Next Best:

Resources for Moms Who Choose Not To or Can Not  Breastfeed

Not every mom chooses to breastfeed.   Not every mom can physically breastfeed, although it is more rare than people believe.  What should moms do who can not or choose not to breastfeed? 

Respect Comes First

First of all, let us state loud and clear:    It is our responsibility as a global community to care for mothers, make sure they have the best, unbiased information free of conflicting agendas, and support them to succeed and feel empowered in carry out their parenting decisions.  All moms deserve to be respected to make the decision that is best for themselves and their families, and no mom deserves to be judged.  We stand behind this whether a mother is feeding breastmilk, formula, or some combination of both.  Judgment of mothers has no place in truly wanting to help mothers and babies.   There are many mothers who can not or choose not to breastfeed, whether it is due to a double mastectomy, poorly performed breast-reduction surgery (but don’t give up until you check out; or taking medication that is contraindicated by breastfeeding (and those are far fewer than we are being led to believe–see   Some survivors of childhood sexual abuse find it too difficult to breastfeed directly but can pump, others have been able to breastfeed successfully with counseling and help.   There is some research being done–but not nearly enough–on why some mothers have low milk supply.  Some parents adopt and relactation is not a viable option.  For some mothers, the reality of being a single parent or a provider, and going back to work under conditions that are hostile to breastfeeding, the obstacles become so insurmountable that breastfeeding is not feasible.   We need to focus our efforts on putting pressure on those “Booby Traps“, not moms.  In short, there are many more reasons why mothers choose not to or can not breastfeed.

So, we’ve got your back here too, girl!    If you are clear that you will not be breastfeeding, then we support you to get the best information on alternate feeding methods.     If you still have conflicting feelings about whether breastfeeding is right for you, we encourage you to resolve them so you can move forward with clarity and confidence.   Either way, we wish for you the opportunity to develop a loving bond with your baby, and a wonderful journey into motherhood.     

What is REALLY Second Best?

Here is a BIG secret.   The next best thing to breastfeeding is NOT formula.   According to the World Health Organization, formula is the 4th choice in line after breastfeeding!    The correct rank, is 1) direct breastfeeding; 2) the mother’s pumped or expressed milk in a bottle; 3) another mother’s pasteurized, screened, donated human milk, and 4) artificial milk feeds.     This means that the health risks of artificial baby milk (abm, or formula) are greater than any other choice.   Formula is not second best, it should be used as a last resort.  This is very contrary to the marketing claims of the formula industry stating that formula is the only safe alternative to breastfeeding when a mother can not or chooses not to breastfeed. 

Human milk photo graciously donated by

So, if you will not be breastfeeding, we encourage you to look into either pumping and feeding your milk to your baby, or if that is not possible, then obtaining donated, screened, pasteurized human milk.   Right now, there are only a few human milk banks, but thanks to increasing demand, more are being established.   Best for Babes envisions a world where milk banks in the U.S. (as of August 2009 there are 11); are as ubiquitous as blood banks (2,200?), so that all babies needing it, except those with galactosemia, can receive donated human milk.   (Galactosemia is an extremely rare condition affecting only 66 babies of 4 million born annually, or 0.00165% of all births.)  Until more people demand more human milk banks, and drive the change to make that happen, many mothers are forced to rely on formula.    Pasteurized human milk from a milk bank loses some of it’s potency during the pasteurization process but is still far easier for babies to digest, and contains immune-boosting substances. 

For information on the screening & donation process of donor milk, please see

Donor milk can be obtained through a prescription from your physician, usually a neonatologist or pediatrician.   Some insurance companies are starting to cover the cost of donor milk (while the milk is donated, the processing cost still needs to be paid).   As long as there is a prescription, donor milk can be provided for as long as it is needed.  For more information on which hospitals have donor milk and who pays for it,  see our post in conjunction with 2010 Pregnancy Awareness Month.

Formula Recommendation

If you have decided to feed your baby formula, our recommendation is to choose a generic organic formula recommended by your child’s pediatrician or primary healthcare provider.   Generic brands are much less expensive than name brands,  and for a variety of common sense reasons we think organic is better (note, however, that not all formulas that claim to be organic are actually 100% organic; additives like DHA and ARA are not and there is some controversy over this).   In discussing this with your physician, a red flag should go up if he/she insists on a particular brand, as that may indicate too much influence of formula company representatives, which in turn suggests a “booby trap” that has kept you from considering breastfeeding, pumping breastmilk, or feeding donated human milk if available.

What About Guilt?

So, what if you used formula, or plan to use formula, should you feel guilty?  Are we trying to make you feel guilty by pointing out a little-known truth, that formula is associated with greater health risks across the board than breastfeeding, pumped breastmilk, or donated human milk?   The answer is no.  Here’s why you should not feel guilty:  For far too many mothers, our culture has erected either 1) so many social barriers (squeamishness, fear of nursing in public, perception of breastfeeding as gross) or 2) so many institutional barriers (hospitals, physicians, employers, insurers, store & restaurant policies, etc.) that moms are not interested in breastfeeding or find it to difficult to breastfeed, or difficult to provide pumped or donated breastmilk.  Parents are boxed into a corner where  they have been led to believe that formula is the only realistic option, and that they can’t do anything about it.   When most moms realize how they have been “booby-trapped” and prevented from succeeding at achieving their personal breastfeeding goal, they feel usually feel sadness and anger, not guilt.   

Those feelings of sadness and anger can be powerful motivators to spur social change to help other mothers and babies. We urge you to join the fight to “beat the booby traps” so that more moms who want to breastfeed can succeed, and so that moms who can not breastfeed, can have access to the next best: screened, pasteurized, donated human milk.

Resources & Reading did a heartbreaking and wonderful story on a mother’s quest to save babies, although she lost her own.  If you do nothing else, read this story, which explains a great deal about Human Milk Banks and why they are so important.   We are deeply grateful to for writing about a topic so few moms know anything about.

More resources to come, please contact us if you have suggestions!

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