Benefits of Breastfeeding 1

Benefits of Breastfeeding vs. Artificial Formula

Omar Amireh, Robert Demofonte, Kirsten Hurd, Steven Lukac, Courtney Michaels

Youngstown State University

June 18, 2018

 Benefits of Breastfeeding 2

Abstract

Through extensive research, substantial evidence has been found to support our proclamation

that breastfeeding provides a greater amount of nutrients as opposed to the use of artificial

formula. We discovered that breastfeeding is not only beneficial for the baby, but the mother as

well. It was clear that natural breastmilk not only served as the best source of nutrients, but that

breastfeeding supports earlier cognitive development, shows a positive outcome for the mother

and reveals health benefits during infancy as well as after. Also, we discovered that financially,

breastfeeding is one way to save money and if one were unable to physically express breastmilk,

the mother has different opportunities and alternatives to provide breastmilk to their baby

without resigning to artificial formula. In conclusion, breastfeeding provides more beneficial

outcomes for both mother and baby than artificial formula.

Keywords: breastfeeding, skin-to-skin, health benefits, development, nutrients,

alternatives.
 Benefits of Breastfeeding 3

Benefits of Breastfeeding vs. Artificial Formula

When people say, “breast is best,” they are not lying. Breastfeeding traces back all the

way from the 1950’s where almost all U.S. newborns were nursed (Weimer, 2001). Breastmilk

provides a network of wellness that is both beneficial for a mother and their infant as compared

to bottle feeding. Although artificial formula is widely used, it does not provide as many

benefits to the mother nor the baby. Breastfeeding has been shown to provide nutrients, health

benefits, cognitive growth, financial support, skin-to-skin benefits, as well as alternatives for

mothers who are not able to physically express breastmilk. For expecting mothers looking to

provide their baby with the greatest amount of nutrients, breastfeeding is more beneficial for

both mother and baby than artificial formula.

One benefit of breastfeeding is that a woman's breastmilk provides many nutrients to a

growing infant. According to Hale, a former midwife , “It provides free nourishment that is

perfectly balanced: temperature – controlled and adapts to meet the nutritional and energy

requirements of the growing child” (2007). There are many components to breastmilk that make

it nutritional as well as beneficial for a growing infant. Breastmilk contains fats, proteins, and

vitamins that are essential for an infant’s health. Shenker, an Oxford doctor and a cofounder of

the Hearts Milk Bank says, “Compared with other species, a higher proportion and diversity of

fatty acids support the growth of the brain which is particularly large in comparison to that of

other mammals” (2017). Breastmilk also contains colostrum. Colostrum is produced by the

mother right after birth. Shenker acknowledges, “It provides an energy – rich dose in just a few

milliliters per feed” (2017). Colostrum is high in carbohydrates, proteins, and even white blood

cells which infants obtain from drinking their mother's breastmilk. Shenker says, “Of these, the

most common cells are breast specific macrophages, which can engulf and absorb harmful
 Benefits of Breastfeeding 4

microorganisms” (2017). When bacteria and different infectious organisms enter an infants’

body these macrophages are activated to destroy them. Breastmilk also contains an important

protein called lactoferrin and enzymes called lysozymes. Lactoferrin helps infants store iron and

both lysosomes and lactoferrin aid in the destruction of harmful bacteria that enter an infant.

Breastmilk also helps infants gain immunity to pathogens. Shenker acknowledges, “Antibodies

produced by the mother, which are transferred into milk as well as to cells in breast milk, are

highly targeted against infectious agents in her environment” (2017). Formula fed infants do not

get this type of immunity as breastfed infants, making them more prone to pathogens.

Breastmilk also promotes the growth of good bacteria in the gastrointestinal tract. According to

Hale, “Recent research also shows that naturally occurring substances within breast milk, known

as prebiotics have a directly beneficial effect on the babies gut microflora” (2007). Eventually,

this will allow an infant’s gastrointestinal tract to stop harmful organisms from invading the gut.

Breastmilk also contains numerous amounts of sugars called oligosaccharides. Shenker

mentions, “Although most oligosaccharides have unknown functions, some help to block

bacterial antigens from sticking to the wall of the gastrointestinal tract” (2017). Bacteria like

pneumococcus can cause things such as pneumonia and sepsis in an infant which these sugars

can prevent.

Another important component found in breastmilk are multipotent stem cells, which are

sent from the mother to the infant while feeding. Hassiotou, a biomedical doctor and a member

of the University of Western Australia Hartmann Lactation Research Group explains, “If we can

understand the properties of these cells and their role in the breast and the breastfed baby, we can

use them as models for breast cancer research and in innovative stem cell therapies” (2011).

Stem cell therapy can be used to help people who are suffering from Parkinson's disease and
 Benefits of Breastfeeding 5

even diabetes, according to Dr. Hassiotou. These cells can not only turn into breast cells but can

differentiate into other cells found in the human body including bone, fat, brain, and liver cells

which have the potential of treating these certain types of diseases. Hassiotou also says, “The

benefit of obtaining stem cells from breast milk is that they can be accessed non-invasively,

unlike getting them from the bone marrow, umbilical cord blood, or peripheral blood” (2011).

Stem cells can be hard to obtain and the discovery of stem cells in breast milk will further aid in

stem cell research. There are many aspects of breastmilk that make it unique for a growing

infant. It not only provides nutrients for a growing infant, but also serves as a defense

mechanism and aids in stem cell research as well, and that’s not it; breastfeeding also serves

many health benefits for a growing infant and the infant’s mother.

It is obvious that breastfeeding provides a multitude of neonatal nutrition and promotes

physical and cognitive development, but despite teaching and understanding of the benefits

associated with breastfeeding, approximately twenty-two percent of infants in the US were

compliant with such recommendations (Ross-Cowdery et al., 2016). This figure is startling and

warrants emphasis on the benefits of breastfeeding.

Research has shown that breastfeeding in the first six months of life is crucial for

development in the first one to two years of life. The first fluid produced by the mother

following birth is known as colostrum. Colostrum is produced in low quantities in the first few

days postpartum. Though it is low in lactose, it is rich in immunologic components such as

secretory IgA, lactoferrin, leukocytes, as well as developmental factors such as epidermal growth

factor. The composition of colostrum fulfills its primary purpose of building the immune

system. Likewise, levels of sodium, chloride and magnesium are higher and levels of potassium

and calcium are lower in colostrum than later milk. As development of the mammary epithelium
 Benefits of Breastfeeding 6

progresses, the sodium to potassium ratio declines and lactose concentration increases, indicating

secretory activation and the production of transitional milk. Transitional milk shares some of the

characteristics of colostrum but represents a period of “ramped up” milk production to support

the nutritional and developmental needs of the rapidly growing infant and typically occurs from

five days to two weeks postpartum, after which milk is considered largely mature. By four to six

weeks postpartum, human milk is considered fully mature (Ballard & Morrow, 2013).

As the mother initiates breastfeeding, she not only fulfills the nutritional needs of the

baby, but she will also reap the benefits of lactation. Childbearing is associated with long-term

weight gain and postpartum weight retention that has also been associated with adverse

outcomes in later pregnancies. Breastfeeding, conversely, is associated with postpartum weight

loss. In a large prospective cohort study, it showed that greater intensity (exclusivity) and

duration of breastfeeding was associated with greater weight loss at 6 and 18 months postpartum

in women of all BMI categories (Baker, 2008). Secondly, breastfeeding is associated with a

decrease risk of cardiovascular, metabolic, and endocrine diseases. Pregnancy is associated with

changes in glucose and lipid metabolism that support the growing fetus, however, these changes

can be deleterious to the mother’s health. Breastfeeding, on the other hand, is associated with

favorable metabolic changes. Pregnancy is an insulin-resistant state, which results from the

effects on the mother of placental hormones with anti-insulin effects. These metabolic changes

can cause gestational diabetes, and may increase the risk of type 2 diabetes later in life.

Conversely, during lactation, insulin-sensitivity improves and may have lasting effects because a

4–12 percent reduction in the risk of type 2 diabetes was observed for every 12 months of

lifetime lactation.
 Benefits of Breastfeeding 7

Pregnancy is also a hyperlipidemic state with increased concentrations of blood

cholesterol and triglycerides. Contrarily, lactation promotes favorable effects on maternal blood

lipids. Research has found that lactation is associated with lower risk of longer-term metabolic

risk factors and cardiovascular disease. Women who breastfeed their children have been less

likely to have developed hypertension, diabetes, hyperlipidemia, and cardiovascular disease. A

decrease in risk for reproductive cancers has been observed among women who have breastfed,

possibly reducing their reduced lifetime exposure to hormones such as estrogen. According to a

2002 meta-analysis, women with breast cancer were less likely to breastfeed their children and

had a shorter average lifetime duration of breastfeeding rather than women who had not

developed this disease (Dieterich et al., 2012).

Moving forward, it has been found that breastfeeding also supports a greater development

of cognitive function. That being said, cognitive development surrounds the idea of thinking

range and learning skills such as: language, attention, planning, problem solving and memory.

Susan Tawia wrote in her article:

This paper reviews the most recent evidence for an effect of breastfeeding on

cognitive development, but goes beyond IQ, beyond just a number, and looks at

just what kind of brain development happens when infants are breastfed and what

developmental, education and social consequences occur when infants are

artificially fed (2013).

Studies have shown that the first 9 months of life are the most critical times of brain growth and

cognitive development for children. Cognitive scores are tallied using the relations of head

circumference, a measurement of the general brain development, and correlating with brain
 Benefits of Breastfeeding 8

volume. Ultimately, what is being studied is if breastfeeding or lack of breastfeeding can affect

the size of an infant’s brain.

A study was performed to review the effect of breastfeeding on children between the ages

of 1-5 years. Researchers found that breastfeeding reduces the extent of head circumference

deficits in a dose-dependent manner. This means that the longer the child was breastfed, the less

likely of underdeveloped brain growth. The article stated, “The prevalence of head

circumference deficit was 13.3% when infants were exclusively breastfed for 30 days or less,

10.6% when infants were exclusively breast for 30 - 119 days and 5.8% when infants were

exclusively breastfed for 120 days or more” (Tawia, 2013). This study confirmed that children

who were breastfed did not have head circumference deficits as compared the the children that

were fed with artificial formula.

Similarly, another study was performed on adolescents who were either artificially fed or

breastfed using brain imaging to measure the development of the white matter in their brains.

The focus was on white matter because, “White matter is predominately made up of the myelin

sheaths that surround the nerve cells. Myelin acts to ensure that impulses or signals that are

transmitted along nerve cells travels quickly and efficiently” (Tawia, 2013). Children between

the ages of 10 months to 4 years of age received MRI scans while sleeping. Tawia stated in her

article, “Deoni et al (2013) found that young children artificially fed as infants exhibited less

white matter development than infants who were exclusively breastfed for at least 3 months”

(Tawia, 2013). In the end, this study was able to show that the group of children that were

exclusively breastfed had a faster growth in the development of white matter than children who

were artificially fed or fed with a mixture of breastmilk and artificial formula. It was also found
 Benefits of Breastfeeding 9

that the increase of white matter volume became substantial by the age of 2 for the group of

children that were exclusively breastfed.

Interestingly, this next study performed was based on EEG (electroencephalographic)

activity with evoked potentials. According to Tawia,

An evoked potential is an electrical potential or response recorded from the

nervous system following a stimulus, as distinct from spontaneous brain electrical

activity that is detected by EEG. There are three kinds of evoked potentials in

widespread clinical use: auditory evoked potentials; visual evoked potentials; and

somatosensory evoked potentials, which are elicited by electrical stimulation of

peripheral nerves (2013).

The evoked potential testing analyzes function and supplies information about the physiology of

distinct nerve pathways. For example, “.. visual evoked potentials are used primarily to measure

the functional integrity of the visual pathways from retina via the optic nerves to the visual

cortex of the brain” (Tawia, 2013). In other words, the evoked potentials are able to be used to

measure the neurophysiology of the developing infant. The study was performed by exploring

the visual, auditory and somatosensory evoked potentials of 1 year olds who were either

artificially fed or exclusively breastfed. Although all evoked potentials were found to be

decreased in artificially fed infants, visual evoked potentials especially were affected.

This last study was executed by observing the quantity of infants at the age of 8 months

passing the estimated milestones, which consist of crawling, pincer grip, and babbling. The

sample was studied among a group of 1,656 healthy infants that were exclusively breastfed.

Like the others, this study also resulted in an increased positivity with duration of breastfeeding.

According to McCrory,
 Benefits of Breastfeeding 10

A US study found that breastfeeding initiation was associated with significantly

reduced risk of parent reported concerns regarding children’s fine and

gross motor skill development, as well as their receptive and expressive language

development after adjustment (2012).

In summary, this study leads to the idea that breastfeeding gives a positive influence on the

language and motor skills development in the early stages of a child’s life.

Another main component that comes with breastfeeding is skin-to-skin contact of the

mother and child. Jenny Clark, a nursing midwife, states, “Skin-to-skin contact involves the

newborn being placed on to the mother’s abdomen in a prone position straight after birth, then

carefully dried” (2014). This position is crucial, as it helps to keep the baby calm, regulating

heart rate, temperature, and also to facilitate breastfeeding. Kayla Johnson, who is a registered

nurse with a BSN, supports this by saying how multiple studies have found that infants spend

more time in quiet, deep sleeps, have lower and more stable heart rates, and have better gas

exchange while in this position (2013). These effects are from the baby using the mother’s

warmth, reducing its own energy use, and listening to the soothing heartbeat it has been near for

its entire life, which calms the baby down. In conjunction with this research, Pierre Kuhn, a

neonatologist and professor of pediatrics at the University Hospital of Strasbourg, expresses how

along with its other short and long term benefits, skin-to-skin contact appeared to be extremely

effective in reducing pain (2016). Therefore, skin-to-skin contact helped keep the baby calm and

reduce anxiety during procedures done with the baby. Besides the use of heart monitors and

thermometers, children who are exposed to skin-to-skin contact demonstrate an increase in

various aspects through life. Clark explains that there have been multiple studies that have

shown not only early life benefits, but improved physical development, brain function, and social
 Benefits of Breastfeeding 11

awareness in them over time (2014). These findings are mainly tested for and shown in early

stages of development but continue all the way through adulthood. Johnson asserts,

“Breastfeeding has also been associated with a lower risk for psychopathology in later life,

including adult anxiety and alcoholism” (2013). With all of these benefits for the child, the

mothers are preparing them for life during the first days after birth.

While the baby has a great amount of benefits from skin-to-skin contact, the mother

benefits in quite a few ways herself. One way mothers improve from skin-to-skin contact is that

it aids in the development of maternal behaviors, with mothers showing more affectionate

responses to her child (Johnson, 2013). Being through all the stress of labor and then having the

baby placed right onto the mother’s chest allows a deep emotional bond to be created between

them, which later shows in life. One of the more immediate effects is that the mother reports

more positive feelings toward their infant and were often more sensitive, as well as having less

stress and depression in general (Johnson, 2013). The stress relief that comes with skin-to-skin

contact further allows the mother to grow closer together with her child. Johnson specifies,

“Close physical contact and lower stress levels allow the mother to become in tuned with her

infants physical and emotional needs, significantly contributing to positive parenting and

physiological, cognitive, and socio-emotional growth of the child” (2013). This shows how the

mother and child feed off of each other’s strengths and happiness, creating a beneficial cycle. All

of these advantages are attributed to skin-to-skin contact, which creates numerous health benefits

for mother and child.

Breastfeeding not only provides a great source of nutritional benefits to the baby as well

as the mother, but likewise, includes many benefits financially for the whole family. According

to the most recent data, approximately 64 percent of women giving birth in hospitals breastfeed
 Benefits of Breastfeeding 12

and 29 percent of those women still breastfeed at 6 months (Weimer, 2001). The USDA’s

Economic Research Service (ERS) found that a minimum of $3.6 billion could be saved if more

mothers giving birth choose to breastfeed their children. These savings include three different

childhood illnesses, medical expenditures, wages lost by parents attending to an ill child, and the

prevention of premature deaths (Weimer, 2001). Whether the child is fed breast milk exclusively

through the mother’s breast or if the mother has to express the milk into a bottle for their child, it

is widely believed to be the most beneficial method for both nutritional and financial reasons for

infants and parents (Weimer, 2001). Breastfeeding saves the average family an astronomical

amount of money by not having to purchase artificial formula every week and also by saving

money on doctor visits when the child becomes sick. As we all know, children catch numerous

amounts of illnesses and doctor visits are highly expensive, therefore, with the most accurate

amount of nutrition given through breastfeeding, not only will children grow healthier, but

parents will also save money in the process.

According to Jon P. Weimer, author of “The Economic Benefits of Breastfeeding” article

stated, “In a 1997 policy statement, the AAP reported that research in the United States, Canada,

Europe, and other developed countries indicates that breastfeeding decreases the incidence and

or/ severity of diarrhea, lower respiratory infection, otitis media, bacterial meningitis, botulism,

urinary tract infection, and necrotizing enterocolitis” (2001). It has been shown that breastfed

infants are less likely to catch common infectious illnesses than formula-fed infants. This

finding can be translated to mothers who breastfeed who tend to miss fewer days from work to

care for an ill child than mothers who strictly formula feed their children (Weimer, 2001). In
 Benefits of Breastfeeding 13

comparison to formula feeding, breastfeeding was found to result in a net benefit of $478 during

the first 6 months of the child’s life (Weimer, 2001). When looking at the total medical costs of

infants that are breastfed versus formula-fed, the study had found that breastfed infants had fewer

inpatient admissions and their total medical costs averaged $200 less than those infants receiving

artificial formula (Weimer, 2001). Breastfeeding helps to reduce the risk of acquiring several

chronic illnesses with associated costs that can accrue over several years and sometimes over a

lifetime (Weimer, 2001). When trying to decipher which option is the best for your child, it is

always good to keep in mind that a mother produces the most nutrients for her child and her milk

is free.

Commonly, breastfeeding is seen as milk ejection of a woman that is a transient

phenomenon that takes 45 seconds to 3.5 minutes to occur (Gardner et al., 2015). As noted by

Gardner, “Successful lactation is dependent on both milk synthesis and milk ejection” (Gardner

et al., 2015). Although breastfeeding is the most convenient method of milk removal, many

mothers are unable to physically breastfeed their children and often try to look for other

alternatives rather than purchasing artificial formula (Gardner et al., 2015). In fact, according to

Dr. Katherine Carroll and Dr. Kenneth Herrmann, “There is a rising trend in the United States of

America to feed hospitalized very low birth weight (VLBW) premature infants pasteurized donor

human milk (PDHM) from human milk banks (HMBs) when a mother’s own milk (MOM) is

unavailable” (2012). Donor milk for premature infants is said to reduce the incidence of

necrotizing enterocolitis (NEC), improve enteral feed tolerance and gastric emptying and to

achieve the rapid establishment of full enteral feeding (Carroll & Herrmann, 2012).
 Benefits of Breastfeeding 14

As a first time mother, it is important to know that breastfeeding is a skill that requires

practice, patience, and great encouragement (Blincoe, 2005). When mothers are physically not

able to breastfeed due to difficulty with the baby not latching on properly or an issue due to the

mother, breastmilk can either be expressed manually with a breast pump or more readily by

using an electric or battery-powered breast pump (Blincoe, 2005). The milk can then be stored

in the fridge or frozen, but however, it should be kept in mind that the composition of breast milk

corresponds to the developmental needs of a baby at the time milk is produced, so it is best if it

can be used in its freshest state (Blincoe, 2005). The great thing about expressing breast milk is

that it can still be kept in plastic bottles without fear of losing any of the milks nutrients (Blincoe,

2005). When mothers cannot breastfeed they tend to be pushed to what they believe is the only

other option, artificial formula. Mothers across the world should be informed that before trying

artificial formula for their baby, they should look into the alternative methods such as expressing

their breastmilk into a bottle and storing it, purchasing donor breastmilk and then when all other

options fail, according to all the research collected on the best options to receive the most

nutrients for mother and baby, is when artificial formula should be used.

In conclusion, for expecting mothers looking to provide their baby with the greatest

amount of nutrients, breastfeeding is more beneficial for both mother and baby than artificial

formula. Although artificial formula is easily accessible, breastmilk has been found to provide

greater nutrients, health benefits, cognitive growth, financial support, skin-to-skin benefits, and

alternatives for mothers that are not able to physically express breastmilk. These claims have

been shown to benefit the infants and the mother presently and in the future. With that being
 Benefits of Breastfeeding 15

said, it is important for expecting mothers to be educated thoroughly on all options available to

provide the greatest benefits before resigning to artificial formula.

 Benefits of Breastfeeding 16

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American Journal of Clinical Nutrition. 2008;88(6):1543–51.

Ballard, O., & Morrow, A. L. (2013). Human milk composition: Nutrients and bioactive

factors. Pediatric Clinics of North America, 60(1), 49–74.

Blincoe, A. (2005). The health benefits of breastfeeding for mothers. British Journal of

Midwifery, 13(6), 398-401.

Carroll, K., & Herrmann, K. (2012). Introducing donor human milk to the NICU: lessons for

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Clarke, J. (2014). The first embrace. Nursing Standard, 29(4), 26-27

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