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We encourage mothers to breastfeed if they want to and are able to do so. Most mothers will be familiar with the “breast is best” mantra. While there are some benefits to be had for both mothers and babies that are exclusive to breastfeeding, we find the current climate to be unnecessarily negative towards mothers who cannot or choose not to breastfeed.

The research that has been done around breastfeeding is complicated by the fact that you cannot randomize babies to be breastfed or formula fed, which would be the most scientifically valid way of getting good information about the benefits of breastfeeding. All of our information has to be gathered by studying babies whose mothers chose to breastfeed of their own accord and comparing them to babies whose mothers chose to formula feed of their own accord. But because the choice of how to feed is not under the researcher’s control, there are often inherent differences between the mothers in each group (these are called confounding variables). An example of a confounding variable is maternal socioeconomic status (SES). A mother with a higher family income might be more easily able to have a long maternity leave where she is afforded the time to be able to exclusively breastfeed her baby. A mother without such income might feel compelled to return to work much earlier and find it difficult or impossible to maintain breastfeeding while doing so. We know that socioeconomic status affects health in many ways, and so if we see a difference between the health of a breastfed infant from a high SES family and a formula fed infant from a low SES family, it is difficult to know whether those differences are related entirely to the way they were fed, or whether those differences would have arisen regardless of feeding method simply because of the disparity in their socioeconomic status.

There are statistical methods to try to reduce the effects of confounding variables on results in research, but there are many such confounding variables and the more there are, the less reliable the outcome of the research.

Some of the best research we have on breastfeeding looks at ‘sibling studies’ where for whatever reason one sibling happened to be breastfed and one sibling happened to be formula fed. This reduces the likelihood that environmental factors (like maternal smoking or education level) or SES have played a role in any differences between the siblings because both of them would have pretty much the same environment and benefit from the same SES growing up. These kinds of studies show far less benefits to breastfeeding than those riddled with confounding variables.

A nice summary of recent evidence can be found here.

A video summary of the science can be found here.

In short, there are benefits to breastfeeding, but they are not SO great that mothers need to feel shamed, embarrassed, or guilty if they are not able to, or do not choose to breastfeed. Formula feeding is perfectly safe and effective when done properly. Breastfeeding should be the first choice if you are physically able to AND if you personally judge that it works for your family, your life, and your baby. You are the only person who can decide that, and we are not in the business of guilting people for making perfectly reasonable choices for their families.

Our labour and delivery room nurses have training and extensive experience in supporting and educating about breastfeeding. If this is your goal, we will certainly do everything in our power to help you achieve it.

If you are planning to formula feed, or want to be familiar with how to do it just in case, Health Canada has specific information here.