JAMA Patient Information: Feeding your Newborn

There are many considerations when deciding whether to breastfeed or bottle-feed your baby. Breastfeeding has many advantages and is the best source of nutrition for your baby. However, in some situations, your doctor may recommend bottle-feeding with formula rather than breastfeeding. If you have some medical conditions, such as being infected with the human immunodeficiency virus (HIV) or hepatitis B, bottle-feeding with formula can protect your baby from exposure to the disease through your breast milk.

An article in the March 1, 2000, issue of The Journal of the American Medical Association (Nduati et al) reports on a study of women infected with HIV who fed their babies with either breast milk or formula. The researchers found that babies who were fed breast milk were more likely to become infected with HIV than babies who were fed formula.

Advantages of Breastfeeding for the Baby:

• Provides nutrients, hormones, and proteins that are essential for growth, brain development and digestion.
• Reduces the risk of infections of the middle ear, digestive system and respiratory tract by providing natural antibodies (proteins that fight infection).
• Reduces the risk of food allergies.
• Babies experience fewer digestive problems than with formula; breast milk includes enzymes to aid digestion and absorption of nutrients.
• Babies are less likely to experience anemia (lower than normal red blood cell levels).

Advantages of Breastfeeding for the Mother:

• Helps the uterus (the womb) return to its normal size more quickly after delivery.
• Helps the mother lose weight after delivery more quickly, because the body burns more calories when you are lactating (producing milk).
• May help reduce risk of breast cancer, if you nurse for at least three months.
• Can be more convenient; when you are with your baby, breast milk is always available.

When You Should Bottle-feed with Formula:

• If you are infected with HIV
• If you are infected with hepatitis B
• If you have tuberculosis and have not yet been treated for the disease
• If you are receiving certain cancer treatments
• If you smoke, drink heavily or use drugs (breast milk can pass nicotine, alcohol and other drugs to your baby)
• If you are taking medications, check with your physician about the best timing for breastfeeding. Since many medications are passed in breast milk, it might be better to take some medications after a breastfeeding session.
• You should tell your doctor about any of the above situations as soon as you know you are pregnant. If you think you are at risk of being infected with HIV, hepatitis B, or tuberculosis, your doctor can test for these diseases and let you know if it is safe to breastfeed.

Advantages of Bottle-feeding:

• You can use formula (or breast milk if you do not have a medical condition that would prohibit its use; obtained by using a breast pump) to bottle-feed your baby.
• Gives other parents and caregivers an extra opportunity to bond with the baby.
• Helps you know exact amount of food the baby is receiving.
• Can provide more flexibility to the mother's schedule.

Getting Started:
Even though breastfeeding is a natural process, it may take some time for you and your baby to become skilled at it. If you would like to breastfeed, you can speak with a health care provider who specializes in breastfeeding and be given instruction so that you know what to expect and you are more comfortable with the process.

Taking Care of Yourself:
You need to take care of yourself and ensure the quality of your breast milk by getting extra fluids (at least six to eight glasses of water per day) and extra calcium. You should avoid beverages that contain alcohol or caffeine before a breastfeeding session with your baby. You should also quit smoking for your health and the health of your baby.

Source: American Medical Association