom of the pot. Another feeding equipment used in Europe between the 16th and 18th centuries was a paper boat. The device was used to feed pap and panada to infants. Pap consisted of water or milk-soaked bread, and panada consisted of broth- cooked cereals. Broth is a savory liquid made of water in which bones, meat, fish, or vegetables have been simmered. Both substances were used as a supplement to animal milk, when the baby did not thrive. Alas, it was difficult to clean the bottles, paper boats and teats during the 16th to 18th centuries. The build- up of bacteria subsequently made the feeding bottles harmful to the health of the infant. In the early 19th century, the use of dirty feeding equipment combined with the lack of proper milk storage and sterilization resulted in the death of one third of all infants fed artificially in their first year of life. In the middle of the 19th century, the development of the feeding bottle and the nipple took great steps. Glass bottles have been used and the modern bottle evolution has already begun. The first feeding bottles, produced in France in 1851, have been elaborated. During this time in France, however, it was still more popular to feed the infant with a spoon or to have the child nibble directly from the nipple of an animal. In 1896 in England, boat- shaped bottles were developed, became popular and sold well in the 1950s. Originally made of leather, nipples introduced in the 19th century were preferred to the use of cork- made devices. In 1845 the first Indian rubber nipple was introduced. Despite the repulsive smell and taste of the first rubber nipples, they were refined and adapted. Artificial feeding became a popular choice with the invention of the modern bottle and nipple, the availability of animal milk and the change in the acceptance of wet nursing by society. In direct consequence, medicine began to focus on the nutrition of infants from an alternative milk source.

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Formula.

The use of animal milk in infant feeding was recorded in 2000 BC. Alternative milk sources have since developed to include today’s synthetic formulas. The use of artificial means grew rapidly and was influenced by publicity campaigns. This had a severe negative effect on breastfeeding trends, despite research that revealed many differences between breastfeeding and infants fed artificially. Even though artificial or formula- fed infants are much safer today than they have been in decades, breastmilk is still the best source of infant nutrition. Animal milk was the most common source of artificial feeding throughout the ages and up until the end of the 19th century. The first chemical analyzes of human milk and animal milk started to appear in the 18th century. Jean Charles Des-Essartz, in 1760, published his Treatise on Children’s Physical Upbringing, which discussed and compared the structure of human milk with that of cow, sheep, ass, mare and goat. Des-Essartz justified the best source of child nutrition is human milk. Many scientists have tried to formulate non-human milk to resemble human milk. In 1865, chemist Justus von Liebig created, invented and advertised a child’s food, first in a liquid form and then in a powdered form to conserve it better. Liebig ‘s formula “consisting of cow’s milk, wheat and malt flour and bicarbonate potassium was considered the perfect baby food” ((History Infant Feeding) The preservation of food was another significant scientific progression of the 19th century. Nicholas Appert developed a method for the sterilization of food in sealed containers in 1810. The invention of evaporated milk, originally developed by William Newton in 1835, followed its development. In 1853, Texan Gale Borden added sugar to the milk that had evaporated, canned it and sold it as Eagle Brand Condensed Milk, which became a popular infant food. John B. Myerling, in 1885, developed an unsweetened condensed milk, which was referred to as “evaporated milk.” After the marketing of Liebig ‘s infant food and the invention of evaporated milk, many other commercial products and formulas were quickly introduced. By 1883, there were 27 “patented” infant food brands. These products were produced in powdered form. Food was fattening, but valuable nutrients such as proteins, vitamins and minerals were lacking. Over time, nutrients were added separately. The use of artificial formula was linked to many infant deaths during the summer due to the spoiling of milk because it was left in bottles. Between 1890 and 1910, emphasis was placed on cleanliness and greatly improved milk supply quality. By 1912, easy-to- clean rubber nipples were available, and many homes were able to store milk safely in an ice box. Scientists also began to develop milk- free formulas for infants allergic to cow’s milk in the 1920s. The first milk- free formula was based on soy flour and was made public in 1929. The synthesis of soy lacked essential nutrients, especially vitamins. The problem was eventually solved with the reinforcement of vitamins. As formulas developed and research supported their effectiveness, manufacturers started advertising doctors directly. By 1929, the American Medical Association (AMA) formed the Food Committee to approve the efficiency and effectiveness of the structure of the formula, forcing many children’s food companies to seek AMA approval or the organization’s “Seal of Acceptance.” In the 1940s and 1950s, doctors and consumers considered the use of formula to be a well- known, popular and safe breast milk substitute. As a result, breastfeeding had been declining steadily until the 1970s. In developing countries, aggressive marketing of formulas has contributed to a global breast-feeding decline. The decline produced negative advertising for formula manufacturers and a movement began to promote breastfeeding in the 1970s. During the next 30 years, their efforts have led not only to a steady increase in the percentage of infants that were breastfed in the United States, but also the length of breastfeeding. The breastfeeding rate in the twentieth century was 90 percent, and in the 21st century it decreased to about 42 percent. Research shows the growing trends in the development of atopy, diabetes mellitus and obesity in children. The negative impacts of the formula on the health of children, which supports Des-Essartz ‘s claim that breast milk is superior for infant feeding, have led to a breastfeeding versus formula feeding period. Breastfeeding has remained the clinically preferred method of infant feeding throughout the history of wet nursing. Despite this preference, scientists have been trying to create a synthetic formula that is equal to human milk since 1865. While nutrients in synthesized formulas appear almost identical to nutrients in breast milk, makers recognize that breast milk is the ideal form of nutrition for infants on formula labels.

Breastmilk Versus Formula             Public health campaigns and medical literature have traditionally described the ” benefits of breastfeeding” against a reference group of formula-fed infants.  Several authors have noted that the subtle difference affects the perception of child feeding in public. If breast is the best way then the formula is just decent or normal implicitly. This difference was underlined by national survey data showing that in 2003, while 74.3% of US residents disagreed with the saying: ” Child formula is as good as breast milk,” only 24.4% agreed with the statement:” Feeding a baby formula in place of of breast milk increases the chance that the baby gets sick (Stuebe 2009). The baby will get sick due to the lack of necessary nutrients that specific child needs. In 2002, the Ad Council organized the National Breastfeeding Awareness Campaign for women of reproductive age who would not normally breastfeed. It was found out  that women who were advised about the ” benefits of breastfeeding” saw lactation as a ” bonus,” like a multivitamin, which was helpful but not essential for children’s health. Lactation is another term for breastmilk. Women responded differently when the same data was presented as the ” risk of not breastfeeding” and were much more likely to say that they would breastfeed their children (Stuebe 2009). Research shows that breastfeeding is a viable treatment for both mothers and infants for disease. Current guidelines recommend exclusive breastfeeding up to the first 2 years of life for a minimum of 6 months, even though breastfeeding in the United States is often short of these recommendations.  Data indicate that variations in hospital practices account for breastfeeding differences. Advancements in the quality of the prenatal and perinatal support could have a significant impact on the health of mothers and children. Specific and innate immune factors in human milk offer special protection against pathogens in the environment of the mother. Furthermore, milk immune factors protect against infections like H influenzae, S pneumoniae, V cholerae, E coli and rotavirus. Non- breastfeeding is associated with both mothers and children’s health risks. Epidemiological data suggest that women who do not breastfeed are more likely to develop breast and ovarian cancer, obesity, type 2 diabetes, metabolism and cardiovascular disease. The patient’s perspective of clinical opinion is linked directly to breastfeeding. A Massachusetts study found that only eight percent of doctors thought their recommendation on breastfeeding methods was important, but more than a third of mothers reported that their provider’s advice on breastfeeding practices was important. The Baby Friendly Hospital Initiative has been extensively implemented worldwide, reaching over 15,000 maternity hospitals in 134 countries, although routine practices in many maternity hospitals do not support breastfeeding. Breastfeeding counselors can help to eliminate outdated practices and offer evidence- based support for breastfeeding. The Baby Friendly Hospital Imitative, BFHI, was implemented for the initiation and duration of breastfeeding across the world.

Breastmilk has the perfect balance of nutrients, contains high levels of nutrients, easily digested and absorbed Content varies according to milk production stage, which meets the changing nutritional requirements infant determines amount consumed. The cost benefits consist of free milk since it comes from the women’s breast, Breast pump one can buy if they want to Nursing pads, nursing bras. The advantages to breastmilk are it is always at perfect temperature unless it is stored in a refrigerator, no preparation time is needed, the milk is readily available, the mothers milk holds immunoglobulins, giving the baby passive protection/immunity. Passive immunity is are passed from the mother’s immune system through the breastmilk to the babies which in turn gives the baby are temporary protection to the things the mother has been sensitized. Sensitized is the process of becoming sensitive when parts of the called immunoglobulins Skin-to-skin releases bond-supporting hormone in the mother, oxytocin. Oxytocin is a hormone released by the pituitary gland that causes increased contraction of the uterus during labor and stimulates the ejection of milk into the ducts of the breasts and is commonly referred to has the love drug because it is usually released when people snuggle up or bond socially. The disadvantages of are that the mother must either be present or the milk must be pumped to feed the infant, early breastfeeding might be uncomfortable for new mothers, certain medications might halt the breastfeeding process, and certain habits can not be resumed when feeding the infant. Breast milk has antibodies that can help prevent sickness in your baby. Breastfeeding can help prevent your baby’s health problems, such as allergies, eczema, ear infections, stomach problems meningitis and diarrhea. Breastfeeding babies are less likely to be infected with breathing infections and hospitalized. Breastfed babies are less likely to become obese or have diabetes. Breastfeeding may help prevent sudden infant death syndrome (SIDS). Mothers who breastfeed find it easier to lose weight after pregnancy. Breastfeeding can help reduce the risk of breast and ovarian cancers, diabetes and other mother diseases. Breastfeeding is especially important for premature babies. The ability to feed a baby completely can help a new mother feel confident that she can take care of her baby. Breastfeeding also burns calories and helps to reduce the uterus and accelerates the healing process of the female body in general.

Bottle feeding with formula on the nutrient side is not as efficient absorbed as breastmilk, the nutrition factors depend on the proper preparation by the caretaker, some babies have a hard time tolerating some nutrients. For the cost formula ranges from fifty-four dollars to one hundred ninety-eight and people need to buy bottles and nipples ten dollars to hundreds of dollars to hundreds of dollars. Advantages are, anyone can feed the infant and the bonding of the baby and its caregiver. The breastfeeding and formula debate is extremely critical for those in very poor countries and low income families, for one very important factor and life giving substance, water. 

Formula in Very Poor Lives.

The powdered formula depends on clean in order to be used correctly Rafael Perez-Escamilla, director of Global Health Concentration at the Yale School of Public Health says “If the water is not clean, formula becomes a death sentence for the infant” (Brink 2018). Formula feeding has caused the death of over 800,000 infants which could have been saved by breastfeeding Reducing diarrhea, respiratory infections and diluted formula malnutrition. In addition, new research conducted in July 2017 by JAMA Pediatrics showed that beneficial bacteria from the mother colonize in the intestine of the baby, helping the child to create a healthy microbiome. Microbiome is a bacterium in the intestine that help fight disease throughout life. Since the bacteria are unique to mother and baby, the microbiome was the first personalized medicine of nature and cannot be replicated in the manmade substance. The buying of formula can use thirty percent or more of the income of an impoverished family, says Perez-Escamilla and that “Women then begin to dilute the formula to make it longer,” Drinking the formulation watered down leads to malnutrition, disease and even death.  With overwhelming evidence supporting breastmilk the U.S still supports the formula over breastfeeding when it comes to poorer nation due malnutrition and poverty. The U.S is not the only ones with this mindset. It is a common misconception that women who are malnutrition cannot breastfeed their child but that is not true. The can still breastfeed their child and their breastmilk is still better than formula. Only in extreme cases of malnourishment and specific medicines can be are exempted.

Conclusion

In conclusion breastmilk is favorable compared to formula because of the history behind it. It has been in use in order to nurture infants the way they need to be nurtured, It gives them exactly what they need not too little or too much. It has little to no drawbacks, more positives traits than formula. Research suggests that breastfeeding prevents adverse conditions in health, while formula feeding is linked to its development. The evidence confirms that breastfeeding is still the best source of nourishment for infants and the safest method of feeding infants.

References

• Stevens, E. Emily, Patrick, E. Patrick, Pickler, Rita. (2009)  A History of Infant Feeding, The National Center for Biotechnology, 1-7.
• Stuebe, Alison (2009) The Risks of Not Breastfeeding for Mothers and Infants, National Center for Biotechnology 1-2, 12
• (2018) Breastfeeding Vs Bottle Feeding, American Pregancy Association, 4-6.
• Brink, Susan (2018) Why the Breastfeeding Vs. Formula Debate is Especially Critical In Poor Countries, NPR, 2-4.
• Ben-Joseph, Pearl, Elana. (2018) Breastfeeding vs. Formula Feeding, KidsHealth, 2-4
• Caron, Christina, (2018) Breast-Feeding or Formula? For Americans, It’s Complicated, The New York Times, 1
• Kaneshiro, K. Neil. (2017) Breastfeeding vs. formula, MedlinePLus Trusted Health Information for You, 1