Why are breastmilk and formula not the same?

Is formula the same as breastmilk?   


There are some people out there that argue that there is no difference between breastmilk and formulas now that so many “improvements” in formula have occurred.  At the biochemical level, formula is not the same as breastmilk, not even close. If you take a look at a can of formula and the list of ingredients, it is patently obvious that breastmilk contains at least 20 times more “ingredients” than formula. Breastmilk contains live cells, stem cells, white cells, immune factors and antibodies which cannot be added formula and that’s just the beginning. In every other situation people would readily admit that powdered milk which is then re-constituted with hot water is not the same as fresh milk.


Formula and breastmilk are not at all the same, not even close.


Formula company advertising has tried to convince parents for years that their formulas are the same are the same as breastmilk.  Photo 1 shows an ad, probably from the late 1890s or early 1900s, which states, in French “Artificial Milk Feeding”, using the word normally used for “breastfeeding” (allaitement).  Sneaky no?


Help with breastfeeding



Formula just like mother's milk?

The makers of this formula believed that it is exactly the same as mother’s milk.  Really?  Did they really?



















And what else does it say?  “le seul lait stérilisé identique à celui de la femme” : The only sterilized milk identical to a woman’s milk!!!!


So by the beginning to the 20th century, formula was being advertized as just like breastmilk. This has always been essential to formula company advertising because otherwise it would be difficult to convince people to use formula not only in situations where it is medically indicated but also massively and unnecessarily as it is used now.  Formula being “just like breastmilk” has even become a way to compete among different formula brands using words like “closer to breastmilk than ever”.


What does the next photo tell us?


Formula is not breastmilk

Formulas are “improved” all the time but never equal breastmilk



















It states that “our formula” has been around since your great great great grandmother’s time and then goes on to list all the improvements since that time.  But this ad was printed in the 1990s before:


  1. DHA (docosahexaenoic acid), and arachidonic acid (ARA) – compounds which have always been in breastmilk, which have not been added to formulas until recently and which now that they have been added have been found not to have the same effect as when they are in breastmilk.  Because just adding stuff to formula doesn’t mean it works in the same way as the ingredient works in breastmilk.
  2. The protein content of formulas was reduced and even at this time formulas still contain too much protein.
  3. Before nucleotides were added to formula (they made a big deal out of this too, though the importance of nucleotides in formulas has yet to be shown to do much of anything at all).
  4. Before oligosaccharides, the famous prebiotics, that formula companies have made such a big deal about in the last decade. Oligosaccharides has always been in breastmilk
  5. Before probiotics which mothers are buying by the handful. Breastmilk always contained probiotics.
  6. Before most “special formulas” were made for things like spitting up and “allergy”.


Think about what this means.  It means that formulas that were touted as “just like breastmilk” in the 1890s as well as 1990s  was “improved” by all sorts of changes since then.  It means that if these changes were so important to babies’ health, then what about all the babies who received “unimproved formulas” all the way back to your great great great grandmother’s time?  These formulas were inadequate, even harmful.


And what about all those hundreds of other compounds in breastmilk which have not been added and which will never be added?  And those compounds yet to be discovered.  Breastmilk is a very complex, living fluid and we are just beginning to understand how complex as we discover new ingredients.


Let’s start off by saying that a mother’s milk is unique, depending on that mother and that baby


Yes, it is true, every mother makes milk which is different than any other mother.  That is because like all physiological fluids (blood, for example) milk varies from person to person.  As an example, the amount of sodium in your blood may vary quite widely, normally, by as much as 15%, depending on how thirsty you are, how much sodium was in your lunch and other factors as well.  That’s just one example.


We know also that colostrum, the first milk, is very different to the later milk.  Very different.  Yet formula companies and many doctors tell us that formula is a good milk for babies to drink during the first few days.


Aside from the much heralded nucleotides, formulas contain no antibodies.  But antibodies are only one of many immune factors that are present in breastmilk that are not present in formulas.  Breastmilk contains lactoferrin that is so important to immunity that the formulas are jumping on the lactoferrin bandwagon to discover how to include it in their products.  And breastmilk also contains these immune factors: lysozyme (and enzyme that attacks bacteria and kills them by destroying their cell wall), mucins, lactadherin, bifidus factor and many others.  And probably many others are yet to be discovered.  These immune factors do not just sit there, they work together, in a beautiful cooperation, like the instruments in a symphony orchestra, to protect the baby according to which bacteria, viruses or funguses the baby may be exposed to.  Even if the immune factors could be added to formulas, they would not have this “cooperation” as they cannot react to infection, because it’s the mother, through her breastmilk who produces these immune factors in response to infection.  Breastmilk is a living, dynamic fluid.


Breastmilk has alpha lactalbumin, which in the presence of fats in the body, is changed to HAMLET (human alpha lactalbumin made lethal to tumour cells), no relation to the Prince of Denmark, which exercises broad anti-tumor activity against many different type of cancer and lymphomas


And breastmilk varies from morning to evening, from day to day, from week to week. Because of this, it will never be duplicated by any formulas.


Furthermore, breastmilk is full of anti-inflammatory factors, which decrease inflammation.  Inflammation, on its own, can cause tissue damage and inflammation occurs in the presence of the battle of immune factors against bacteria or viruses.  Because of the huge numbers of “good” bacteria in the intestines, breastmilk prevents this inflammation which normally would occur when immune factors fight microbes, saving tissue damage of the gut, and probably one of the reasons breastfeeding premature babies are less likely to get a serious, potentially life-threatening condition called necrotizing enterocolitis.


There are dozens, if not hundreds of immune factors and other important components in breastmilk that are not present in formulas.  Just to mention two more; one, an important recently discovered immune factor: milk fat globule membranes.  Oh, this is hot and the formula companies are working feverishly to include milk fat globule membranes into their milk.  If they ever manage, they will tell us how important this immune factor is, hoping we will forget that all the other formulas before the new one didn’t have milk fat globule membranes.  And the other? Stem cells, the mind boggles thinking how stem cells in breastmilk could be used to help in clinical medicine.


But see my article in Scientific American from 1995 .  The article explains how breastfeeding protects babies against infection and why it is important to keep babies breastfeeding when the mother has an infection, including the common infection I get emails about all the time, methicillin resistant Staphylococcus aureus (MRSA).  Yes, the sick mother protects her baby if she continues breastfeeding.


Also hot these days is the microbiome, all the bacteria that are part of you.  Formula fed babies and breastfed babies have different bacteria in their intestines and elsewhere.  And what difference does it make? The microbiome may determine the child’s:


  • Development including neurological and cognitive development
  • Immune function
  • Protection against various pathogens
  • Digestive function
  • Stress levels
  • And who knows what else?  We are just beginning to plumb the secrets about the difference your microbiome makes


As one article suggests


  • “We are only beginning to appreciate the potential health benefits that could be accrued from this venture across diagnostic, preventative and treatment realms. We look forward with great anticipation to this transformed appreciation of how our microbial wealth during early life primes for health in adulthood.”


Are there things in formula that should not be there?


Of course, here is a quote from an article about aluminum in formulas. Shelle-Ann M Burrell, Christopher Exley. There is (still) too much aluminium in infant formulas BMC Pediatrics 2010; 10:63.  These authors are not crazed breastfeeding radicals.  In their article, they write “Infant formulas are integral to the nutritional requirements of preterm and term infants”.  Well, I disagree with infant formulas being integral to the nutritional requirements of preterm and term infants. Breastfeeding is integral, yes, but not formula.  But then they go on to say “While it has been known for decades that infant formulas are contaminated with significant amounts of aluminium there is little evidence that manufacturers consider this to be a health issue. Aluminium is non-essential and is linked to human disease. There is evidence of both immediate and delayed toxicity in infants, and especially preterm infants, exposed to aluminium and it is our contention that there is still too much aluminium in infant formulas.”


For those who are fond of exotic foods, infant formulas have been found on occasion to contain:


  • Rat hair
  • Beetle parts and beetle larvae
  • Pieces of glass
  • Melamine—due to adulteration of milk by greedy people


Do humans make mistakes?


Of course they do.  And over the years there have been dozens of recalls of formula due to mistakes made in the manufacture of formula.  Here is just one example:

Mistake in making formula

When mistakes are made, it can be very serious for the baby.


















































So? Formula just like breastmilk?


What an incredible statement.  Anyone who says such a thing is either completely ignorant of the biochemistry of breastmilk and formula and doesn’t know what they are talking about or is plain saying nonsense for political reasons.  And if formulas and breastmilk are that different, then they have very different effects on the baby and the mother.  Just pretending it ain’t so doesn’t make it so.


And these differences do not make a difference for the baby or the mother?  Seriously? Here is the truth:  You don’t take the normal, physiological and have to prove that it is better than the artificial.  Formula feeding is an intervention, and in medical terms, you have to prove an intervention safe before it can be recommended as routine us, as in infant feeding. In fact, most women these days “cannot breastfeed” because they are undermined in their ability to do so.  Hospital routines around labour and birth, separation of mothers and babies, early introduction of bottles and poor advice from health professionals results in most mothers who “cannot breastfeed”.  If they had normal births, and good help from the beginning, most such mothers would be very successful breastfeeding.


And one more thing, last but certainly not least.  The act of breastfeeding is different from bottle feeding.  Breastfeeding is a close intimate, physical and emotional relationship between two people in love.


Need breastfeeding help? Make an appointment at our clinic.

  • Vanessa

    July 19, 2017 at 4:01 pm Reply

    Yet no real world evidence that breastfeed children and adults are any healthier than formula fed. Pick apart who was formula fed and who was breastfeed among a group of kindergarteners or middle school or high schools kids. You won’t be able to because there is NO difference. How dare you tell bottle feeding parents that there relationship with their children is in any way different only because their child’s mouth was not sucking on their nipples? Oh yes I know , your whole income depends on convincing women breastfeeding is the epitome of being a good mother and having healthy children. Disgusting.

    • Jack Newman

      July 19, 2017 at 4:10 pm Reply

      People read what they want to read don’t they? There is nothing in this blog that says anything about breastfed children being different or healthier, though you are wrong, they are. There is, in fact, lots of evidence that not only the children are healthier, so are their mothers. But this article says only one thing: that the statement that formula is the same as breastmilk is completely false and could only be made by someone who doesn’t know what they are talking about. So don’t take offence. Try reading for a change instead of getting on your high horse and saying that I write such things so I can make money. I would make a lot more money being a regular pediatrician.

      • Suzanne Barber

        July 21, 2017 at 11:02 am Reply

        Nicely put Jack! Probably another mother here who has been failed by lack of appropriate feeding support and evidenced based advice wearing a badge of guilt for feeling that she failed her child by bottle feeding.

      • Barbara

        August 13, 2017 at 4:27 pm Reply

        Thank you for your important work!

  • Sarah Miller

    July 22, 2017 at 6:37 am Reply

    Nice attack on a mother Jack, kudos. No one is going to argue that formula and breastmilk are the same. But formula is a wonderful option for mothers that allows them to feed and love their babies when breastfeeding isn’t possible. Don’t even try and tell me that some people don’t get the right support as I had 3 sessions with LCs trained under you and they failed me drastically so I happily supplemented with formula. After 12 weeks of no support, just patience I now exclusively breastfeed – so again, don’t tell me this is related to my own issues. No issues here, just a massive BS radar.

    • Jack Newman

      July 22, 2017 at 7:15 am Reply

      Every time one writes something about breastfeeding, it’s taken as an attack on mothers who didn’t breastfeed. And so, we cannot say anything and things will never improve because people are afraid. The comments on my post, some of them were so vicious and hurtful that I had to ban the authors. No one argues that formula and breastfeeding are the same? The video that prompted the blog actually says so in so many words that formula and breastfeeding are the same. And many many of the comments on my Facebook post say it’s the same, and that I have no scientific proof that they are the same.

      As for your experiences with lactation consultants, actually most are good but many are not and I cannot answer for them. Furthermore, you are now breastfeeding exclusively? Well, if you can do that at 12 weeks, then you could have done it from day 1 had you had GOOD support and help.

      • Barbara

        August 13, 2017 at 4:28 pm Reply

        True!! Thank you Dr N!

  • Sarah Miller

    July 22, 2017 at 12:43 pm Reply

    Okie dok Jack…

  • Barbara Hein Hall

    August 3, 2017 at 9:50 am Reply

    Wonderful presentation with evidence based information!
    Thank you!

  • Nicole

    August 16, 2017 at 1:18 pm Reply

    I’m considering giving a bottle of formula 1-3x/week so I can get back to the gym. I need to get back for my emotional and physical well-being.

    I’m on Domperidone 12/day, blessed thistle & fenugreek (recommended 9/day), brewer’s yeast and flax in my oatmeal 1/day, tons of water, lots of calories. I’ve been to the lactation Doctor multiple times, and babe had posterior tongue tie clipped at 3 weeks.

    I pump max 1 oz/day. So if all goes well, I have a 4-oz bottle once a week. Very likely less.

    Sometimes I’ll be dropping off a sleeping babe at gym daycare, but sometimes I won’t.

    Am I harming my little one with a bottle of formula 1-3x/week? She’s 7 weeks and has been EBF since day 1. I am conscious, yet still feel guilty, that I am harming her if I don’t get back to gym and take care of me, too.

    So far, she’s not had an issue taking a bottle from dad and going back to breast 1x/week.

Post a Comment