Breastfeeding is amazing, yes. But so is bottle-feeding! In a society that is very pro-breastfeeding, it can be easy to jump to conclusions or cast judgment when we see someone offering their baby a bottle, whether they're a stranger or someone we know. When we consider that there are so many reasons why a parent might choose to bottle feed, it's pretty awesome that the option exists.
(Oh, and also, remember that it might be pumped milk in that bottle—many people end up feeding their babies pumped breastmilk, exclusively or in combination with formula and/or breastfeeding).
Remember that as with all of parenting, everyone comes to this journey with a different story—one that we usually know nothing about.
So to help push back on some of this potential judgment, let's consider 17 of the reasons that someone might be bottle-feeding their baby.
1. They are taking a medication incompatible with breastfeeding.
Medications can make their way into breastmilk and therefore into the baby. While most medications are safe for breastfeeding, some aren't, for example, some chemotherapy and some drugs meant for mental health. Additionally, some people who take medications may not feel comfortable continuing to breastfeed, even if it's deemed safe.
2. A situation out of their control impacted their milk supply.
So often people stop breastfeeding due to low milk supply—it's essential that we remember that this can be caused by any number of factors, many of which are out of their control: being separated from the baby for prolonged periods, medical emergencies, unsupportive medical professionals or family members, and so much more.
3. Their work situation doesn't allow them to pump enough.
When someone goes back to work after having a baby, they will need to pump as often as the baby nurses to maintain their milk supply—this can be as often as every 2 to 3 hours. This is simply not possible for many people, based either on their profession or their employer's policies. I am a midwife—when I went back to work after my maternity leave, I couldn't exactly ask a baby to wait to be born because I had to pump first. My milk supply dried up incredibly quickly.
4. They became a parent through adoption or surrogacy.
We can't assume to know how a baby joined someone's family. If someone adopts a baby or becomes a parent through surrogacy, they might be able to induce lactation if they want to—but it's hard, and not right for everyone.
5. They have a breast structural issue that prevents them from breastfeeding.
Inverted nipples and breast hypoplasia are a few examples of structural issues that can make it harder to breastfeed.
6. They have a medical condition that makes breastfeeding contraindicated.
Drs. Snehal Doshi and Kevin Kathrotia told Motherly that people with the following medical conditions are usually not advised to provide human milk:
- HIV infection
- T-cell lymphotropic virus type I or type II
- Use of certain drugs
- Suspected or are confirmed presence of Ebola virus
Additionally, someone with an active herpes lesion on their breast might be recommended to not breastfeed.
7. They have a condition called D-MER.
Lo Mansfield, a labor and delivery nurse wrote that D-MER, or Dysmorphic milk ejection reflex, "is characterized by the abrupt onset of negative emotions (dysphoria) just before milk let down and continues for no more than a few minutes." In other words, people with D-MER get incredibly sad every time they breastfeed. It may only be temporary but for some people, it's enough to make breastfeeding too difficult to continue.
8. Their doctor advised formula.
There are many reasons why a medical professional might recommend formula—jaundice, low blood sugar, growth needs, etc. Now, some of those reasons are controversial (so if it happens to you and you disagree, always feel free to get a second opinion). That said, it's also possible that it was the best recommendation for the baby or parent. And it's also possible that the parent didn't know they could get a second opinion or didn't have access to one.
9. They are a trauma survivor and breastfeeding is triggering for them.
For some trauma survivors, breast stimulation can be incredibly triggering. They might decide to support their healing by not breastfeeding or pumping.
10. Bottle-feeding is better for their mental health.
Breastfeeding is hard, and sometimes it can start to take a toll on our emotional wellbeing. I know many people for whom breastfeeding is incredibly stressful or upsetting, and many feel that these stressors lead to their postpartum depression. Choosing to stop breastfeeding might therefore be the best decision for someone who knows it will help their mental health.
11. They've had a mastectomy.
People who have had a double mastectomy cannot breastfeed; and if they've had a single mastectomy they can only feed on one side, which may or may not mean that they decide to supplement with formula.
12. The baby has a condition that necessitates bottles over breasts.
There several situations that might make it hard (or impossible) for a baby to breastfeed including latch issues from tongue or lip ties, a cleft lip or palate or prematurity (premie babies often don't have the facial strength to latch onto a breast yet). Again, it's also possible that the baby has low blood sugar, jaundice, slow weight gain or another situation, and their medical team recommended adding or switching to bottled milk.
13. They have cultural beliefs that emphasize bottle-feeding over breastfeeding.
Culture has a significant impact on the way we think about many aspects of parenthood, including feeding. Some cultures prioritize breastfeeding while others do not.
14. They don't feel comfortable breastfeeding in front of other people.
Many people who breastfeed at home or privately do not feel comfortable doing so in front of other people. We can't assume that just because we see someone giving their baby a bottle, that the baby is exclusively bottle-fed.
15. They need to measure the baby's intake carefully.
One of the tricky things about breastfeeding is that you can't measure exactly how much milk is going to the baby. Often that's okay, and we can follow the baby's signs to know when they are full. But there are scenarios where we need to know exactly how much the baby is eating—this is much more possible with bottles (of formula or pumped milk).
16. They do not have access to lactation professionals to help them overcome issues.
Many breastfeeding and pumping challenges that come up can be resolved with the help of a lactation counselor or consultant—but what happens if someone doesn't have access to that help? Reasons for this might be financial, geographic or even weather-based—I once worked with someone who gave birth right before a huge snowstorm that took her community over a week to recover from (this was before virtual consultations were prevalent). By the time the roads were clear enough to get to a lactation appointment, her milk supply had decreased dramatically.
17. They don't want to.
Last but certainly not least—some people just do not want to breastfeed. And that's okay. Let's stop making parents feel bad about making choices that support their wellbeing, especially when we don't know the whole story.