Infant Feeding Hierarchy and Terminology

This post was originally published Feb 16 2010 on cafemom. I'm posting here and now because I'm sorry that I haven't posted this month and it's my apology. Having a newborn and two older kiddos is time-consuming!

As I write this, I realize this is a touchy subject for some. First off, understand that this has nothing to do with the choice you made or had made for you (I have formula feeding friends and no problem with that) nor you as a person; this is only about the substances involved. If you are here to start a debate, please stop reading now.

Fist, we've all heard "Breast is best." That's a universally accepted truth, right? No. Too many people misunderstood that message to think that breast milk must therefore somehow be something more than the norm, so the message has been changed to, "Breastfeeding is the standard."(1) However, even using the original message, we can come to the same conclusion--that cow or soy based infant formula is an inferior feeding method. The formula companies acknowledge this freely (usually when defending themselves in court) despite their advertising. 

So here's we're going to explore the "Breast is Best" language. Best, as we know, in the "good" hierarchy, is the top. It is better than better, which is better than good. Well, infant feeding has a hierarchy as well. (2) It is listed as:

1. Milk at the Mother's Breast2. Mother's Pumped Milk in a Bottle3. Donated Milk from Another Mother
4. Infant Formulas

So, using this, we can apply it to the language hierarchy in which the word "Best" appears. This would mean, mimicking the list above:

Best: Milk at the Mother's Breast
Better: Mother's Pumped Milk in a Bottle
Good: Donated Milk from Another Mother
... : Infant Formulas

Well, what comes below good? Well, automatically, we would say that going down the same catalog, what would come next is either "worse" or "bad" (considering that bad takes the place of good in its pyramid, then is followed by worse and worst). However, I think we can skip the first, but to avoid applying "worst" to the next in the list, let's expand it.

Best: Milk at the Mother's Breast
Better: Mother's Pumped Milk in a Bottle
Good: Donated Milk from Another Mother
Worse: Infant Formulas
Worst: Cow's milk

So, the same conclusions are drawn from either terminology. Even if Breast is Best, that does not make formula "good" or even the next alternative. Although this is the not the first journal to create this hierarchy, another (3) is in reference to preterm infants, which actually lists formula as worst:


Breast is Best, breast is standard. Formula was designed as a medical option for infants who could not breastfeed either due to one of three extremely rare conditions or for the less than 2% of mothers who physically cannot produce enough milk or the less than 5% who, for other medical reasons, cannot breastfeed. Regardless of personal psychological response, the next best option for ALL babies, is the milk from another human mother. After all, why would we equate feeding our child milk produced from this:








As superior or even equal to the milk specifically created for this?:

Photo by of Blessed Life Photography

 Doesn't any healthy mother want the best for their child? So why don't we advocate more strongly to provide alternatives to the "fourth best" AKA worse, option to breastfeeding for mothers who either can't or don't want to nurse their babies? Why do we spend more time trying not to offend their choice to use the only option they believe is viable or obtainable instead of working to give them MORE options? Better options?

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(1) Watch Your Language by Dianne Weissinger
(2) UNICEF, WHO, UNESCO: Facts for Life: A Communication Challenge. New York: UNICEF 1989; p. 20.
(3) Global Health Policies that Support the Use of Banked Donor Human Milk: A Human Rights Issue.
Further reading:
4. Enterobacter Sakazaki and other microorganisms in powdered infant formula
5. What Every Parent Should Know About Infant Formula
6. The Deadly Influence of Formula
7. Human Milk Banking
8. Nutrient By Nutrient Why Breast Is Best
9. Nutritional Information for Human Milk