> giving a replacement milk is the best solution

That's the reason maternity wards have fridges full of donated milk so that at least during the first days/weeks/months of life, especially for those born prematurely, the replacement milk is actual breast milk.

The point about maternity leave is a good one. Obviously countries should have a maternity leave that is longer than the breastfeeding period. That the US doesn't is pretty terrible imho. (This isn't an employer expense in all those countries that have it, it's usually a tax funded system)

And that's a great program, mostly because of the initial health benefits. I do understand breast milk is the best first option, even if you are basically running a modern wet nurse program. But it doesn't seem to replace the need for formula after the initial time frame which is many months afterwards.

Assuming the mother has the time and has no circumstances such as medication or illness that prevents her from breastfeeding why is there a need for formula after the initial time frame?

Because babies breast feed for months, ideally anyway. The hospital breast milk is really important for premature babies (cuts down hospital stays), and is really healthy for newborns regardless. But babies ideally breast feed for at least 6 months (The pediatric society might say much longer than that, easily googleable and telling of my own laziness on searching).

Assuming there are absolutely no medical or circumstantial reasons to use formula (such as the complication with work in my original reply and public acceptance of breast feeding in public), there aren't many reasons. You know, except being able to be away from your child for any length of time in the first months. But this simply isn't reality, nor is breast milk always enough (my mother simply couldn't produce enough milk for my little brother to stay healthy, and his asthma was already a concern). Some women die in childbirth as well. Not to mention psychological concerns (I refuse to have a child. Pregnancy and breast feeding are the stuff of nightmares for me). We need the option there just to make sure all babies have nutrition.

And the more folks push, the more acceptable it is to shame non-breastfeeding mothers. That really freaking bothers me.

I'd say the conditions you listed are wholly acceptable, lack of milk, psychological concerns etc. I fully support women who choose to formula feed.

I've found though that most people push formula more than anything. My partner and I have just had our first baby, she's fully breastfed and barely a day goes by where people ask whether we're supplementing with formula as breast milk does not contain the right or enough nutrition for them.

I side with breast milk first and and foremost if it's a viable option as I'm less inclined to believe large formula manufactures such as Nestle really have the best of interests.

The opposite is actually also true: many people push breast feeding at all costs, and formula is to be avoided for ideological reasons as you stated. Pediatricians hate these people, because it is super important for the newborn to get enough, and many moms can't do it with breast feeding alone. Hence the questions "are you supplementing?" It makes sense why these questions would be common during the first month or two, because hungry babies are such a bad thing.

If the baby is purely breast fed and getting enough milk, you have to probably have add some extra iron to their diet around month 6 or so.

We had to start supplementing early, my wife could never get her production up enough to fully feed the baby. Our pediatrician was relieved we were ok with supplementing, a lot of moms in SoCal aren't and it's a super big issue. They (the pediatricians) seem to be at battle with breast feeding ideologues, people really need to be pragmatic.

I agree pragmatism is the best way forward. As long as production is up though and the baby is putting weight on well I personally wouldn't push for formula nor would my partner.

I think the problem we found with our personal situation was from day one anything that occurred such as baby crying,fussing, not sleeping was attributed directly to poor breast milk by both people we knew and strangers. My partner felt forced to move to formula but luckily with support from our midwife her supply came in well and both baby and mother are happy.

Choices and support are the most important things but if supply,will,health and the option allow a mother to breastfeed I think the benefits do outweigh formula.

Happy to hear you had a supportive paediatrician!

Strange, are you in the states? There is a huge push right now for breast feeding in most USA hospitals.

Doctors are pattern matchers, your newborn symptoms could have been in their experience the baby not getting enough milk. If it wasn't the pediatrician, well, they are your best source for the baby's health, everyone else isn't qualified (including nurses, midwives, etc...).

Also, it takes a while for the milk to come in after the baby is born, it is an incredibly tricky process of getting the baby fed where nature doesn't do us many favors. The baby probably was hungry, the milk probably came in later than they wanted, but all is still ok. Finally, you know what goes into baby with formula, with breast milk it is much harder to tell, making the job of determining if the baby is getting enough much more difficult.

Breast feeding has benefits sure, but they aren't so much that it is worth starving the baby. It is a serious tightrope to walk, especially in the first few weeks before production comes in completely (if it does at all, many women have problems).

In Spain. It's been a nice discussion, I do disagree with the statement of you know what goes into a baby with formula. At the end of the day weight gain is the best indicator not to mention the problems of formula fed babies being more prone to sicking up feeds (which makes it hard to 'measure' how much they get).

You can use weight (output) in both cases. But with formula, you also have a good idea of what the input is. Later on you can pump breast milk to get a better idea of input, but that doesn't work well at the beginning.

If you have a colic baby, all bets are off, of course.

In Dallas, Texas, we face the opposite. My wife wasn't able to breastfeed for a variety of reasons. Even when you tell someone that breastfeeding wasn't medically possible for us, people still want to give you advice on how we should have done things differently and how breastfeeding is so much better. There are a lot of women who seem to think that using formula is a hair short of child abuse and are very vocal about it in America, which leads to all kinds of neuroses in those who can't or don't wish to breastfeed.

This could be a cultural difference from here in Spain. Sorry that you both had go through that. Perhaps the common thread we've both faced is that people will judge and interject with whatever you do for your children.

That's frustrating, people are zealots, clearly extenuating circumstances exist and you just have to do the best you can.

May I ask, where do you live? Where I am at, people push breastfeeding. I find your situation odd. Like if people were pushing soda over water. That does not make sense in this day and age.

Barcelona. We have a very supportive medical system but there is a trend towards cesareans and formula feeding (according to our paediatrician).

You mis-interpreted my statement -- I never said there weren't extenuating circumstances, or that there NO place for formula, in fact I believe it's a necessary evil for many people given their life situation, but that doesn't make it comparable to breastmilk from a healthy, well-fed mother if it's available.