Breastfeeding, Formula, and the Lie that “Breast Is Best”

“Breast is best.” That slogan is so ingrained in my head that sometimes it even pops up when I’m buying chicken at the grocery store. (Poultry, obviously, is not the issue.) But as a new mom, that phrase sat heavy on my shoulders. It didn’t just feel like a suggestion — it felt like a moral directive. And when my body didn’t play along, the shame was real.

A Quick History of “Breast Is Best”

The “Breast is Best” campaign was born in the 1970s by a British couple who wrote a book to increase the all-time low rates of breastfeeding. WHO and UNICEF adopted the message in the 1990s, backed by research showing breast milk provides ideal nutrition and immune protection for infants. In public health, it was a win: higher breastfeeding rates meant healthier babies.

But somewhere along the way, this well-intentioned slogan turned into a blunt instrument, leaving mothers who struggled—or simply chose formula—feeling like failures.

Today, the AAP recommends exclusive breastfeeding for about the first six months, and then continued breastfeeding along with complementary foods for at least a year (and beyond, if mother and baby are willing). Breastfeeding is linked with reduced risk of ear infections, diarrhea, and sudden infant death syndrome, and it may even lower mom’s risk of breast and ovarian cancer.

My Failure to Thrive

As a public health professional, I expected I’d follow the AAP’s breastfeeding guidelines to the letter, with the small exception of my weekly glass of wine during pregnancy.

Since I had planned to return to work when Grace was 3-months old, I knew that pumping would play a big role in breast feeding for that first year. I ordered my Spectra breast pump and prepared to jot down all of that pumping activity notebook. I skimmed a few books but figured my maternal instincts would kick in once the baby arrived. And for the first few days, they did. My daughter latched, the nurses nodded approvingly, and I felt like we had this figured out.

And then—by her first pediatrician visit—she had lost too much weight. From her small starting weight of 6 lbs 11 oz, she had dropped a few ounces. Our pediatrician gently suggested a lactation consultant. I downloaded the app she suggested – Boober –  and was horrified to see a price tag of $800/hour. (For the record: nope.)

Instead, I Ubered 45 minutes to a clinic. I pumped. I ate lactation cookies my aunt baked. I tried every hack the internet offered: power pumping, breast shields, multiple let-downs, morning sessions. I pumped for 45 minutes and got two ounces. I pumped around the clock, skipping sleep, logging ounces like they were gold.

And still—it wasn’t enough. Two weight checks later, our pediatrician handed me a package of formula. She told me: Keep breastfeeding if you want, but keep this on hand. You have to feed your baby.

“Keep breastfeeding if you want, but keep this formula on hand. You have to feed your baby.”

Within days, I gave her the first bottle of formula.

When I went back to work, I was pumping in the bathroom, balancing a computer on my lap and hoping I could squeeze 3 ounces out of 30 minutes. As fate would have it, a colleague had a daughter who was one day older than mine and had no trouble stashing pints in the fridge. 

What Science Actually Says

Yes, breast milk is biologically amazing. But formula is also scientifically designed to provide complete nutrition for babies. Modern infant formulas are safe, regulated, and effective. Research consistently shows that what matters most for a child’s long-term health isn’t whether they were breastfed or formula-fed, but the overall environment they grow up in—love, safety, responsive caregiving, and access to healthcare.

Formula Isn’t Failure

Here’s what we don’t talk about enough: breastfeeding can take a real toll on mental health. Pumping around the clock, stressing about ounces, and feeling shame when it doesn’t work out—that’s a recipe for anxiety and depression.

Society has made progress: insurance-covered pumps, lactation consultants (for less than $800/hour, thankfully), breastfeeding rooms in offices, even pods in airports. But we still don’t support a mom’s mental health while she’s breastfeeding.

We need to say this out loud: A mom’s wellbeing matters just as much as the baby’s ounces.

There’s no “correct ratio” of breast milk to formula. There’s just feeding your baby in a way that works for both of you. Sometimes that’s breast. Sometimes it’s formula. Often it’s both.

The shame? That comes from culture, not science.

For the record: my daughter’s weight continued to be a source of concern until her two-year checkup. I’m still trying to get her to drink milk, though now I can at least buy it at Starbucks.