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Where Does Infant Formula Come From? A Brief History Of The Breast Versus Bottle Debate

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For Jennifer McGinley, 27, her breastfeeding struggles began the moment her water broke. She was 36 weeks pregnant, and her daughter was born premature at 4 pounds, 11 ounces. The baby never learned to latch, and McGinley spent the first month of her baby's life pumping breast milk.

After McGinley got sick, things took a turn for the worse.

"I have common variable immune deficiency [CVID, a condition that impairs the immune system], so I can't fight off common colds, sinus infections, urine infections, etc.," McGinley told Romper. "I had to be on some high-dose antibiotics and couldn't breastfeed anymore. My body stopped producing."

McGinley stopped breastfeeding before the six-month mark, going against the World Health Organization (WHO)'s recommendation that infants be exclusively breastfeed for the first six months of their lives. Now, McGinley has a healthy 6-month-old who is exclusively formula-fed. But it hasn't been easy.

“I can't count how many times I've been ‘mom-shamed’ by family, friends and complete strangers,” she told Romper.  

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Women --some of them breastfeeding-- carry out a 'mamaton' (from Spanish 'amamantar' ,breastfeed and 'marathon') outside the Legislative Assembly in San Jose on August 3, 2016 protesting against the recent dismissal of a secretary who was breastfeeding by a deputy of the Partido Accion Ciudadana (PAC) .

Jennifer is far from alone in formula-feeding her daughter. By the time a baby reaches 6 months old, chances are higher they’re being given formula than breast milk as their main source of food, despite the WHO's recommendations, according to the 2014 Breastfeeding Report Card by the Centers for Disease Control and Prevention.

The reasons why a mother might opt for formula vary widely, from an inability to produce breast milk (as was the case with Jennifer) to a demanding job that doesn't provide the time or space for a mother to feed or pump for her child. Regardless, despite the "breast is best" mantra, it is far from uncommon for mothers to bottle-feed — which is why it's strange that women are still being shamed for it.

Bottle-feeding is one of the biggest sources of contention in the so-called "mommy wars," with many moms reporting being called out online or criticized at family gatherings for giving their babies formula. Some mommy bloggers have even gone so far as to compare baby formula to cigarettes, comparing formula manufacturers to Big Tobacco.

Yet despite the controversy over formula, for the past century formula has served as a life-saving option for babies who cannot be fed breast milk for whatever reason. Today, some moms are coming out saying that bottle-feeding was not only the best option for feeding their babies, but also that formula helped save their babies' lives.

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This photo taken on October 20, 2016 in Vevey shows a display of Nestle Nido milk powder in a showroom of Swiss food giant's Nestle. Sales of Swiss food giant Nestle rose slightly in the first 9 months of 2016, in a 'more sluggish' environment, which led the group to strongly revise downwards its expectations for the full 2016 year. According to a statement released October 20, the group recorded a one-percent increase in sales over the first nine months of 2016 to 65,500,000,000 francs (60 billion euros).

Formula has been around in some form for more than 100 years, but it certainly isn’t the first alternative feeding option moms have employed. In the past, mothers who could not breastfeed have relied on everything from evaporated milk to cocktails of various animal milk products, most frequently cow's milk.

In 1865, a German chemist by the name of Justus baron von Liebig, created the first infant formula, which was made of cow's milk, wheat and malt flour, and potassium bicarbonate. Yet these earlier attempts at infant formula were largely nutritionally deficient, with many formula-fed babies suffering from conditions like scurvy or rickets as a result.

Women who couldn't breastfeed for whatever reason also turned to wet nurses, or lactating women who fed other women's babies out of good will or as a profession. While some cultures seemed to embrace the “it takes a village” philosophy to child-rearing, allowing lactating women to share the responsibility of a nursing child, wealthier women employed wet nurses as a status symbol, according to Ian G. Wickes in the 1953 journal The Archives of Disease in Childhood. In 17th century England, for instance, it was typically upper-class women who hired wet nurses, while working-class women nursed their own children.

By the 1880s, 27 different infant formulas were being marketed and sold, even though most spoiled quickly and lacked the nutrients babies needed in order to thrive. Over time, through additional research and development, formula became more nutritious. More sanitary manufacturing and storage methods were also developed, according to the Journal of Perinatal Education.

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AUCKLAND, NEW ZEALAND - MARCH 10: Cans of baby formula are seen on March 10, 2015 in Auckland, New Zealand. Fonterra and Federated Farmers received anonymous letters in November last year, threatening to contaminate baby formula with 1080 unless New Zealand stopped using the poison for pest control by the end of March. (Photo by Fiona Goodall/Getty Images)

Over the first half of the 20th century, formula evolved into an increasingly acceptable and safe choice for mothers struggling to breastfeed. Physicians increasingly recommended that moms bottle-feed instead of breastfeed, and formula companies also aggressively marketed baby formula as a superior product to breast milk, according to A History of Infant Feeding.

Advertisements like the one for Formulac Infant Food, as seen below, showed images of beautiful, healthy, rosy-cheeked babies, accompanied by quotes from doctors saying they chose formula for their own babies. An ad for Mellin's Food, an infant formula manufacturer, included a quote from a mother saying her child was ill until she switched to their formula.

Thanks in part to these ads (which were, it's worth noting, predominantly appearing in women's magazines), breastfeeding rates rapidly declined between 1930 and 1970.  By 1971, only 24% of newborns were breastfed before their mothers left the hospital, according to the American Journal of Public Health.

Courtesy of Wikimedia Commons
Courtesy of Wikimedia

In the mid-1960s, however, breastfeeding rates once again started to surge in North America, with organizations like the La Leche League drawing attention to the health benefits of breastfeeding and the nutritional deficiencies of infant formula. To prevent infant formula manufacturers from making extreme claims about the benefits of formula, organizations like UNICEF and WHO worked together to create regulations for the marketing of breast milk alternatives, and in 1979, the International Baby Food Network was formed, advocating for safe feeding practices and the ethical marketing of formula worldwide.

In 1995, it was reported that 60% of mothers reported initiating breastfeeding after their babies were born, the highest percentage since 1955. Today, nearly 77% of infants are breastfed immediately after birth, according to data from the Centers for Disease Control (CDC). That's in part thanks to pushes from the American Academy of Pediatrics and the WHO to normalize breastfeeding and increase breastfeeding rates worldwide, citing the immunological benefits of breast milk and the fact that breastfeeding increases the bond between mother and child.

Despite these health benefits, however, the number of mothers who exclusively breastfeed their children starts to decline as their babies age. By the time their babies are 6 months old, only approximately 45% of all mothers in the United States are still breastfeeding them, according to the CDC, with many moms opting to use formula instead.

“By the time I could pump or breastfeed my daughter without writhing in pain, I could barely express a drop of milk. My supply was completely gone!”

The factors most influencing the decision to quit breastfeeding include a perception that breast milk was not satisfying their baby, or that their baby had lost interest in breastfeeding and started to wean. Circumstances surrounding work and parental leave also play a big role in the choice to bottle feed, according to a 2012 report in the Review of Economics of the Household, with an earlier return to work going hand-in-hand with a shorter duration of breastfeeding.

Some women like Brooke Clevenger, a new mom from southern Missouri, had no choice but to seek out alternative feeding methods because a medical emergency kept her from breastfeeding. At eight weeks postpartum, a gallstone landed her on the surgical floor of a hospital for more than a week, forcing her to undergo two surgeries.

“By the time I could pump or breastfeed my daughter without writhing in pain, I could barely express a drop of milk,” she said. “My supply was completely gone!”

Yet that hasn't stopped social media from fueling the rise of "lactivism," or moms and health experts strongly advocating for breastfeeding over bottle-feeding. While the so-called "mommy wars" encompass a wide range of issues, with intense debates raging on everything from cloth diapering to co-sleeping, the formula-feeding versus breastfeeding debate refuses to die.

This month, for instance, spawned the rise of "tree of life" selfies, in which breastfeeding moms used filters to connect their babies to their breasts. Many bottle-feeding moms were outraged, arguing that the selfie trend shames and stigmatizes women who feed their babies formula. One parenting blogger, the Skeptical OB, even posted (and then deleted) a meme comparing the images to the Confederate flag.

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A young mother bottle feeds her baby in the 'Basma' protection unit in Casablanca on May 25, 2010. The 'Basma' protection unit provides protection to unmarried and pregnant Moroccan women or young mothers following unwanted pregnancy. Many Moroccan women's rights groups and political parties, eager to change the country's blanket ban on abortion, are lobbying Parliament for changes to the law in cases of incest or rape.

Feeding a newborn baby is not a small or insignificant decision, and when it comes right down to it, all moms want the best for their children. So it makes sense that some moms, when taking their own wellness into account, in addition to their baby’s, might come to the realization that formula is the obvious choice for their family. That's why, in response to the push to breastfeed, mothers who formula-feed are countering the "breast is best" mantra with their own message, "fed is best."

No matter the motivation for the choice, mothers around the world can be thankful that a nutritious and safe alternative to breastfeed is widely available.

"I wouldn't change my decision," Kristel Acevedo, 31, told Romper, explaining that she chose to formula feed for the sake of her emotional wellness and relief from a painful latch. "It helped me enjoy my baby more and gave me a little more freedom since I could share feeding responsibilities with my husband and other family members.”