Risks of Formula Feeding

What are the possible risks of using breast milk substitutes (infant formula)?

Breast milk substitutes, often called infant formula, do not contain all of the same elements as human breast milk, and therefore cannot support a baby’s overall health and development in exactly the same ways.  Infant formula is considered to be a suitable breast milk substitute to support an infant’s growth when breast milk is unavailable. 

There are risks associated with feeding babies a breast milk substitute.  These may include:

• Reducing the mother’s supply of breast milk, especially when formula is given in the first 4-6 weeks after baby is born 
• Decreasing the mother’s confidence in her ability to exclusively breastfeed her baby and the duration of the breastfeeding relationship so that the benefits for both mother and baby are reduced
• Increased cost: formula is expensive to purchase.  According to 2008 local data for Simcoe County and District of Muskoka, the cost of feeding an infant iron fortified cow’s milk based formula for 6 months is on average $668.25 (powdered), $688.49 (liquid concentrate), and $2369.25 (ready to feed). It is important to note that babies who are not breastfeeding will require infant formula for the full first year of life.
• Potential for contamination with bacteria related to the manufacturing process or unsafe handling or storage.  World health experts caution that it is preferable for infants, particularly newborns and babies up to two months of age, to not receive powdered infant formula as this product is not sterile and may become contaminated with harmful bacteria more easily than liquid concentrate or ready-to-feed preparations of formula. 
• Infants may become ill if their formula is mixed incorrectly (too weak or too strong), or if it becomes contaminated with germs during preparation. 

In order to reduce the risks for your baby if they require infant formula, you can:

• Follow these guidelines to support the safest preparation, storage and handling when using powdered infant formula. 
• Prepare infant formula according to the manufacturer’s directions.  Read the instructions for preparation and storage on the label carefully, and follow them exactly as written.
• Check the Health Canada web site for food recalls if you have a concern about a particular infant formula
• Call Your Health Connection for tips on safe feeding practices for breastmilk substitutes and to learn more about nurturing a bottle-fed baby

If your healthcare provider has recommended that your baby receive a supplement of infant formula for medical reasons, it is important to develop a plan together that will minimize the risks for your baby and that will support continued breastfeeding where possible. 

Things to consider include:

• How much formula your baby needs to receive and how often
• What method you will use to administer the formula to your baby (lactation aid, cup, bottle, etc.)
• How long your baby will continue to need the formula (what is the end goal?)
• How to safely choose, prepare, store the formula
• How to continue supporting breastfeeding and breast milk supply during this time

Best Start has developed a resource for healthcare professionals, which reviews guidelines for supplementation of breastfed babies, and may be useful in developing a feeding plan for your baby with your care provider.

For more information, call or click Your Health Connection at (705) 721-7520 and speak with a public health nurse.