What are the Benefits of Feeding Expressed Milk?

Providing expressed breastmilk is a wonderful choice when breastfeeding does not work out.

There are many advantages to providing breastmilk over formula. The risks of formula are well documented. They seem to be cumulative, meaning the more the baby gets, and the sooner the baby gets it, the more likely he is to experience the associated problems.

Breastmilk -- whether expressed or offered from the breast -- offers health benefits. You are most certainly reducing the increased risk of these diseases, known to be more common in formula-fed infants: sudden infant death syndrome (SIDS), ear infection, respiratory infection, meningitis, Type I diabetes, childhood lymphomas, leukemia, diarrhea, reflux disease, allergies and asthma just to name a few.

Though most research has been done comparing infants exclusively breastfed for three to six months to formula fed babies, I think it is reasonable to assume that many of the advantages of expressed breastmilk over formula are nearly the same as breastfeeding.

There also seems to be a dose-dependent aspect, meaning the more formula received, the more likely the baby is to experience the risks of formula. (Kristine, et al 2000) One study even showed that the baby’s intellect was tied to receiving breastmilk, not the process of breastfeeding, or the intelligence of the parents, as was argued in response to earlier studies.

Talk with other moms on the Exclusively Pumping message board.

On the next page find out if there is a nutritional difference between breastmilk provided by nursing and expressed breastmilk.

Is There a Nutritional Difference?

In regard to the differences between breastmilk provided by breastfeeding and expressed breastmilk, we have learned through research that some of the immune components, vitamins and fat may be lost during the storage and handling of expressed milk. (Lawrence 1994) (Arnold 1999)

I want to strongly stress that even with these losses, expressed breastmilk is much better for your baby than formula. With breastmilk, like any food, fresh is best, second to that would be refrigerated and frozen would be the next choice, though again still vastly superior to formula. To compensate for the loss of some of the components through storage and the changes that occur in the composition of breastmilk related to the age of the baby and time of day, it’s a good idea to try to provide some freshly-pumped milk as often as it is reasonable.

When a baby is nursing from the breast there can be enhanced immune response. Mothers will also start to produce specific antibodies to illnesses when exposed directly to a germ, so if there is a cold or other minor infectious illness going through your family it might boost your baby’s protection to provide more freshly pumped milk at that time.

While pumped breastmilk, provided by bottle, is not exactly the same as breastmilk directly taken through breastfeeding, it is certainly as close to breastfeeding as one can get. Breastfeeding is always considered the number one choice for all infants, with mother’s own expressed milk as a very close second choice. Banked breastmilk (though not widely available) would be the third choice, with formula coming in a distant fourth.

On the next page learn what challenges you may face if you decide to exclusively feed your baby expressed breastmilk.

What are Some of the Challenges?

While providing expressed breastmilk by bottle may reduce the frustration and anxiety of your current feeding situation, it can present some unique challenges that should be considered when making the decision.

It takes a lot of time, effort and usually, very frequent pumping with a high quality pump to establish and maintain a complete milk supply through pumping alone. Breastpumps are not as effective at stimulating a let-down or removing milk from the breast as a baby who is successfully breastfeeding. Milk supply is determined by how much milk is taken from the breast. (Zoppou, et al 1997) With the newer, more efficient pumps many moms are able to provide 100 percent of their baby’s breastmilk.

Other moms may experience fluctuations in their milk output and/or have difficulty building or maintaining their supply and need to supplement with formula periodically or regularly depending on their situation However, any amount of breastmilk you are able to provide would be to your baby’s benefit.

To maximize your pumping, research has shown that using a high-quality double pump, pumping frequently -- at least six to eight times a day -- and breast massage are all know to help increase your milk output. (Hill, et al, 1999) (Jones, & Spencer 2000)

On the next page find out how to maximize the quality of the milk you express for your baby.

Maximizing the Quality of Your Expressed Milk

One way to maximize the quality of your expressed milk is to use storage and feeding containers that are made of glass or hard, clear or cloudy plastic bottles since they are known to be the best choice to minimize any loss of the milk components.

Mothers interested in maintaining the best quality of expressed milk should also avoid, or minimize the use of plastic storage bags. A considerable loss of fat and possibly fat-soluble vitamins occurs when breastmilk is stored in plastic bags and there is an increased risk of contamination through holes or tears. (Arnold, 1999) However, many mothers find the convenience of storage bags offsets the related concerns since expressed breastmilk stored in plastic bags is still far better for the baby than formula. Additionally, the risk of tears in the bags can be minimized by double bagging and/or storing the bags in a rigid plastic container with sealed lid to prevent other freezer items from coming in contact with the bags and creating tears.

When re-warming your milk, some vitamins may also be lost. Excessive heat and microwaves should never be used to warm milk. These decrease many of the milk’s anti-infective properties, as well as vitamin C.

On the next page find out if bonding with your baby will be affected by feeding expressed milk, rather than feeding at the breast.

What about Bonding?

Some people are concerned about any differences in bonding when babies are exclusively fed with bottles. Certainly if a mother and baby are struggling at every feeding and ending up in tears, that has the potential to diminish the bonding experience feedings generally provide. In some situations, switching to bottles may actually enhance the bonding between mother and infant.

One of the ways breastfeeding is thought to foster mother-infant bonding is through the frequent and close physical contact that breastfeeding provides. I would encourage mothers who are bottle feeding, whether with breastmilk or formula to make sure their baby is held for all feedings. Bottles should never be propped for safety reasons and even as the baby gets old enough to hold the bottle on her own I would still recommend holding the baby in your arms for feedings. Babies who are bottle feeding can also enjoy some skin-to-skin contact, whether at feeding time or other times. Holding your baby against your bare skin is a wonderful experience that I would encourage you not to miss out on.

Research shows that there are components in breastmilk that enhance the development of your baby’s vision. It has also been proposed that switching sides at the breast helps promote the equal development of both eyes. You may want to try to switch from your left to your right arm at alternate feedings when holding your baby as you bottle feed, rather than using the same position each time to help encourage this development.

Wondering if your baby will ever accept the breast? Turn to the next page to find out how to make peace with feeding your baby your expressed milk.

Will Your Baby Ever Accept the Breast?

Even with the help of good LC, it is not always predictable if a baby will eventually breastfeed effectively. And then again, I have heard of some babies eventually latching on and breastfeeding after as long as four months of being fed expressed breastmilk.

How will you know when it’s time to stop trying to get your baby to your breast? It’s important to remember that only you can determine what is right in your family, hopefully with the help of highly experienced LCs.

Everyone’s personal definition of “breastfeeding not working out” and “when to stop trying” can vary widely and depends on many factors.

Some moms feel better about stopping or greatly reducing breastfeeding attempts if they know they can continue to provide breastmilk in a bottle.

Some mothers feel relieved to know they can continue to try breastfeeding occasionally, while abandoning the grueling schedule of trying to breastfeed, then supplementing and pumping with every feeding.

Some mothers have shared that although their baby could not breastfeed effectively for nutrition, that they would happily accept the breast for comfort in between feedings.

References:

Arnold, L. Recommendations for Collection, Storage and handling o f a Mother’s Milk for her Own Infant in the Hospital Setting, The Human Milk Banking Association of North America, Denver, (1999)

Hill, P, J. Aldag, & R. Chatterton, “Effects of pumping style on milk production in mothers of non-nursing preterm infants.” Journal of Human Lactation, 5(3) 1999, 209-16.

Jones, E. & S Spencer “A randomized controlled trial to compare methods of milk expression following preterm delivery” ILCA Conference session: Oral Research Presentations July 29, 2000.

Kristine L. et al, “The role of breastfeeding in sudden infant death syndrome” Journal of Human Lactation, 16 (1), 2000 13-20.

Lawrence. R. Breastfeeding: A Guide for the Medical Professional, Mosby, St Louis, (1994), 92, 158, 162-63.

Zoppou, C, S. Barry, & G. Mercer, “ Comparing breastfeeding and breast pumps using a computer model” Journal of Human Lactation, 13(3) 1997 195-202.