So, Which is Easier, Breast-Feeding or Formula-Feeding?

All right! Now that vacations out of the way and I can get back to a more regular blogging schedule, let's talk about that breastfeeding survey! I asked you to fill out a short, 10-question survey about your own exposure to infant feeding and your feelings about which is easier. I was actually fairly surprised by the results, and I think you might be as well.

I received 26 responses, not including my own. If you'd like to respond and haven't yet, I'll leave the survey up for a little while longer. I can revisit it in a few months and see if a greater number of responses alters or reinforces my conclusions.

The first two questions asked whether, in your experience or observation, breastfeeding and formula feeding are "very difficult, difficult, manageable, or easy." The majority of you answered, for both questions, "manageable," which was surprising to me. The second most popular answer for both questions was "easy." Overall, it seems infant feeding in general, be it by breast or bottle, is not considered a great challenge. Many responders felt the need to clarify or justify their responses by adding comments that different variables may affect their feelings, such as whether they work outside the home (making breastfeeding more difficult), or by stating that even if they thought breastfeeding was difficult, it's still worth doing. Two responders who felt formula feeding was difficult commented that it was because of all the bottle-washing.

And what do I think? I think formula feeding is very easy, if you have a baby who tolerates regular formula. I also think breastfeeding is easy, but there is a greater learning curve. I also think breastfeeding is not easy for everyone, for various reasons ranging from a physical problem with creating enough milk, to emotional difficulties, to a baby with physical or medical problems. All-in-all, having done both, I am going to come out and admit that formula feeding is easier in many ways but that I prefer breastfeeding on the whole.

The third question asked if you know how to properly prepare formula. I asked this because I think most people think they know how, but they may not be aware of the official guidelines to prevent bacterial contamination. The majority of you say that you do know how to prepare a bottle of formula properly. Certainly, preparing a bottle is not rocket science, but I was curious to see how confident we all were about our bottle-preparing skills. For the record, I knew the basics (how to measure, how to sterilize/sanitize bottles and nipples, how to warm the bottle). Some health authorities recommend boiling the water prior to use and not allowing it to cool below 70 degrees Celsius before mixing it with the formula powder. It is important to note that powdered formula is not sterile and is not safe for use with very young babies or babies with immune system compromise. Ready-to-use formula is sterile (but also considerably more expensive).

To contrast this, I then asked whether you know what a proper latch should look like when breastfeeding. Most of you say you do know, which is encouraging. The important thing to remember about your baby's latch is that it should feel right. However, if you're looking from the outside, your baby's lips should be flared outwards. The nipple should fall far back in the baby's mouth, so that a good section of the areola is in the baby's mouth as well. Many lactation consultants will advise you to try for an "asymmetrical" latch, meaning that the baby's lower jaw is closer to your chest than his upper jaw. The baby's chin should not be tucked into his chest, and his ear, shoulder, and hips should be in a straight line - his body should not be twisted, and he should not have to turn his head or strain to reach the nipple.

It really got interesting after this. The next four questions asked you specifically about your exposure to formula and breastfeeding aside from your own baby (if you have one). While most of you had often seen babies being fed from bottles, only about a quarter of you had seen babies breastfeeding on a regular basis. Several of you had seen bottles being prepared, and a third of you had prepared bottles for other people's babies. I was not surprised to find that there was far more exposure to bottle feeding than breastfeeding. Certainly the bottle is a pervasive symbol of babies and baby care in the Western world, especially the United States.

Finally, I asked you to decide which is easier, breastfeeding or formula feeding. The majority of you said breastfeeding is easier. Many who said that formula feeding is easier felt the need, again, to modify their responses by adding a comment that they still believe breastfeeding is better, even if formula feeding is easier.

What's interesting to me is that there was a definite reluctance to classify breastfeeding as difficult. I assume most of the respondents are breastfeeding advocates, experienced breastfeeding mothers (or their partners), or favor breastfeeding over formula feeding with their own children. If we say that breastfeeding is not easy, we may increase reluctance in giving it a try, especially among those who are specifically wondering which is really easier. Those who said formula feeding is difficult generally mentioned bottle-washing as a major turn-off. Those who wanted to comment as to what they found difficult about breastfeeding tended to allude to the difficulties associated with pumping and being "tied" to your baby.

I think this reveals a few basic issues in the "breastfeeding versus formula feeding wars." (By the way, the majority of you were not aware of this issue before becoming pregnant with your own baby.) The first is that there is still not enough general exposure to breastfeeding in everyday life. We need to see more breastfeeding in public, on TV, within our own families. Because of the strong formula/bottle-feeding culture in the United States and other Western countries, many children grow up never seeing a baby breastfeeding. Reinforcing this is baby dolls with bottles, the bottle as a symbol of "baby" in baby shower decorations, congratulatory greeting cards, baby birth announcements, and so on.

The second is that there is a perception that in deciding which feeding method to use, it matters which is "easier." I've written a couple of posts on this topic (for example, here and here). Many aspects of child-rearing are neither easy nor fun, while others are incredibly rewarding. What's important is not whether one is "easier" than the other, but which one is more beneficial to mother and child.

So is breastfeeding easier than formula feeding? In all honesty, no. It isn't. But both have their challenges, and the question is whether breastfeeding is overall more beneficial to mother and baby than formula feeding. And to that, I can say unequivocally, YES, it is.