Alternatives to Breastfeeding: Options For When You Can't Breastfeed
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When I first had my son, I had no idea that there are many reasons why moms are ultimately unable to breastfeed. I thought it was just a choice, so I didn’t look into alternatives to breastfeeding. We tried for 14 weeks, but with little improvement on poor latching, chronic acid reflux (medically known as GER), and low milk supply, we were unable to make breastfeeding work. When we moved on to the next big ordeal - okay, now what’s the next best thing I can feed my baby? - it was an overwhelming frenzy sorting through all the options and information to find a healthy option. For each of the alternatives below, I’m presenting both the pros and the cons. My ultimate goal is not to influence you but to provide synthesized health-related information about the alternatives currently available! Don’t fret, mama. You’ll figure out the best thing to do for your baby (and yourself)!
Exclusive pumping
For some moms, breastfeeding is not an option due to challenges other than low milk supply. If you produce enough milk for your baby - or you produce enough that it’s worth pumping to you - using an electric pump is a popular alternative to traditional breastfeeding. This is a great option for moms who can’t make breastfeeding work but feel very strongly about giving baby their own milk.
Most exclusive pumping moms, also known as EPers, use double-electric or even hospital-grade pumps and replace what would normally be breastfeeding sessions with pumping sessions. They may also use hand pumps or self-express milk when traveling or in public. Since using a breast pump is so different from nursing, in the sense that moms body does not receive the same signals from a pump as she would from baby, many moms take galactagogues and follow pumping regimens in order to maintain milk supply. Similar to nursing, once milk supply is established, most moms can cut back on pumping sessions (sometimes to as little as 4x/day) and still produce the same output of milk.
Breast milk can be stored in bottles for refrigeration (such as for same day use) or packets designed specifically for breast milk, which can be frozen for up to one year. Some moms with an oversupply even “stock up” on milk and are able to stop pumping earlier than their original goal.
Because this kind of lifestyle is a serious commitment, there are support groups and great resources for moms who decide to exclusively pump. I was an exclusive pumping mom for about 5 months, and I will testify that making friends in these groups can really keep you going! Unfortunately, for us, my milk supply remained at less than 16oz per day, even with cluster pumping, galactagogues, and a hearty amount of water. I also lost 2oz anytime I tried to drop a session. With all the planning and strategizing it takes to follow a pumping routine (especially when out and about or traveling), it started to be a burden that wasn’t producing good enough results. (I also felt like an animal hooked up to a milk-removal machine, but most moms agree with this.) BUT I was at least thankful to be able to give my son some breast milk everyday for about six months - and I’ve talked with a few moms who have gone up to a year!
other human milk
When you can’t produce enough milk or have chosen not to breastfeed, you can find other human milk for your baby if you don’t want to use infant formula. However, it can be a challenge to find human milk that is “donated” for any baby. Many donor milk banks have criteria in order for your baby to receive donated milk, such as premature birth and/or a medical condition.
In most cases, unless you have a trusted friend who will pump and give her extra milk to you, human milk costs - and usually a steep price. Moms with an oversupply of breast milk sell their extra milk either by the ounce or in bulk. But some moms find it’s worth paying in order to give their baby human milk as opposed to processed animal milk.
When my son refused the breast, I looked into other human milk as an option. I wanted the next best thing for him, and not even a hundred years ago, moms with low to no milk would have leaned on a wet nurse. However, when I did the research, I learned three things that made me apprehensive about using another mom’s milk:
1) I would be paying around $1-2.50/ounce, typically on the higher end if she claimed to have a healthy diet. While I loved the idea of my son gaining all the benefits of human milk, we could not afford it. Even at the lower end of $1/ounce, that would be about $960 per month. I understand there’s a lot of work involved with pumping and storing breast milk, and I even appreciate the entrepreneurial spirit. But, personally, it was a sore spot to buy breast milk on a sort of black market system like it’s any other commodity. Read here and here for differing perspectives on “the shady market of breast milk sales.”
2) It’s based on an honor system. If a mom says she follows a healthy diet and practices safe hygiene and storing methods, you really don’t have a way to evaluate or confirm. Without knowing her, you have to trust that she is doing exactly as she says. And while it has been my experience that most moms genuinely want to do right by one another (we all know how hard this job is), still, it usually takes time and a personal relationship to build trust - especially the kind that affects my baby’s health.
3) It would be difficult to guarantee that I always received the same mom’s milk. And if the breast milk switched up on my son, how would that affect his system? I think there are ways to develop partnerships or buy in bulk if you can afford it. But it’s something to consider for the long-term.
Nonetheless, some moms still feel like this is a healthier alternative to using animal milk of any kind.
Homemade Infant Formula
This alternative is still being met with public controversy but is quickly growing in popularity as more moms turn to whole food nutrition for their families. With homemade recipes, moms can use natural, simple, unprocessed ingredients rather than commercial formula processed in a factory and made shelf-stable for long periods of time.
One of the biggest cautions against homemade formula is the use of raw, unpasteurized milk. Personally, I’m not a proponent of it because of the risks with unpasteurized milk. I do understand why some moms would want to use it: 1) The heating process of pasteurization which kills pathogens also denatures some of the milk’s nutrients, and 2) There are good bacteria which are beneficial for baby’s gut. Additionally, the milk must be diluted properly in order to be suitable for baby’s developing kidneys - otherwise, it’s completely unsafe. The Weston A. Price Foundation has a popular recipe.
There is another route when it comes to the homemade option, which involves using milk and/or lactose that are in powdered forms (so as to avoid the risks of unpasteurized milk), while the other ingredients are still in their natural state. This Homemade Goat Milk Formula from Mt. Capra is the option we chose, and I felt like I was giving my son the next best alternative to mom’s milk, while not taking the same health risks as traditional homemade formula. They have a ton of information, including how their formula meets all baby’s nutritional needs. That brings me to my next point.
There is a way to know what baby requires and which formulas will fulfill those requirements. The Infant Formula Act of 1980 was developed after a major infant health incident and formula recall in 1979. This legislation spells out minimum and maximum levels of ingredients to be included in infant formulas. The FDA sets standards for production (updates recently made in 2014). Exceptions are made for formulas designed for babies with very specialized needs (due to conditions such as severe allergies or fatty acid disorders, for example). Ideally, the goal with any infant formula - homemade or commercial - is to model as closely as possible to mom’s breast milk (though that is quite the feat).
Commercial Infant Formula
Many experts and pediatricians still hold to commercial infant formula as the best alternative to breastfeeding because it is required to pass levels of nutritional value and quality inspection by the FDA. I also know moms who prefer it because they trust it more than making formula at home, and they find it more convenient. Conversely, some moms and nutritionists are questioning if commercial formula is really the best option and if the sweeteners used in some formulas have long-term health consequences.
There are several benefits to commercial formula. The ingredients are all there - no mixing, no messing up, no risks with the type of milk you are using. You can travel more easily, rely on someone else to feed baby, and it is easy to make one bottle at a time. You know that it had to meet The Formula Act of 1980 nutrition requirements as well as manufacturing and production standards set by the FDA (even if those aren’t as high as we would like them to be).
The FDA states that commercial infant formula is one of the most heavily regulated products in the United States, which means that you shouldn’t have to worry about contaminants, pathogens, or other scary things. All the same, the ingredients do have to undergo separation techniques including extreme heating and drying methods, as well as the addition of emulsifiers, stabilizers, and carriers to keep the formula viable on store shelves. Think corn syrup or corn maltodextrin, which can be used as the carbohydrate source (more on formula nutrition here) and are processed as sugar in the body.
Additionally, unless you are buying organic, you may not know where the milk comes from or what kind of diet the cows (or goats) were fed. If the cows are fed grains, that food usually contains corn and/or soy, which passes into their milk. Cows with grass-fed diets who were not treated with growth hormones or antibiotics are best. Some moms order infant formula from Europe because the organic and ingredient standards are higher, i.e. free from any type of corn or soy, unnatural sweeteners, and synthetic ingredients. Many companies provide information about their milk sourcing on the label or their website, so you can check which brand might be best if you are going with this alternative!
If you are trying to choose a healthy formula alternative, this can be a good place to start. I know it feels overwhelming, but it’s also empowering to make an informed decision - and move on to enjoying those precious hours with your babies!
Disclaimer: I am not a spokesperson or associate of Mt. Capra. However, I do earn a small commission on any purchase via my referral. The funds help me keep this website up and running and fund weekly ice cream dates with my buddy. Nonetheless, I would share this formula with you anyway - and leave it totally up to you to decide whether or not it is right for your baby!
