New Research Shows American Pediatricians Are Stuck Between Breastfeeding Recommendations and a Mom’s Reality

Only 1% of Pediatricians Have Never Recommended Formula to Patients. Here’s What the 99% are Saying.

Feeding a baby for modern moms is caught between a tale of two worlds. One in which you are expected to meet society’s high expectations of how it should go on paper, and one in which the reality of being a mom in 2020 knocks that plan completely off track.

Stuck between the breastfeeding benchmarks from global health officials and the reality of moms rarely meeting those benchmarks are our beloved Pediatricians; a group of well-intentioned, well-educated, supportive medical officials on the frontlines of helping moms on a hormonal rollercoaster who are losing sleep over every single ounce their baby does or does not gain based on how they feed them. 

What’s fascinating is that this tension between the Centers for Disease Control and Prevention (CDC) recommendation that women should exclusively breastfeed their babies for the first six months of life and the reality of a teary-eyed mom saying she is losing her supply/doesn’t have time/doesn’t want to keep going leaves Pediatricians in limbo. Do they tell you what is suggested and push you to continue breastfeeding? Or do they go against those recommendations and talk about supplementing or switching to formula? The data from Bobbie’s 2019 pediatrician survey shows something very fascinating- they actually do both. 

Feeding an Infant is Not an Either-Or Scenario

A recent survey by Bobbie of 360 pediatricians in the US, but with respondents mostly from coastal urban areas, shows how this is really not an either/or conversation. In fact, 80% of pediatricians surveyed say that they believe breastfeeding is always best and suggest that mothers should do whatever it takes to breastfeed. Meanwhile, 80% also recommended formula if their patients were having difficulties breastfeeding.

Dr. Jacqueline Winklemann, a Board Certified Pediatrician and Bobbie Medical Advisor, weighs in on the why behind this dichotomy, “Nutrition education is lacking from our training as pediatricians. We are not taught to look at ingredients, sourcing or regulation. Later in training, during our pediatric training, we are taught  by our programs as well as by our professional organizations, including the American Academy of Pediatrics (AAP) to encourage and support exclusive breastfeeding for the first 6 months of life and continue breastfeeding until at least one year of age.”

Dr. Jacq says that after years of working with moms and babies, she now realizes that much of the issue is what you learn outside the official medical research. “We are shown study after study that demonstrates the benefits of breastfeeding and breastmilk for both mothers and babies, said Dr. Jacq. “What we are NOT taught is the struggles, the frustrations, and the stigma associated with feeding infants. We are not given a complete picture of the issues, but moms are discussing their issues and concerns with us, and have opened our eyes to the realities that surround this topic. On the bright side, most pediatricians are willing to listen, support, and encourage moms to have their own feeding journey.

The 1% Sticking to Breastmilk

Despite the overwhelming breastfeeding narrative present on social media, moms supplementing or turning to formula is actually the norm, with 83% of parents in the US using formula in their baby’s first year of life. The good news is, it’s clear pediatricians are supporting patients in their reality with an incredible 99% of US pediatricians have recommended formula.

This means that 1% either have managed to keep their patients’ milk supply up or just haven’t had the guts to talk formula. This data tells us that pediatricians are meeting moms in their reality; being straight shooters about options and most importantly, not furthering the judgment, internal guilt, or stigma that a mom often faces when turning to formula. Here are the top reasons pediatricians say they are recommending formula:

• Mother’s Health 68% 
• Latching Issues 65% 
• Low Milk Supply 54%
• Baby’s Health 48%
• Mom Doesn’t Want to Breastfeed 40%
• Low Weight Gain 20%

The Current Formula Landscape is… Complicated

But recommending formula has perhaps never been more complicated for pediatricians. The industry and market is blurred by new releases of trendy toddler formulas that are categorized as baby food, a very popular black market of unregulated and technically illegal formula from Europe, and the disappearance of two organic formula brands from the shelves, Honest Company and Plum Organics. Pediatricians say the top three things they look for when it comes to suggesting a particular brand are: 

• Quality ingredients (65%) 
• Health Claims (65%) 
• No Artificial Ingredients (41%)

And it seems the pervasiveness of European formula among millennial moms is making its way into pediatric practices with a whopping 87% of pediatricians having recommended German formula in particular in the past six months. It’s clear even American pediatricians wish there were more options of regulated infant formula here in the US. And it might come down to regulations on ingredients and nutritional standards. 

“The interest in European formulas came from the desire of the millennial mom to find the best ingredients, sourcing and regulation when it comes to infant formula. This generation cares about product quality, food products with clean ingredients, sustainability, animal welfare and the environment. Access to information from around the world has made it easier to explore options outside the US,” said Dr. Jacq. 

While she can look at the labels, it still doesn’t sit well with her to recommend it to a mom for a few reasons. “I have had many parents ask for European formulas while their babies are hospitalized, and for me it is difficult to go ahead and recommend a product that is not regulated in the US and one that we don’t have access to at the institutional level. With that said, I understand their desire to provide the very best for their young baby, and the simplicity of their recipes and the strict guidelines when it comes to artificial or controversial ingredients is something we as pediatricians wish we had more readily available in the US,” said Dr. Jacq. 

The Formula Brass Tacks is All About Ingredients

European formulas are known for their more simplistic recipes, grass-fed dairy sources, and the higher standards banning pesticides and additives in the EU. The EU also recently updated its nutritional guidelines with a new standard for DHA to be included in infant formula, whereas the US does not have any DHA minimum requirements. The top 3 ingredients that pediatricians recommend avoiding are: 

• Soy (58%) 
• Brown Rice Syrup (58%
• Corn Syrup (48%)
  

The Takeaway? Pediatricians Say Babies Long Term Health is Not Impacted by Breastmilk vs. Formula

What’s most encouraging about this latest research is that it shows that although the recommendations from global health experts have not evolved along with the realities of modern motherhood, it appears pediatricians have. From their experience and perspective, they do believe that however you feed your baby, your baby will be just fine with 80% responding that whether a baby is breastfed or formula fed does not impact the long-term health of the baby.

Finally, a bit of clarity from the pediatricians in the thick of it with us.