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The Effect of Breastfeeding Versus Formula on the Health of Infants: A Review

  • Apr 19, 2022

 ABSTRACT

World Health Organization (WHO) recommends breastfeeding in infants up to six months at least. Six months of breastfeeding provides the necessary nutrition and immunity to the infants and prepares their bodies to fight against varying diseases and disorders. Infant formulas have been on the rise owing to the current rate of globalization and westernization. Rising product innovations make infant formulas available in flavors, offering all essential minerals to the infant body. In many cases, it becomes impossible to breastfeed infants and this is where the formulas come in handy. However, depending upon formulas is a wise choice or not is a question of many.

Keywords: World health organization (WHO), Infant, Breastfeeding, Diseases, Formula.

Infant formula ingredients are something that needs to be paid attention to before buying a product. Active and organic ingredients in a formula can be very beneficial in promoting the overall health and wellness of an infant. Data Bridge Market Research analyses that the infant formula ingredients are growing at a CAGR of 4.52% in the forecast period of 2022 to 2029. However, some challenges that lie ahead of the market are a lack of awareness in the underdeveloped economies.

INTODUCTION

According to the American Academy of Pediatrics (AAP) and the World Health Organization (WHO), breastfeeding is the best nutrition for infants. It is recommended by the bodies that infants (0-6 months) must only and exclusively be breastfed. However, there is a strong need to understand and comprehend the physiology of lactation and the social and cultural context of breastfeeding.

Breastfeeding is Important for Babies or Infants Because: 

  • It fulfills the body's basic nutritional requirements in terms of proteins, carbohydrates, fats, and calcium
  • It develops antibodies in the body that effectively protect the body against viral and bacterial infections
  • It is easy to digest, is readily available, and free of cost
  • It improves the level of cognitive intelligence in babies
  • It reduces the risk of type 1 and type 2 diabetes, high cholesterol, Hodgkin's disease, and lymphoma in babies and breast cancer, diabetes, heart disease, osteoporosis, and ovarian cancer in breastfeeding moms
  • It plants good bacteria into the infant's gut and improves the functioning of vital body organs

Breastfeed is regarded as a personalized formula containing all the right nutrients. After six months of breastfeeding, it is recommended to continue breastfeeding and other food items to the babies. The catch here is that breast milk will automatically modify its composition of nutrients that the baby or the infant needs at a certain stage of his/ her lifecycle.

What Problems are Associated with Breastfeeding?

However, there are certain problems associated with breastfeeding. Pain is one of the most common of all in women. Sore and cracked nipples can also develop excruciating pain the breastfeeding mothers. Sore and cracked nipples are generally a result of not positing well the baby. Sore and cracked nipples may also invite thrush infections in women. Most of women are driven by a lack of confidence. They tend to get worried about the fact that they aren't lactating enough and as a result babies or infants aren't getting the desired quantity of diet. On the other hand, breast engorgement is some is a concern too. Breast engorgement is a case when the breasts get too full of milk and this may lead to hard, tight, and painful breasts. Breast engorgement generally is experienced in two cases: one in the initial days of breastfeeding when it becomes difficult to manage the breastfeeding cycle (when the mother lactates and when the baby needs food) and second where the baby grows old and doesn't need to be fed frequently. In some cases, breast engorgement can lead to a blocked milk duct which develops a small painful lump in the breasts. In all of these cases, it is recommended to consult a breastfeeding specialist. Many times, just offering the baby both breasts alternatively can stimulate the milk supply and reduce the risks of all the problems discussed above. But when some aren't in capacity to deal with such problems for any reason, whatsoever, infant formulas can be a good choice to go with.

Infant formulas are the powdered food products that serve as an alternative to human milk and are designed to be consumed by infants up to 1 year of age. Infant formulas are manufactured keeping in mind that the composition of nutrients is kept same as that in human or breast milk. With the rising adoption of infant formulas in the developed economies, the manufacturers are focusing on product innovations in terms of taste, flavor, ingredients and packaging. However, one must not try and feed the baby with self-made formula or with cow milk. The reasons behind the increasing rate of adoption are the advantages provided by formulas.

Some of the benefits are:

  • These help in reducing the probability of developing ear infections, diarrhea, respiratory infections, meningitis and others
  • Unlike breastfeeding, formulas can be fed flexibly at the public places, moreover, male or female can easily feed the infant with the formula
  • Formulas help to keep track of intakes. This results in avoiding over-feeding the babies.
  • Formula fed babies remain satisfied for longer durations as compared to breastfed babies. This is because formulas take longer time to get digested.
  • Breastfeeding mothers have to be careful towards their eating habits; however, formula feeding gives this liberty to the mothers

Formula milk is regarded as the best alternative to breast milk. Like breast milk, infant formula is rich in vitamins, minerals, and nutrients required by the babies' bodies to thrive good growth.  It must be noted that formula is only allowed for sale once it meets regulatory and safety standards. Once the FDA passes them, they are made available to the end-users via all kinds of distribution channels.

However, like breastfeeding, formula feeding too has its cons. Published reports have suggested that formula-fed babies or infants are 16.7 times more likely to suffer from pneumonia that those breastfed. Infant formulas can also develop food allergies and allergic reactions in babies. Formulas also slow down the digestion mechanism in babies. Not every formula contains the antibodies that are either present in the breast milk. This indicates that formulas don't provide added protection against infection and illness. No formula can ideally replicate the exact composition of human or breast milk. Many good formulas are expensive in nature which is not affordable by a certain section of the society.

Supplementing is another approach that is followed by a good chunk of population. Supplementing refers to feeding the infant with a combination of breast milk and formula. However, supplementing should only be given after consulting with a specialist. Supplementing can offer benefits of both the feeding options and can cover a great range of problems offered by the two.  Supplementing is generally chosen when a child has some medical issues or mother is suffering low milk supply.

OBJECTIVES:

The purpose of this review article is to find out the answers to certain questions using secondary data available in the form of research publications, journals, case studies, published articles and other such sources. This study intends to achieve the following objectives:

  • Is formula feeding a good alternative to breast feeding?
  • Do breastfed infants have a lower incidence of developing diseases than formula fed infants?
  • Can artificial means duplicate the composition of breast milk?

Breastfeeding can sometimes be painful for the mothers. Biting of nipples by the babies is one of the reasons for the same. In some cases, breasts produce more milk than required which can be pumped and stored using accessories. In this regard, Data Bridge Market Research has prepared a report on the global breastfeeding accessories market. North America is the dominating region in the market due to the high awareness regarding breastfeeding accessories, positive policies promoting breastfeeding at public places and improved healthcare infrastructure within the region.

DATA ANALYSIS:

Data extraction and analysis is a crucial part of this review report. This section aims to understand the related publications, extract the relevant information, and review it systematically. Both quantitative and qualitative resources have been scrutinized to derive the relevant findings and conclusions. This sections aims at decoding the answers to the objectives of the report.

According to Muh Begum, by any means, the composition of breast milk cannot be duplicated. Breast milk has its unique set of composition which any infant formula cannot replicate. Breastfeeding reduces the probability of diarrheal infections in infants, which has contributed to reducing the rate of morbidity worldwide. Infants or babies that are fed with non-human milk tend to develop more and sever illness. Pneumonia is another highly prevailing disease in such children.  Ear infections in non-human milk fed children are surging at a great rate. Breastfeeding has proved to be a long term healthcare cost reducing factor, thereby promoting the natural form of nourishment in infants or babies. Breastfeeding also helps in saving money that would otherwise be heavily spent on formulas in case of absence of knowledge. It is scientifically proven that breastfeeding develops and nurtures a natural bond between the breastfeeding mother and breastfed child. Breastfeeding is important for the child's optimal growth, development, and health. Pediatricians, clinicians and gynecologists are responsible for inducing the importance of breastfeeding in to-be parents during routine obstetric and pediatric visits.   

A research conducted in Bandar-Abbas, Iran in 2010, studied the impact of occupational factors on the continuation of breastfeeding and formula initiation in employed mothers. This study was conducted for the age group of 6-12 months of infants. 212 mothers (aged 22 to 39 years) were chosen as respondents using a questionnaire to draw quantitative data analysis. These respondents were selected via convenience sampling, where, the inclusion criteria was infant being healthy and aged between 6-12 months and maternal employment. The results concluded that in 52.83% of the total cases, mother used formulas to feed their infants with breast milk completely discontinued in 27.36% of cases.  78.3% of the mothers faced the absence of a nursery facility at their workplaces, resulting in 56.63% of these women depending upon formula feeding. The 76.47% of cases did not have suitable physical space to pump the breast milk, which forced 60.5% of these women to formula feed their infants. This is to be noted that this figure is significantly higher in cases that had access to a suitable physical space for breast milk pumping. 50.99% of the mothers weren't allowed to leave the workplace for breastfeeding their child during the working hours which forced 55.56% of them to use formula. The study concluded that maternity leave shorter than 6 months and dearth of a suitable physical space for breast milk pumping derailed breastfeeding rate in infants aged between 6-12 months.

A systematic review and meta-analysis of cross-sectional and longitudinal studies evaluate the relation between body composition and breastfeeding or formula feeding in healthy, infants. Early diet may have an impact on body composition later in life. Breastfeeding and formula feeding have different effects on newborn body composition. The range of postnatal ages at which measurements have been taken has also affected the comparisons between separate researches because body composition changes fast and nonlinearly during the first year of lifespan. The systematic review included 15 studies, whereas the meta-analysis included 11 studies. Fat-free mass was higher in formula-fed infants at 3–4 months [mean difference (95 percent CI): 0.13 kg (0.03, 0.23 kg)], 8–9 months [0.29 kg (0.09, 0.49 kg)], and 12 months [0.30 kg (0.13, 0.48 kg)], and fat mass seemed to be relatively low at 3–4 months [20.09 kg (20.18, 20.01 kg)] and 6 months [20.18 kg (20.34, 20.01 kg) Formula-fed infants, on the other hand, had a larger fat mass at 12 months [0.29 kg (20.03, 0.61 kg) than breastfed infants. Therefore, the study concluded that formula feeding is attributed to a change in body composition in infancy as compared to breastfeeding.

The study examines the nutritional information of breast milk and newborn formulas to better understand the necessity of nursing and the usage of infant formula from birth to 12 months of age when a replacement form of nutrition is essential. Breast milk is the richest source of nutrients for all infants. It provides a range of other benefits as a biologic fluid, including modulation of postnatal intestine function, immunological ontogeny, and brain development. Only 38% of newborns worldwide are exclusively breastfed. Only 75% of infants in the United States begin nursing at birth but, by three months, 67 percent, or 2.7 million, of them are relying on infant formula for some portion of their nourishment. The overall U.S. population's six-month "any breastfeeding" rate is 43 percent, with only 13 percent meeting the recommendation to breastfeed exclusively for six months. Human breast milk is a complex matrix consisting primarily of 87 percent water, 1.0 percent protein, 3.8 percent fat, and 7percent lactose. The fat and lactose in milk give 50 percent and 40 percent of the total calories, respectively. During lactation, the fat content of human breast milk ranges from 3.5 to 4.5 percent. Triglycerides, which make up around 95 percent of total lipids, are the most important lipid fraction. Casein and whey are the two main protein types found in breast milk. Casein forms clots or curds in the stomach, but whey remains a liquid and is easier to digest. Whey accounts for 50 to 80 percent of the protein in breast milk which depends on the stage of the milk. In early lactation, the whey/casein ratio in human milk varies between 70/30 and 80/20, then drops to 50/50 in late lactation. Secretory IgA, alpha-lactalbumin, and lactaferrin are the most common whey proteins. Lysozyme, bifidus factor, folate-binding protein, lipase and amylase, casein, alpha1-antitrypsin and antichymotrypsin, and haptocorrin are among the other proteins. Infant formula is a commercially manufactured infant food alternative. It is made from cow's milk or soymilk and tries to duplicate the nutritional makeup of breast milk as precisely as possible. The majority of infant formula is made from bovine milk. To more precisely mimic the content of human breast milk, cow milk must be skimmed and diluted. Vegetable oils, vitamins, minerals, and iron are added to cow-milk-based infant formula. Infants with galactosemia or congenital lactase deficiency can benefit from soy protein-based formulas. Hypoallergenic formulas and amino acid formulas are the alternatives for infants who are unable to tolerate cow's milk or soymilk formulas. The study concluded that breast milk is the best source of nutrients for an infant's growth and development, and it's also high in antibodies, which serve as the first source of adaptive immunity in the digestive system of a newborn.

The article discusses the health concerns of not nursing for both newborns and mothers, along with the role of the obstetrician in counselling women about infant feeding and assuring a good start for breastfeeding at birth. Formula feeding is linked to a high risk of infectious morbidity as well as a higher risk of childhood obesity, type 1 and type 2 diabetes, leukaemia, and sudden infant death syndrome. Breastfeeding failure is associated with the increased risk of premenopausal breast cancer, ovarian cancer, retained gestational weight gain, type 2 diabetes, myocardial infarction, and metabolic syndrome in mothers. Obstetricians are uniquely positioned to counsel mothers about the health benefits of breastfeeding and ensure that mothers and babies receive adequate, evidence-based care from the moment they are born. Several studies show that formula feeding is attributed to greater hazards for both newborns and mothers as compared to breastfeeding. The obstetrician-gynecologist can play a significant role in improving health outcomes for two generations by encouraging breastfeeding as the preferred method of newborn nutrition. The study concluded that the formula feeding is linked to a variety of negative health consequences in both mothers and babies, ranging from infectious sickness to chronic disease and breastfeeding should be recognized as the biological standard for baby nutrition.

According to health organizations such as the American Academy of Pediatrics (AAP), the World Health Organization (WHO) and the American Medical Association (AMA) breastfeeding is the best choice for babies. It delivers optimal nutrition and unique bonding experience that many mothers value. Breastfeeding can help protect your baby from infections, allergies, and a variety of chronic illnesses. Antibodies and other germ-fighting substances transmit from a woman to her baby during breastfeeding, strengthening the immune system. This reduces the chances of a newborn contracting many infections such as diarrhea, meningitis, obesity, diabetes, asthma, allergies and respiratory diseases. Protein, lactose and fat are the component of breast milk and for new-born's digestive system it is known as perfect food. Breastfed newborns, on average, have less trouble digesting than formula-fed infants. Many of the vitamins and minerals that a newborn requires are naturally found in breast milk. The AAP recommends that all breastfed newborns start taking vitamin D supplements within the first two months and continue taking them until they eat adequate vitamin D-fortified formula or milk. Commercial formulas can't exactly replicate the content of breast milk since it is a biological substance produced by each woman for her own child, a process that cannot be replicated in a laboratory. According to several researches, children who were exclusively breastfed have higher IQs than those who were fed formula. Breastfeeding is also beneficial for mothers as it burns calories and shrinks the uterus, thus nursing moms may be able to return to their pre-pregnancy shape and weight sooner. According to research, it may also help reduce the risk of breast cancer, high blood pressure, diabetes, cardiovascular disease, and uterine and ovarian cancer. Diet, time as well as frequency of feedings, diet, personal comforts and latch-on pain are the major challenges of breastfeeding. Breastfeeding can be made dangerous by breast surgery, medical illnesses such as HIV or AIDS, chemotherapy, or treatment with certain drugs. Commercially manufactured infant formulas are a nutritional alternative to breast milk, and they even contain several vitamins and elements that breastfed newborns require supplements to obtain. Commercial formulas, which are made under sterile circumstances, seek to mimic mother's milk by employing a complex combination of proteins, carbohydrates, fats, and vitamins. Formula feeding is the most convenient and flexible method as it allows the mother to share the duties linked with nursing. Formula-feeding mothers don't have to be concerned about what they eat or drink because it won't harm their children. There are no antibodies in commercial formula that are found in breast milk. As a result, formula cannot give the additional protection against infection and disease that breast milk provides. Formula-fed infants may experience more gas and harder bowel motions than breastfed infants. Along with this, other challenges associated with formula feeding are high cost of this formula and planning and organization. The American Academy of Pediatrics recommends that babies be nursed consistently for the first six months of their lives. Breastfeeding is advised for at least 12 months, and maybe longer if both the mother and the infant are willing.

A randomized clinical trial was conducted in Nairobi, Kenya from November 1992 to 1998, to determine how often HIV-1 is transmitted through breast milk and to compare mortality rates and HIV-free survival rates in breastfed and formula-fed infants. Human Immunodeficiency Virus Type-1 (HIV-1) is a virus that basically attacks the immune system of the body and it can also be transmitted through certain bodily fluids such as breast milk. The transmission of this virus from mother to child can happen during pregnancy, birth or breastfeeding. Breast-feeding raises the risk of HIV-1 transfer from mother to child and while peripartum antiretroviral treatment prophylaxis minimizes the risk of mother-to-child transmission around the time of delivery, it basically has no effect on transmission during the breastfeeding procedure. Under the clinical trial, 401 mother-infant pairs were included in the analysis of trial end points out of 425 HIV-1-positive, antiretroviral-naive pregnant women who were enrolled. In the breastfeeding arm, compliance with the allocated feeding modality was 96%, while in the formula arm, it was 70 percent (P.001). Breastfeeding lasted an average of 17 months. 94% of the 401 infants enrolled in the study were followed up on HIV-1 infection or mortality endpoints: 83% for HIV-1 infection and 93% for mortality. At 24 months, the cumulative likelihood of HIV-1 infection in the nursing arm was 36.7 percent (95 percent CI, 29.4 percent -44.0 percent) and 20.5 percent (95 percent C1, 14.0% -27.0%) in the formula arm (P =.001). Breast milk transmission was predicted to be 16.2 percent (95% C1, 6.5%-25.9%). Breast milk was responsible for 44% of HIV-1 infection in the nursing group. Although transmission remained throughout the period of exposure, the majority of breast milk transmission ensued early, with 75% of the risk difference between the two arms occurring by 6 months. Both groups had similar 2-year mortality rates (breastfeeding: 24.4 percent [95 percent CI: 18.2 percent -30.7 percent] vs formula feeding: 20.0 percent [95 percent Cl: 14.4 percent -25.6 percent]; P =.30). At two years, the rate of HIV-1-free survival in the breastfeeding group was substantially lower than in the formula feeding group (58.0 percent versus 70.0 percent, respectively; P=.02). In this clinical trial, 16.2% of these HIV-1 infections were estimated to transmit through the breast milk, with the majority of infections occurring early in breastfeeding. Breast milk substitutes were linked to a 44% of reduction in newborn infections and a considerably better HIV-1-free survival rate. The study concludes the fat that, the HIV-1-positive mothers should make their decision on the safety and affordability of formula feeding for their infants. Breastfeeding for some months is recommended for those who still choose to breastfeed and discontinue as soon as feasible. Moreover, it's also highly important to improve breastfeeding technique and prevent breast pathology and whenever possible avoid breastfeeding or exclusively breastfeeding for a short period. Antiretroviral therapy to reduce viral load in breast milk during lactation is expected to reduce infectivity during breastfeeding. Immunocompromised women may be a particularly relevant target for antiretroviral therapy during lactation because to the increased likelihood of breastmilk transfer.

The report focuses on the relation between the relation of various common infant feeding practices and weight gain (obesity) which are very rarely addressed. It basically throws light on the fact that how the common infant feeding practices influence the development and prevention of childhood obesity. Obesity is generally a huge public health issue across the globe, and it tends to begin in childhood. The sudden and rapid weight gain during childhood is a well-known risk factor for obesity. The excess body weight gained during childhood often follows the children into adulthood. Breastfeeding has an inverse relationship with weight gain velocity and BMI. These connections are basically dosage dependent and are slightly lessened when breast milk is fed through a bottle and are also significantly reduced after the newborn period by formula supplementation. The investigation for the study was conducted at the CHILD birth cohort. Breastfeeding was commenced by 97 percent of the 2553 mother-infant dyads, with a median duration of 11.0 months. Solids were introduced to the majority of infants (74 percent) before the age of six months. Among "exclusively breastfed" infants, 55% received some expressed breast milk and 27% had formula briefly in the hospital. All other feeding styles were associated with higher BMIzs at 3 months when compared to exclusive direct breastfeeding: adjusted: +.12 (95 percent CI: .01 to.23) for some expressed milk, +.28 (95 percent CI: .16 to.39) for partial breastfeeding, and +.45 (95 percent CI: .30 to.59) for exclusive formula feeding. Short-term formula supplementation in the hospital had no effect on these correlations as long as exclusive breastfeeding was established and maintained for at least 3 months. By 6 months, formula supplementation was related with higher BMIzs (adjusted: +.25; 95 percent CI:.13 to.38), whereas solid food supplementation was not. The results for the weight gain velocity were actually similar. With the prior observational studies, it determines the fact that breastfeeding is basically inversely related to the newborn growth velocity, BMI and obesity. A randomized trial of breastfeeding promotion, on the other hand, had no effect on infant WFA 22; however, it did not include a nonbreastfed control group, and observational analyses confirmed that infants exclusively breastfed for at least 6 months had lower WFA compared to those weaned or supplemented earlier. When compared to exclusive breastfeeding, nursing before 6 months is related with a twofold increased risk of rapid weight gain, a +0.44 SD increase in BMI by 12 months, and a threefold increased risk of overweight. These effects are strong, surpassing maternal obesity's projected effect. Finally, if exclusive breastfeeding was initiated and maintained for at least 3 months following hospital discharge, brief formula supplementation during the newborn period had no discernible effect on these correlations. The study basically suggests that the lesser breastfeeding time, bottled breast milk feeding and formula supplementing have independent effects on infant weight gain, BMI, and risk of being overweight. Biological differences in the macronutrient compositions of formula vs breast milk, or differential effects on the gut flora, are expected to be the possible reasons for these effects. Moreover, it further determines that the infants fed from the breast actively suckle and self-regulate, but on the other hand, those fed from a bottle are much more passive and may not learn to balance energy intake appropriately. The study shows that breastfeeding's "baby-led" character might enhance satiety responsiveness. The child can regulate and balance the intake of food in relation to satiety even later in childhood.

An online parental namely Autism Internet Research Survey was conducted on April 2005, to determine whether breastfeeding or the use of infant formula supplemented with docosahexaenoic acid and arachidonic acid is associated with Autistic Disorder. This survey basically emphasizes on the common link between autistic disorder, breastfeeding and infant formula supplementation. The major aim of this survey revolves around finding out whether breastfeeding or using infant formula fortified with docosahexaenoic acid and arachidonic acid is associated with autistic disorder. Autism disorder (also commonly referred as autism or AD) is basically a brain development disorder that apparently affects how an individual perceives and even interacts with others, resulting in various issues including social interaction and communication issues. The aetiology of the condition is still completely unknown in most cases, and traits such as limited and repetitive or ritualistic patterns of conduct are also part of the illness. In some cases, parents have reported their children's regression or even in some cases loss of previously learned skills, followed by the emergence of disorder. Breastfeeding is the most proposed procedure for infant feeding. Breastfeeding children until six months old is considered very mandatory as it aids in improving the cognitive ability and academic success in children and may be beneficial to youngsters at risk for autism's cognitive abilities. Infants should be fed breast milk if at all possible, and if the formula is used, it should be supplemented with the polyunsaturated fatty acids docosahexaenoic acid (DHA) and arachidonic acid (ARA). The lack of breast milk or newborn formula enriched with docosahexaenoic acid and arachidonic acid might weaken children's immune systems, potentially leading to the autism. Generally, the breast milk contains vital components such as IgA and other humoral components from the mother which aids in infant's immunological defense. The docosahexaenoic acid and arachidonic acid are considered to be highly crucial for appropriate functioning of the infant's immune system.  In accordance to the findings of this exploratory survey, with results for 861 children with Autistic Disorder and 123 control children were utilized in this case-control study. Logistic regression was used to conduct the analyses. When all the cases were considered, (OR 2.48, 95 percent CI 1.42, 4.35) and after limiting cases to children with regression in development, the absence of breastfeeding was significantly associated with an increase in the odds of having autistic disorder (OR 2.48, 95 percent CI 1.42, 4.35). (OR 1.95, 95 percent CI 1.01, 3.78). When all cases were considered (OR 4.41, 95 percent CI 1.24, 15.7), and after limiting cases to children with regression in development, use of infant formula without docosahexaenoic acid and arachidonic acid supplementation versus exclusive breastfeeding was associated with a significant increase in the odds of autistic disorder (OR 4.41, 95 percent CI 1.24, 15.7). (OR 12.96, 95 percent CI 1.27, 132). According to the survey, children who were fed infant formula without docosahexaenoic acid/arachidonic acid supplementation or were not breastfed at all, were considerably more likely to have this disorder. The study indicates that when compared to breastfeeding, the cessation of nursing for more than six months is significantly associated with an increase in the chances of having autistic disorder. The utilization of infant formula without docosahexaenoic acid and arachidonic acid addition was similarly linked to a significantly increased risk of autistic condition. The conclusion of the study however, is that breastfeeding and use of infant formula supplemented with docosahexaenoic acid/arachidonic acid are suggested to protect against autistic disorder and less breastfeeding and the lesser utilization of infant formula without docosahexaenoic acid/arachidonic acid supplementation, results in increment of the probability of this disorder.

This systematic review article provides an association between the feeding, duration of breastfeeding and the timing of formula or cows' milk introduction and the possible impact of the same on the development of T1D. Type 1 diabetes (T1D) also referred as juvenile diabetes or insulin-dependent diabetes, is basically a long-term chronic condition under which the pancreas produces little or no insulin. Increased thirst, hunger, weariness, frequent urination and blurred eyesight are some of the symptoms. It usually shows up throughout adolescence. Breastfeeding has been suggested to strengthen the child's immune system and the early exposure to infant formula and a short duration of breastfeeding have been associated with a higher risk of T1D.  Breast milk's protective role has been linked in part to its composition, notably to antimicrobial compounds such as lactoferrin, lysozyme, and secretory immunoglobin. Moreover, it also contains macrophages, which influence T and B cell function, exhibit phagocytic activity, and produce immunoregulatory substances. An increased duration of breastfeeding during infancy may have a protective role against the development of T1D in comparison to an early introduction of cow's milk or milk formula. Moreover, the dietary exposure to several cow milk proteins may increase the risk of b-cell autoimmunity.  In comparison to an early introduction of cow's milk or milk formula, an increased duration of nursing throughout infancy may protect against the development of T1D. Diabetic children, in compared to healthy children, were either breastfed for a shorter period of time or were not breastfed at all, according to studies. The diabetes-affected infants were less likely than healthy children to breastfeed. According to the studies, Fort et al. discovered no difference in the age at which solid meals were given between cases and controls, but a 2:1 ratio of diabetes infants to healthy children who had a soy formula in infancy. This review article basically concludes that breastfeeding for a short period of time or not at all may be a risk factor for the development of T1D later in life.

FINDINGS AND CONCLUSION:

The findings and conclusions are purely based upon the quantitative and qualitative analysis of all the literature that was studied. The findings and conclusion are drawn on the basis of careful examination of every fact and figure and without any pre-conceived notions or personal views. The literature, in the form of publications, was studied with a view to find the answers to the objectives of this study. In depth analysis has helped to achieve the desired results.    

It is no surprise that breastfed babies are at a lower degree of risk of developing diseases than formula fed babies. Numerous studies conducted in this direction of pointed to the fact that formula fed infants have a higher incidence of suffering from diarrhea. Breastfeeding provides a natural form of nourishment and nutrition to the babies. It develops antibodies in the babies which help to protect them against a wide range of infectious and viral diseases. In case the mother is sick, it is a great chance that the baby has already been exposed to her illness. However, breastfed babies will be able to effectively combat the illness due to antibodies that are not entirely present in the formula feed. Moreover, in case of sickness in breastfed infants, the illness is likely to be less severe. Mothers can even breastfeed babies in cases of cold and flu. Breast milk reduces the risk of chronic and acute infections in the infants such as type I diabetes, ulcerative colitis, and Crohn's disease. Breast milk is considered superior to infant milk in preventing the diseases because breast milk shields against diseases through specific and non-specific immune factors and has long-term consequences on the metabolism.

The above figure discusses the relative risk of not breastfeeding for infections and mortality compared to exclusive breastfeeding. The analysis indicates that, in comparison to exclusive breastfeeding, partial breastfeeding had moderately higher relative risks than. Further, not breastfeeding had a very high prevalence of relative risks. In the first 12 months of life, breastfed children have shown greater immunity than formula fed children. The figure indicates that not breastfeeding category suffered the highest cases of diarrhea and pneumonia mortality. This doesn't mean that breast fed children don't suffer from diarrhea. There is a huge difference between the severity of the diseases between breastfed and non-breastfed children. Not just that, there is such a difference in the composition of breast milk and infant milk that even the duration of prevalence of diarrhea may significantly vary between the two. However, in cases where breast feeding did not persist beyond two months, the protective effect of breast feeding had stopped.

In a study by the Collaborative Group on Hormonal Factors in Breast Cancer, the researchers have claimed that for every 12 months a woman breastfed, the risk of developing breast cancer decreases y 4.30%. On the similar lines, Data Bride Market Research conducted a study on breast cancer diagnostics market. The major market growth determinants include rising number of breast cancer screening programs, growth in the number of private diagnostic centers and surging volume of patients suffering from breast cancer and breast associated disorders.

From the above study, it can be concluded that no artificial means, in combination with any kind of technology, replicate the composition of nutrients that are found in breast milk. Breast milk has a unique set of composition that develops on itself in correlation with the growing age of infant. Human or breast milk is far superior to any kind of formula due to varying nutrients and antibodies. This composition is directly proportional to the baby's overall physical and mental development. Breastfeeding mothers don't have to stick to a specific diet formula or pattern. It is scientifically proven that the mother would make good milk irrespective of its consumption. It is best and also advised to the breastfeeding mothers to eat a variety of nutritious foods to stay healthy.    

The above given figure represents the percentage of infants, less than six months of age, who are exclusively breastfed in the different territories. Further, the comparison has been drawn between the results of 1995 and 2005. The figure indicates that since 1996, exclusive breastfeeding rates have increased by more than 20 percent on average. Several countries have shown a remarkable growth of more than 60%. East Asia-Pacific region is maintain a steady pace of growth and will continue to do so in the coming years.

Infant milk is rapidly gaining popularity in the developing economies. A wide range of product innovations and approvals have prompted infant formula application at workplaces. Commercial infant formulas are regulated by the Food and Drug Administration (FDA), a hallmark of safety and security. Infant formulas are rich on docosahexaenoic acid (DHA) and arachidonic acid (ARA), which are nothing but omega-3 fatty acids that are readily found in breast milk. Infant formula is rich in vitamins, proteins, calcium, and minerals, which meet the essential body and mind development requirements. From the above discussion, it can be concluded that any kind of infant formula cannot match the level of nutrition provided by the human milk. However, infant formulas are the best nutritious alternatives to breast milk. Infant formulas are manufactured under sterile circumstances using a complex combination of proteins, sugars, fats, and vitamins.

Achieving such set of combinations is not possible to prepare at home. Therefore, it is advised not to feed the baby with homemade formulas. Regular cow and soy milk are to be avoided entirely during the first 12 months of the baby. Regular cow and soy milk are deprived of the required nutrition. As a result, experts recommend the use of formulas in cases where breastfeeding is not simply in the picture. Formulas must be fed only after careful consideration and as per the suggestion/guidance of the experts. Signs of a good formula feeding are- gaining of weight after first 3 to 7 days of formula feeding, the baby produces a good 6-8 number of diapers on daily basis, the baby passes stool 2-5 or even more times a day and the baby acts satisfied after each round of feed. New infant formulas are being manufactured using extra ingredients to make them more like breast milk. Manufacturers have increased their focus towards inducing prebiotics and probiotics in the formulas. This would lead the formula-fed babies to grow healthy bacteria in their bowels, reduce the chance of gastroenteritis, and have softer poo and less nappy rash.   

Feeding the infant with rice based infant formulas can tag along numerous health benefits. Data Bridge Market Research henceforth, prepared a detailed report on the global rice based infant formula market. The rice based infant formula market is segmented on the basis of type, product type, form, infant age and distribution channel.

REFERENCES:

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