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Breastfeeding is making headlines, but take a closer look before you change the way you feed your baby.

Courtney Schmidt, PharmD
Courtney Schmidt, PharmD Managing Editor, Illuminate Blog

A new study published this week in the journal Pediatrics addresses the issue of whether formula supplementation within the first days after a baby’s birth can actually prolong breastfeeding in the long-term. The study has gained a lot of publicity since its conclusions seem to contradict current recommendations of exclusive breastfeeding for infants.

But, what does it mean for mothers in real life making real decisions about how best to feed their babies?

The study

  • 40 healthy, full-term infants who were exclusively breastfed and lost 5% (or more) of their body weight within the first 24 to 48 hours after birth were included in the study.
  • The infants were randomly chosen to either continue exclusive breastfeeding or receive formula supplementation as well as breast milk.
  • Those who received formula were given 10ml of formula by syringe after each breastfeeding. This was discontinued after the mother’s mature milk came in.
  • Results showed that infants who received formula supplementation were more likely to be exclusively breastfed after three months.
  • The authors concluded that early formula supplementation may improve the rate of breastfeeding at three months of age.

Limitations to consider

Before drawing any conclusions from a study, it’s important to consider the study’s limitations, and this one has several. In the world of medical research, this is an extremely small study. The smaller the study, the more difficult it is to generalize the findings to the population at large.

It’s also important to recognize that participants in a medical study must agree to a randomization process where they don’t have control over which therapy they’ll receive. Mothers who would agree to this particular randomization process may not have had a strong preference for exclusive breastfeeding in the first place. Since the mother’s determination to exclusively breastfeed is known to be a significant factor in the outcome, it is difficult to tell whether the same results would be seen in the general population.

Perhaps the most troubling oversight, however, is the failure to describe the education and support of breastfeeding practices provided to these mothers. Details of the advice and direction these women may have received from doctors, nurses and lactation consultants were not described. However, these factors could play an important role in long-term breastfeeding success.

What does it mean?

While this study provides an interesting piece to the larger puzzle of newborn nutrition, it does not provide enough evidence to compel a change in how mothers feed their infants. There are numerous studies that provide overwhelming support for the current recommendations.

Perhaps some of the sensational headlines (see this one, for example: The Breast-feeding Police Are Wrong About Formula) have surfaced not because this study offers groundbreaking revelations, but more in response to the battle lines that have been drawn around the topic of breastfeeding.

The medical community has been united in its stance recommending exclusive breastfeeding for six months and breastfeeding continuation for one year or more. Yet many mothers feel ill-prepared to meet that expectation. It’s easier for doctors to recommend it than it is for mothers to live it out day after day. And, there doesn’t seem to be any flexibility in those recommendations for individual needs or circumstances within the family.

Those mothers who aren’t able to adhere to the breastfeeding guidelines often feel guilt and shame because the pressure from the medical community and public conversation weighs heavily on them. It follows, then, that this study might offer to those moms some welcome reassurance that formula supplementation might not be all bad.

While this study doesn’t prove that formula supplementation is the answer to the hurdles we face in feeding our newborns, the public response may indicate that there needs to be a little more room for flexibility, support and acceptance for mothers, no matter which way we choose to feed our baby.