I’ve used powdered infant formula maybe two times in the entire time I have supplemented for my daughter (I have supplemented with formula for over a year, out of necessity due to breast hypoplasia and breast surgeries). The main reason why I was never keen on using powdered formula is because of the theory of free radical damage from using a powdered reconstituted animal product. Now, I don’t know if the ready-to-feed and concentrate forms of infant formula I’ve been using contain reconstituted powder in them. If they do, I’ll probably feel like the world’s biggest schmuck. But the more research I do on the subject, the more I realize the oxysterol powdered-milk theory isn’t the only reason why using powdered infant formula isn’t a good idea.
Powdered infant formula is the most affordable form of infant formula there is. Every other form (concentrate, ready-to-feed cans and bottles) is significantly more expensive. This is why most people who for whatever reason decide not to continue lactation (or who can’t easily lactate because of a physical barrier which impedes it — think adoption or breast surgery) usually decide to buy powdered infant formula. It’s not cheap, but it’s cheaper than the already prepared stuff. Many people who would otherwise be able to breastfeed or pump milk for their babies for a lot less money (the price of renting a hospital grade breast pump can be as little as $35/month, or less; the service of a lactation consultant is often cheaper than the cost of one month’s supply of formula), instead buy the powdered infant formula because it is erroneously perceived to be a “cheap” and “good” alternative. There are many barriers impeding the success of breastfeeding for new mothers, but one of the biggest ones is the fact that it is easier (and less taboo) to learn how to prepare infant formula than it is to learn how to breastfeed or pump (also, figuring out how to prepare infant formula can be done easily in public; figuring out how to breastfeed, topless, for example, is unfortunately not acceptable in most places — and trying to figure out how to breastfeed while wearing clothing is like trying to figure out how to swim by practicing in a bathtub — it’s not very effective). Formula companies exploit this whenever they can, seducing women with the promise that formula is “just as good” for their baby and much easier to figure out than breastfeeding in the middle of the night when holding a screaming, hungry newborn and without anyone to help you.
Unfortunately for most mothers, formula companies don’t actually care (in deed; they always pay lip-service to “caring”) if the product is prepared properly or if it’s even safe before preparation. They feel that’s “not their problem,” legally speaking, so they sleep easily at night, even if infants who use their mislabeled products die.
I do not recommend infant formula use at all unless there’s no other feasible option, but I especially do not recommend the use of powdered infant formula. Powdered infant formula is not sterile. Infants have already died from contaminated powdered infant formula (even when prepared according to the manufacturer’s directions). The United States’ Centers for Disease Control and the Food and Drug Administration advise against the use of powdered formula in hospitals because of the contamination risk it poses. It is impossible to sterilize powdered formula in the factory in the same way that liquid formulas can be. Furthermore, if preparing the powdered formula with boiling water to kill the bacteria, some of the vitamins in the formula may be damaged beyond even what the sterilized liquid formulas undergo.
Even when prepared according to the manufacturer’s directions, however, powdered formula never dissolves completely. You can shake the powdered formula with the proper amount of water in a baby bottle until the cows come home (this is what the directions on most if not all powdered infant formulas say to do — shake the measured scoops and water together in the baby bottle), and you will inevitably be left with undissolved lumps in the resultant liquid mixture. These lumps mean the concentration of formula in the liquid is less than it should be, and the lumps often stick to the sides of the baby bottle and never get consumed like they’re supposed to.
In addition to powdered infant formula not being sterile, the possibility of free-radical cell damage from oxidized cholesterol/fat from the formula powder, and the problem with the formation of lumps upon reconstitution, there is also the very real possibility that the directions on the can won’t be followed properly. Most women in the third world don’t have schooling beyond primary school. Consequently, a basic understanding of weights and measures (like liquid measure and powdered formula scoop measure) is often not understood very well. This sometimes leads to formula being prepared at too high of a concentration if the powder is measured before the water is, or it sometimes results in a too-dilute preparation if the woman in question is trying to save money by using less powder than is called for on the can. A too-concentrated formula can lead to dehydration, renal failure, and death in the infant. A too-dilute concentration of formula can lead to malnutrition and a lifetime of health problems, in addition to the possibility of eventual death by starvation. While it may seem “affordable” in the short-run to provide a third-world woman with “free” formula for a time, in the long-run, the results are disastrous and not worth the true, human, cost. The woman dries up, no longer produces milk with her own body, and becomes needlessly dependent on a far inferior, even dangerous product. It becomes like a drug, then. A woman will do anything to get more of it for her baby, because it’s the only feasible option left to her for nourishing her baby once her milk dries up (her milk will start drying up as soon as she starts supplementing with formula if she does not provide stimulation to her breasts — often the woman is not aware of this consequence because not many people are aware of the supply-and-demand aspect of breastfeeding). Over more than one generation, this dependence on infant formula will lead to a loss of knowledge of breastfeeding for a given society (and increased breastfeeding ignorance), leading more women through the generations to become dependent on an external, purchased product rather than trusting their own bodies. It is unconscionable to provide formula to third world countries for free for these and other reasons. It’s also immoral to encourage people to buy “cheap” powdered infant formula when the truth is that the female body can produce a far superior (and practically free!) product, if only the proper education were disseminated about it.
Maybe if everyone had to pay the price of liquid formulas when choosing to formula feed (which is what would happen if everyone knew just how inferior — and even dangerous — powdered formula was), perhaps then breastfeeding and pumping wouldn’t be seen as “gross” and “too much trouble.” It would definitely incentivate a lot of people who erroneously believe formula and breastmilk are “just as good” as one another to at least try breastfeeding and/or pumping before the “easier” formula-feeding, and it may motivate new moms to stick it through the tough times for longer. At the very least, if no one were to buy the powdered formula anymore, it would incentivate those in the formula industry to charge less for their liquid “premium” products, which would be better for everybody — (except, of course, for formula manufacturers and their shareholders).
Formula does not have to be part of the cost of raising a child. It’s not a necessity like a car seat is (for those people who own a car). It is an artificially created need, artificially created through baby-unfriendly hospital policies, aggressive marketing tactics, and the unofficial endorsement of many health care workers (doctors, nurses, hospital administrators, some midwives, etc.) the world over. This artificially created need causes needless illness and death, and it’s all for the sake of making a buck. It is never about the health and well-being of mother and child.
The use of infant formula (homemade or commercially prepared) should be the option of last resort, to be used after all other (better) options have been exhausted. Breastfeeding should always be the first choice, except for the very rare case of severe galactosemia. Powdered infant formula should just never be used at all — babies have better options no matter where in the world they are; much of the time, it’s just a matter of allowing breastfeeding to succeed. Too often breastfeeding is sabotaged by the inappropriate introduction of formula by health care workers, misinformed and exhausted postpartum moms, or well-meaning but misguided family members.
Due to all the health risks associated with consumption of any type of formula, moreover, it is completely inappropriate for any hospital employee or volunteer to feed newborns infant formula routinely unless the mother of the infant is dead, has abandoned the baby, is HIV+, or does not have functioning breasts. And actually, for extreme cases like that, the infants involved should be fed donor breastmilk whenever it’s available (in the case of an HIV+ mom, the mom can try manually expressing her milk into a clean container and flash-pasteurizing the milk to kill the HIV before feeding it to her infant — it would still be far superior to any formula). Funny that if breastfeeding were considered as routine as formula-feeding is now, more healthy donor milk would be available to feed babies whose mothers cannot… Imagine that: A world where every baby is fed breastmilk, and where no corporation is profiting off the sale of human milk. That would surely be a beautiful thing.