I'm going to offer just a couple thoughts here and what I tell my clients who need to supplement.

First - formula is not in my opinion a food of any kind.  It is a conglomeration of chemicals, minerals and nutrients.  It is well known to have significant health risks.  It is known to have significant ease of improper preparation thus causing health risks.  It is well known to be inferior to human milk on all fronts.  The evidence is out there all over the place that it can be dangerous and cause long term damage and harm to humans.  I have in my practice the past 17 yrs seen a handful of babies who were significantly harmed by (needed) formula supplementation and we (parents of baby and I) busted our asses to find donor milk to save baby's life with NO help from their Dr's or insurance.  I have a baby in my practice right now in the same situation.  Luckily I have a large Mommy group and when this need arises - they help - a lot.  Yes these kids are the exception but they sure make a point of how dangerous formula can be to a baby in a 1st world country (or shall I say how dangerous the lack of human milk can be.).

Second - If baby needs supplementation I suggest donor milk first (if mom does not have enough of her own milk).  I suggest talking with the Dr to get a prescription from the milk bank for newborns.  Use formula as a last resort if at all possible.   For older, healthy babies I suggest talking to breastfeeding friends for donation, or talking with my mommy group to discuss donor milk.  Formula is a last resort.  Why?  Because of its known risks - and expense.  It is often less expensive to get donor milk from local moms (replace milk bags or even rent a pump for a long-term donor!) than it is to purchase formula.  Often times parents have no choice but to supplement with formula.  Then we go back to Rule #1 which is - feed the baby.  The benefits of a live child outweigh the risks of formula.

I do absolutely discuss with parents of 6 month olds what is real food and what it not - they want to know and often they just don't.  Many times they can get donor milk easily but think that formula is 'just as good' - until we look at the ingredients and do some research.  If we want to do the bodies of our children any justice at all I think we need to really look at feeding them real food - which formula just isn't.  And just because the 6 month old is healthy does NOT mean that using formula won't hurt them.  It will.  We may not see it - they may act just fine - but what is happening to their gut, to their immune system?  What is going on inside that we can't see now but may see later?  I can have a soda now and not 'feel' anything 'hurting me' in the immediate sense of the word.  Same with candy bars and processed foods.  But the long term, harmful effects ARE known and we, as a culture with our processed foods diets are showing all the signs of long term damage as a result - but we didn't feel it or see it when we were eating it 10 yrs ago.  And I understand the need for practicality - and sometimes it is more practical to use formula.  But, if we can work together to help moms find better options and ways to find that donor milk - why not?

So, I have to strongly disagree that formula at any time is in any way a perfectly fine option to use with babies (unless there is a true issue like galactosemia or a true human milk allergy).  Formula has known risks.  It is not a true food.  Human milk is.  Even the AAP had a statement somewhere (I wish I could find it again!!)  that formula was NOT to be used for full enteral feeds - that it was to be looked at as a medicine.  I love that statement!  And yet, formula is still talked about and advertised as something benign and safe and good for our children.  Frankly, I will continue to encourage my parents to try to find donor milk if they are open to it before using formula.  But know that I also tell parents that Rule #1 is Feed the Baby - and if the only thing we have is formula - then that is what we are using.  

Warmly,
Jaye

Jaye Simpson, CLE, IBCLC, CIIM, MoM
Breastfeeding Network
www.breastfeedingnetwork.net

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