There are few topics in parenting where I will put on my stern mom voice and tell you what to do. Many of our choices as parents are more of a matter of opinion and preference than safety. What we do is (largely) based in love and a desire to do the best for our children. How we feed them, however we feed them, is no different, but I’m not going to mince words: Please don’t feed your baby homemade formula.
I’ll expand upon that thought slightly: Please don’t feed your baby homemade infant formula without understanding that it is very difficult to make it a safer option than human milk or safely prepared commercial formula, and the people giving you recipes for homemade formula are not telling you this. Some people who share these recipes don’t realize the risks. Some have financial interest in you following their advice. The safety—or lack thereof—is the biggest reason to avoid it, and there are other things to consider as well.
Consuming raw milk carries real risks.
While the existence of regulations alone doesn’t prove that consumption is harmful, it is worth noting that most states restrict raw milk sales in some form. The CDC released a report in January 2015 detailing outbreaks of food-borne illnesses related to raw milk consumption, and the statistics show that children were at the highest risk for serious illness. According to this report, “From 2007-2012, 26 states reported 81 outbreaks caused by raw milk to CDC. These outbreaks caused 979 illnesses and 73 hospitalizations.” 59% of outbreaks involved at least one child younger than 5. Keep in mind that these are only reported outbreaks. Raw milk may not be investigated as a culprit because in less raw-milk-friendly areas people may avoid mentioning it to avoid potential repercussions, and not everyone goes to the doctor or hospital when they have an illness. Actual numbers are likely higher.
Adults should be able to make the decision to purchase raw and consume milk after weighing the risks and benefits for themselves. Unfortunately, children aren’t able, or given the opportunity, to do this risk-benefit analysis themselves, and the risks are highest for them.
The correct balance of nutrients is essential, and difficult to achieve.
One of the primary considerations of breastmilk versus breastmilk substitutes is renal solute load. The higher the renal solute load of a food, the more water is needed for the kidneys to properly excrete the byproducts of digestion and metabolism of the food. Protein, calcium, phosphorus, sodium, and potassium contribute to potential renal solute load, and when an infant’s immature kidneys are overtaxed, this can lead to dehydration and worse. Infants who are fed cow’s milk are also at risk for anemia due to the low iron content of cow’s milk, intestinal blood loss that occurs in infants who consume cow’s milk, and the high levels of calcium and casein in cow’s milk (which impact iron absorption).
As you can see from the table below, human milk has much less protein, calcium, phosphorus, sodium, and potassium than cow’s milk and goat’s milk. Goat’s milk is at times called the closest animal-milk substitute for human milk but, as you can see, it has an even higher potential renal solute load than cow’s milk.
Liver-based formula can easily contain too much vitamin A. Three ounces of chicken liver contains 185% of the RDA for vitamin A for an adult woman; the Weston A. Price liver-based formula recipe contains two ounces of liver for an infant per day. Since vitamin A is fat soluble, it is stored in the body and accumulates over time.
Cow’s milk does not provide enough vitamin E, iron, and essential fatty acids that are necessary for infant growth and development. Plus, kind of protein and fat in cow’s milk can be difficult for infants to digest, and that’s not something you can change with the additives people use to alter cow’s milk to create homemade infant formula.
Even if we presume that the many recipes floating around for homemade infant formula are providing the correct balance of macro- and micronutrients (they’re not), what about the other variables?
- Not all raw milk is created equal, and a cow’s milk can change during the course of lactation, just like human milk can.
- Are you using the exact brand of supplement suggested by the recipe? Different manufacturers will have different formulations.
- Has the manufacturer’s formulation of the supplements stayed the same since the recipe was created and published?
- Is the recipe itself accurate?
- Is the equipment you’re using to measure your ingredients accurate? Are you measuring them accurately? Here’s the story of a baby who was hospitalized for a vitamin D overdose because her mother added a dropperful of vitamin D rather than a drop to the homemade formula she was making.
Here’s some more reading about the complexities of matching the nutrition and performance of breastmilk when creating substitutes. In a nutshell:
Manufacturers often add new ingredients to infant formulas in an attempt to mimic the composition or performance of human milk. However the addition of these ingredients is not without risks as a result of a range of complex issues, such as bioavailability, the potential for toxicity, and the practice of feeding formula and human milk within the same feeding or on the same day.
Commercial formula manufacturers aren’t making poison.
The people who put the most money and effort into researching breastmilk are those who are trying to replicate it. The more they can make formula like breastmilk, the easier it is to sell it (and the higher prices they can charge). This is not skepticism or conspiracy theory; it is basic economics.
Commercial infant formula keeps getting better and better. Will it ever match the incredible, varied, ever-changing composition of human milk? No. But we do know it will meet certain nutritional guidelines set by the FDA, and there is oversight in regard to the safety of the manufacturing process. Not only do they have a vested interest in creating a product as close to human milk as possible, they have a vested interest in avoiding contamination and product recalls.
Cronobacter infection is one serious illness that has been linked to commercial infant formula, and those cases happen to the tune of 4 to 6 of them reported per year. There are additional potential contaminants of powdered infant formula, such as Salmonella . It’s a risk, particularly if formula is not being prepared correctly, but a much lower risk than that of raw milk, especially considering the number of infants consuming powdered infant formula in the United States every year (i.e., most of them). Using sterile, ready-to-feed formula significantly reduces this risk, but is also more expensive.
It is expensive and time consuming.
You can purchase a pre-assembled kit for all of the supplements and additives you need for homemade infant formula from Radiant Life. A 37-day supply will set you back $174 (they throw in free shipping, so it comes out to $4.70 per day just for the additives). A gallon of raw milk costs significantly more than pasteurized, homogenized (aka regular store-bought) milk. This website gives it a range of $6 to $8 per gallon. Then you need whey (homemade), which is the liquid left over from making cultured dairy products such as yogurt, cream cheese, or sour cream (made from raw milk, of course). And don’t forget the raw cream. The photo to the right was taken by a friend of mine in southern California (where retail raw milk sales are legal). There’s quite a price difference between raw and pasteurized cream, and you need two to four tablespoons of it per batch of homemade formula.
Then there’s the time involvement. You have to assemble the ingredients. If you’re not buying a pre-packed kit, you’ll be spending time sourcing individual supplements. You’ll have to find a source of raw milk, and likely drive to the farm to purchase it. You’ll have to make a batch of it each day, which is a process much more involved even than safely preparing commercial infant formula.
Maybe you’ll end up saving time only feeding your baby six times a day, though, as some of the recipes recommend 6- to 8-ounce servings. The reality is that this means a baby is getting too much to eat at meal times that are too infrequent. Infants should be eating 8 times per 24 hours (including nighttime feedings), at a minimum.
Proponents of homemade formula give terrible advice about breastfeeding (and lots of other things).
The Weston A. Price Foundation, the source of several homemade baby formula recipes, is notorious for giving awful advice to breastfeeding mothers. Namely, the organization’s president, Sally Fallon, has stated that women who are not following a Weston A. Price diet would be better off feeding their children homemade formula. This goes against all of the research we have on breastfeeding. Not that the Weston A. Price Foundation seems to take this into account.
Another proponent of homemade infant formula, Sarah Pope (The Healthy Home Economist), says, “There are donor programs available for human breastmilk, but because the diet of the donor mother is unknown (and most likely nutritionally insufficient), and the fact that the breastmilk is pasteurized thereby destroying much of the nutritional benefit, this option is not recommended.” While heat treatment through pasteurization does alter some of the components of breastmilk, its bioactive properties are at least party retained while destroying harmful pathogens. (Here’s one summary/position paper stating the research.)
…and this doesn’t even get into the implausible, pseudoscientific claims these sources and other similar sources make about a wide variety of other health topics.
Here’s the bottom line.
If your baby is not getting your breastmilk, your baby should be getting donor breastmilk or (properly prepared) commercially manufactured formula. We’ve come a long way from the time when a third of all infants who were bottle-fed died and the unregulated formulas of the past. Nothing is 100% risk free, but it seems clear to me that homemade formula’s risks outweigh any perceived benefit, particularly for infants who have not yet started complementary/solid foods.
Every baby deserves to be fed safely. Sometimes parents and caregivers have no choice but to feed breastmilk substitutes, and sometimes inappropriate ones. There are organizations around the world trying their best to improve those situations (here is just one of many, focusing on refugee children: Infant Feeding Support for Refugee Children), and my heart breaks for any family who does not have access to the safest ways of feeding their baby.
Most of the people reading this will have more options. This post is written in the spirit of giving you all of the information you need to make an informed decision. I’ll leave you with one final thought. I’ve said previously, the time, effort, and money put toward sourcing the ingredients and making homemade baby formula could be spent on finding donor human milk instead. Breastmilk, after all, is raw milk specifically meant for human infants.
