Formula fed babies are overfed? Only if you redefine underfed as normal and normal as overfed!

Fact or Fake concept, Hand flip wood cube change the word, April fools day

Breastfeeding professionals are sure that breastfed infants are healthier than those who are formula fed.

There’s just one problem; they can’t find evidence to support that belief.

Countries with the lowest breastfeeding rates have the LOWEST infant mortality and countries with the highest infant mortality have the highest breastfeeding rates. Most of the claimed health benefits of breastfeeding have been debunked by studies that correct for the higher socio-economic status of women in industrialized countries who breastfeed. And although breastmilk can save the lives of extremely premature infants who face the deadly risk of necrotizing enterocolitis, breastfeeding professionals can’t point to the lives of any term babies who have been saved.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Calibrate infant growth charts to keep infants out of the hospital, well hydrated and not suffering brain injuries and deaths.[/pullquote]

To the horror of breastfeeding professionals, the scientific evidence shows that formula fed infants are equally healthy to breastfed infants.

What to do? Change the definition of healthy by altering infant growth charts!

That’s just what breastfeeding professionals have done and it’s working … sort of.

The headline from the BBC is typical, Too many babies overfed, experts fear.

It’s time to tackle over-eating from birth to make sure children get the best start in life, according to Public Health England.

It comes as government advisers publish new guidance – the first in more than 20 years – on feeding babies.

That report suggests three-quarters of UK babies and toddlers may be eating more calories than they should.
The same proportion weighed more than the ideal weight for their age, when plotted on growth charts.

The data comes from the Infant Feeding Survey and the Diet and Nutrition Survey of Infants and Young Children carried out in 2010 and 2011.

It’s long been known that breastfed babies and formula fed babies grow differently.

According to the CDC:

The WHO growth charts establish the growth of the breastfed infant as the norm for growth. Healthy breastfed infants typically put on weight more slowly than formula fed infants in the first year of life. Formula fed infants gain weight more rapidly after about 3 months of age. Differences in weight patterns continue even after complementary foods are introduced.

Previous standards evaluated growth based predominantly on formula fed infants since most infants were formula fed at the time they were developed. Many breastfed infants were diagnosed as underweight using these charts. Breastfeeding advocates claimed that it was wrong to evaluate breastfed infants using formula fed infants as the standard.

They had a point, but it’s not clear that it was a valid one. It’s based on the assumption that every breastfed infant is fully fed when the reality is that breastfeeding has a significant failure rate and some breastfed babies are actually underfed. Far fewer babies receiving formula are underfed since they can eat until satiety instead of merely until the milk runs out.

The WHO charts purportedly show “how infants and children should grow rather than simply how they do grow.” But they don’t measure how infants “should” grow, they measure how breastfed infants, including underfed infants, grow. It’s a classic example of the naturalistic fallacy: if something is a certain way in nature, that’s how it ought to be.

This sleight of hand is only sort of working. Sure, it makes for great propaganda but it doesn’t change the fact that breastfed infants are suffering alarming rates of health problems due to insufficient breastmilk.

Breastfed infants are readmitted to the hospital at double the rate of formula fed infants. They are readmitted with hypernatremic dehydration, severe jaundice and hypoglycemia. In the US that translates to literally tens of thousands of hospital admissions each year at the cost of hundreds of millions of dollars. Brain injuries due to insufficient breastmilk are rising and infants are dying. Additional hundreds of millions of dollars of liability payments are being made.

In other words, redefining underfeeding as normal doesn’t change the fact that many breastfed babies are suffering gnawing hunger, dehydration, brain injuries and deaths.

I have a better idea:

Calibrate infant growth charts to keep infants out of the hospital, well hydrated and not suffering brain injuries and deaths.

If we don’t, we will continue to sacrifice the health of tens of thousands of infants each year to breastfeeding professionals’ increasingly desperate efforts to make breast SEEM best.

  • Shawna Mathieu

    Interesting that we’re supposed to believe nursing babies on demand instantly know when they’re full and stop eating, but formula makes babies into binge eaters. I guess they’re going to pretend people don’t formula feed on demand.

  • The fattest babies I’ve seen in my career were the breastfed ones who used Mother as a pacifier and thereby virtually noshed non-stop. The breast is constantly producing a dribble of milk.

    • Charybdis

      Nuh-UH!! It’s impossible to overfeed a breastfed baby because *reasons*! /s.

      I’ve never understood the whole comfort nursing thing. I didn’t offer DS a bottle or sippy cup of formula or milk every time he whimpered/cried. I would run through other soothing methods first, especially when he had been fed recently. It seems (to me) that automatically defaulting to a feeding method to “fix” a tantrum, boredom, upset or anger in a baby and even more so a toddler is teaching them that food is an appropriate coping mechanism.

      Can you imagine the outrage if bottle feeders shoved a full bottle into a baby’s mouth every time they whimpered? Oh, the humanity!

  • Kerlyssa

    who are these people who are honestly worried about infants growing too fast. it’s a bloody newborn, are they worried about its victoria secret modeling career?

    • MaineJen

      That’s my question. How in the world do you define “overweight” in a baby? My (breastfed!) son’s little legs were too fat to fit in his Bumbo seat when he was less than a year. Now he’s 8, and he’s so skinny you can see his ribs half the time. Fat as a baby DOES NOT EQUAL fat as a child/adult.

      • The Bofa on the Sofa

        Yep.

        Let’s accept, for the sake of argument, that formula fed babies do gain weight faster and are heavier than breastfed babies.

        And? So what? Does it matter? Do heavier babies have worse outcomes as they grow up?

        (I propose the answer is…no)

        My sister’s kids were huge. Her middle girl was 26 lbs at 6 months. And was EBF.

        Now, here’s the question: if gaining too much weight is really a problem, should fast gaining breastfed babies be put on restricted diets? The answer is, obviously, no.

  • aurora

    I have never seen the WHO as an authority on anything.
    My son happily drank his formula and slept like a happy camper in the hospital, while the babies next door were screaming for 3 days straight (hunger)? We were back to birth weight before being discharged.

  • MelJoRo

    This issue is of particular concern to me right now as my breastfed infant was born at 45% for weight and 65% for height, and now at 5.5 months is at 20% for weight and 99% for height. His pediatrician is consistently not concerned, saying that babies don’t always settle into a curve for a while (which makes sense, especially when you consider that birthweight is more a condition of the mother’s pregnancy than baby’s genetics). We have started solids, which he loves, and I have offered some extra bottles as a top off which he sometimes takes but often rejects. I know his Ped isn’t A lactivist, but I wish I had a better way to know he was getting plenty to eat. As an FYI, he sleeps well and his behavior and development are all normal, so I know he is not starving. This trend also started when I had a significant oversupply, which has finally regulated our but now o am paranoid I have an undersupply. Ugh.

    • demodocus

      *hugs* If the ped isn’t concerned and munchkin is clearly eating his fill, then he’s fine. He’s just the greyhound model. His regular refusal of top offs is a hint. *hugs* hard for parents not to worry about every little thing.

      • MelJoRo

        Thanks. I wasn’t so concerned until he started to demolish any solids I put in front of him, like he was so hungry. But I think he may just be incredibly excited to eat from a spoon. Today he even ate straight breastmilk off a spoon when we ran out of his portion of cereal and he clearly wanted to keep eating. Earlier he refused an extra bottle, so it seems like the new way to eat is the favorite. I am glad that I can start getting some more calorie dense foods into his diet through solids to alleviate some of my concerns.

        • Mel

          LOL! Yeah, I think your little guy was excited about eating like a grown-up!

          When my son was working on erupting his lower canines at 15 months, he was crabby as heck one day. He wasn’t eating anything on his high chair tray and I assumed that he wasn’t able to pick up the flavored (overcooked) rice and beans since they were so small so I grabbed a baby spoon to feed him with. Spawn screamed at me then began sobbing. I put the spoon on the tray and started to comfort him. He threw the spoon on the floor, grabbed a handful of rice and beans, and shoved it in his mouth while giving me the most baleful look I’ve ever seen.

          I apologized for trying to feed him like a baby. He was mollified.

          • demodocus

            Really, Mommy! Don’t you know -anything-? lol
            I get ya

    • Mel

      My son pulled something similar to that at about 4-6 months. He’s skimmed between the 10th-20th percentiles in weight and height since birth (and after nine months), but he gained some weight at around 4 months that moved him up into the 40th percentile of weight at four months, then dropped his weight percentiles as his height jumped…and then settled back into his 10-20th percentile land.

      Giving him solids and offering top-off bottles as well as breastfeeding means that he’s got plenty of opportunities to eat a day – so if he’s rejecting them, he’s getting plenty to eat. (I chanted that to myself when my little guy was tossing food left and right off his high chair instead of eating and I was having mama-anxiety about if he was getting enough calories for his lungs to heal. And he was getting plenty of calories.)

      I knew a woman who found out she had inadequate supply when her daughter was a bit younger than your son. Her daughter was cranky all the time, seemed to be trying to nurse all the time, woke super-easily from naps and night sleeping and just seemed miserable. When offered a bottle after breastfeeding in response to a pediatrician’s concerns about her weight loss, the baby guzzled the whole thing then fell asleep for hours. She went from being a very hard to comfort baby to an easy baby.

      • MelJoRo

        The top up bottles are a recent response to the seeming hunger when eating solids. I have tossed an insane number of bottles in the last 5 months because my husband loves to insist baby is starving as soon as I leave/attempt to do anything..so I was kind of over pumping for bottles for a while. I am glad to hear though that my thoughts on his happy attitude and long sleep stretches are in line with your experience. My husband and I are both thin, and were as children (I was formula fed and husband was breast fed, neither of had many rolls) so it is probably just genetics. I will say though that his enthusiasm for solids is rather fun!

    • Jessica

      Not to feed the paranoia but my daughter was the same way (95th for height 14th for weight) and jumped to 50th for weight within a month of starting formula. So I think she was underfed. But there were other signs. School saying she wanted another bottle. Not being able to pump as much as I had 2 months earlier. Her fussing after feeds instead of falling asleep. Just keep an eye on him and follow your instincts. (My daughter btw is totally fine at 3, great health, bright, sociable. So no lasting harm done even if she could have done with a few more calories in the interim.) You might try topping off more at night or higher calorie snacks (I mixed peanut butter into purees so it was soft enough to eat without risk of choking).

      • MelJoRo

        Thank you for sharing. I am glad there were no lasting effects, but I am sorry you had to go through that. We start daycare next month and in some ways it will be nice to see the quantity he eats from a bottle each day. I decided to add a power pumping session in the evening for a few days to see if my supply comes up a bit. Worst case is I get a bit more for the freezer, and best case I have a bottle to order him an ensure he is eating plenty. We occasionally feed formula, but but he seems to reject those bottles more frequently, so for the sake of my “extra food” experiment I am trying to offer more breast milk. He has also eaten peanut butter and eggs now, so I am offering those both with his fruit and veg and baby cereal as they are a bit more calorie dense.

        • Jessica

          I am sure he will be absolutely fine!

  • maidmarian555

    So a couple of weeks ago, my son had his 2yr checks with the Health Visiting Team. For some utterly incomprehensible reason, they worked out his BMI, which placed him squarely in the ‘overweight’ category. The HV said to me that over 90% of the children they see for the 2yr check are classed as ‘overweight’ or even ‘obese’ by that standard so they don’t worry about it, they just look at what centile they’re on and whether that’s ‘normal’ for them. He’s in the 75th centile, which is the exact one he was when he was born. It’s no bloody wonder Public Health England think all our babies are fat if they’re using a way of measuring that which clearly isn’t very useful for toddlers. They recorded that BMI and no doubt the data is then used to inform public health campaigns somewhere down the line. Even though they outright said it’s a useless measure. It’s batshit. Utterly batshit.

    • Mel

      My son’s pediatric health team’s computer automatically works out his BMI every time we visit – but it doesn’t seem to work right for infants so even when my son was at <1 to <3 percentile on height and weight for his birthdate, it would still flag him as having a concerningly high BMI.
      That was always ironic because doctors who look at him always describe him as skinny to slender. The phlebotomy team was super-excited when he finally got "baby chubby thighs" at about 4 months.

      • maidmarian555

        I can’t fathom why they bother to measure it if it doesn’t ‘work’ as far as infants and toddlers go. I mean, it’s contentious as a measure for adults and as far as I was aware it’s nowhere near reliable as even an indicator of whether a person is overweight or not until at least somewhere in your teens. My son is a bit of a chunk but he’s tall. I remember after he was born talking to my HV and she said they *know* when they encounter children that are actually too heavy because it causes mobility problems. She was saying they do see (a very small number of) children who can’t crawl or get themselves up because they’re simply too heavy.

        My daughter is now 10months old and has been on the 25th centile since she was born. She looks like a rake compared to my son but I honestly believe if you kept bringing her food at lunch she would happily just sit there eating forever. My son is more or less indifferent to food and often only eats a few mouthfuls at mealtimes. It’s almost like some kids are heavy and some are not and it’s not just a simple case of what or how much you feed them! Obviously that does factor in to an extent but it’s so much more complex than that.

      • The Bofa on the Sofa

        Our doctor’s office didn’t even start to calculate BMI until the kids were 2 yo

    • demodocus

      Ludicrous. Ours adds it to everybody’s charts regardless, but the docs ignore it if you’re a little kid or pregnant.

    • Madtowngirl

      My daughter had her three year old check up last week, and her BMI was “high” but her weight was somewhere in the 40th percentile. She’s definitely not overweight, and is actually a bit small overall for her age. The biggest reason for it being off had to do with it being so difficult to measure her height (she was not a fan of standing against the wall). So, yea, it is a pretty useless measurement at this stage.

    • MaineJen

      My friend just got told her 4 year old was “obese.” We both just rolled our eyes at each other. The fat hysteria is out of control!!

      • maidmarian555

        Wtf??!! It’s insane, isn’t it?

      • It doesn’t even work for adults. I’m “Obese” in Size 6 pants. Comfortably. How is that even a thing?

        • MaineJen

          If you’re shorter or taller than average, I don’t think BMI works as well.

          • I’m waaaaay shorter than average. You’d think that would make it go the other way…

    • BMI is increasingly being abandoned as a good indicator of overweight. I would be especially leery of it when applied to infants and small children, there is so much variation in their sizes.

    • cookiebaker

      My oldest son was always in about the 35th percentile for height and the 75th for weight. According to those numbers, he should have been a little round butterball, but he was skinny! He was a busy, active, somewhat wild kid and if I didn’t buy slim jeans and cinch them tight they’d fall down. He was just really muscular. My pediatrician never said a word about his BMI. Now he’s 16. He’s tall, lean and an incredible athlete.

  • Jessica

    My daughter was breastfed for 6 months, then formula fed due to CMPA. She was 14th centile while breastfeeding, jumped to 55th on formula. Today at 3 she is around 50th. My takeaway–she was UNDERnourished on breastmilk, probably due to the allergy. My son, on the other hand, had enough milk. We switched to formula at 4 months and he has maintained his curve (65th centile) exactly.

    • lawyer jane

      Very similar here. Bumped between 5-15% percentile until 6 months, then rocketed to 75% percentile from 6-8 months when we added in some hypoallergenic formula and solids. May have been due to allergies, or just to getting more calories, unclear! But what is clear is that he was NOT thriving on breastmilk alone.

  • The Bofa on the Sofa

    It’s based on the assumption that every breastfed infant is fully fed when the reality is that breastfeeding has a significant failure rate and some breastfed babies are actually underfed.

    Yep, this is what I pointed out the last time this issue was brought up. On what basis can you rule out the possibility that breastfed babies are not, on average, undernourished?

    Maybe formula feeding is what they should be doing instead?

    It is important to note that the higher weight for formula fed babies as infants does not manifest itself in the long term (see PROBIT)

    • swbarnes2

      Even if the PROBIT study hadn’t shown that, there probably is a genetic, and therefore hereditary connection between insulin resistance and not making enough milk (fenugreek, for instance, can frack around with insulin sensitivity)

      So sure, you might expect there to be a smidgen more overweight and obese bottlefed babies for that reason. But it’s not because of the formula, it’s because of the genetics that kept mom out of the exclusively breastfeeding club that kid inherited that manifest in higher weight.

  • demodocus

    *snort* My daughter and a friend’s daughter are 2 months apart. At 25 and 23 months, they are both healthy and thriving, even if one is in the single percentiles and the other in the 90s. Both are formula fed. My girl is a bit stockier than average and the other girl is a bit skinnier. Their respective peds are happy with the toddlers’ growth. They’ve been holding steady on their arcs for over a year. They just take after their families; one family has several 6 footers, even a couple women, and the other is fairly small.

    • Kelly

      Exactly. My first two daughters were night and day in terms of weight and height. One takes after her dad’s side which are thin and short and my other takes after my side where the babies are born normal size, get massively chunky, and slim way down to skinny and average height kids. It’s hugely genetic even within the same families. My second ate almost 40 ounces of breast milk a day and was a chunk and while she still has a huge appetite, she is slimming down fast.

  • MI Dawn

    I remember my kids being plotted on the growth charts. Because they were a bit preterm and I was pre-eclamptic both times (37 and 36 weeks, respectively), they started on the low end. I exclusively breastfed for 4 weeks, when they started to creep up in percentiles. I combo fed for another 4-6 months and they maintained the same growth. When I went to bottle feeding only, they went up maybe 1-2 percentiles and stayed there.

    The problem I as see it, is that a bottle is “visible” liquid, and so many people hate to throw away anything left in it so they encourage the baby to finish the bottle. We need to teach parents that babies will eat to saiety, so once they stop eating, let them stay stopped, not encourage additional eating. THAT puts on weight. Not the formula itself.

    • Yes! I remember looking into this issue when exclusively pumping, and often I found it quite difficult to differentiate between when this was considered “breastfeeding” and “bottle-feeding.” It didn’t really make a difference–all three of my kids gained a lot of weight in the early months, then slowed way down (including my daughter, who received formula from about 9 months on).

      • Their growth slows down, too, at about that age, so they are less hungry, and solids make them feel satiated forlonger.

    • Dani G

      My daughter was combo fed for first 8 weeks and then exclusively formula fed after that up to a year.

      I don’t understand how people think a parent can force a baby to finish a bottle. When my daughter was full she simply wouldn’t open her mouth to take the nipple. She spit up fairly infrequently as well. The idea that formula babies can be made to overeat feels like a lactivist trope that is not remotely in line with my experience. My two cents.

      • The Bofa on the Sofa

        I don’t understand how people think a parent can force a baby to finish a bottle.

        My older son was combo fed. Like, literally. I gave him a bottle that was a mix of formula and breastmilk. I would make 7 oz. He usually left an oz behind.

        If he didn’t want it, he didn’t eat it.

      • Mel

        My son was good at locking his jaw shut on a sterile Q-tip with colostrum at it at 26 weeks gestation to be damn sure that we didn’t take it away before he had sucked every bit of colostrum off that Q-tip.

        Needless to say, by the time he reached real newborn size, he would give us a “Seriously, I’m done” look and re-lock his jaw when he was done

        By six months, he had learned how to smack a bottle away with one hand when he was done…..

        As a toddler, he’ll wrestle the sippy cup free and pitch it over the side of his high chair……

        He’s been pretty much formula fed since a few weeks past his due date – and he’s got a slight build. Since my maternal grandparents were a whopping 5’5″ and 5’0″ (and we think they both rounded up on the heights), and my brother who is 5’9″ has always been about 15 pounds underweight (even when trying to gain weight), we figure he’s following his own growth curve.

    • It’s really not easy to overfeed a baby. They stop sucking, fall asleep, push the nipple away or start chewing or playing with it. Try and force more in, and they will generally throw up. However, over time, one can gradually convince an infant to take a “little” more, and it can add up.

      • MI Dawn

        Exactly. It’s not easy, but I recall even from my days working in the newborn nursery having to educate parents and grandparents that baby is full when they stop sucking. They do not need to finish a bottle, so please don’t “encourage” them by squeezing the bottle nipple in their mouth.

        It was a lot easier in the nursery, since the parents weren’t paying for the bottles or formula. Enforcing that information at home was a lot harder.