Mother’s Milk — A Natural Nutrition for Infants

---

by Sadia Gulzar

---

Breastfeeding is the lifeline of a child’s survival, growth, and emotional well-being. From the first hour after birth through the first two years and beyond, a mother’s milk provides essential nutrition, protection from disease, and deep psychological bonding to an infant.

World health bodies and paediatricians stress on the importance of breastfeeding. According to the World Health Organization, “there is no substitute for breast milk”. It recommends initiating breastfeeding within the first hour after birth and continuing it exclusively for six months, followed by complementary feeding alongside breastfeeding up to two years or longer. This guidance reflects decades of scientific evidence showing that breastfeeding is essential for an infant’s health and development.

Dr Kiran Mubeen an International Board Certified Lactation Consultant (IBCLC) at the Aga Khan University Hospital Karachi elaborated the differences between breast milk and formula milk: “breast milk is composed of living cells while the formula milk is cow milk processed through artificial methods.”

Importance of breastfeeding

Human milk is not just food, it is a powerful medicine, a living substance uniquely tailored to meet an infant’s needs. It contains the ideal balance of proteins, fats, carbohydrates, vitamins, and minerals required for healthy growth. Breast milk contains a high proportion of whey protein which is easy for infants to digest and essential for organ development; immunoglobulins, crucial components for immune system that play critical role in defending body against infection. It also contains important fatty acids crucial for brain growth and cognitive development, helping children reach their full intellectual potential.

After birth, the first three days are important for baby, as mother body produces colostrum which is a thick yellowish milk rich in antibodies and contains multiple essential immunoglobulins which help in coating the lining of intestine, protects against infections, and builds lifelong immunity. Babies who are breastfed are less likely to suffer from diarrhoea, respiratory infections, allergies, and many chronic illnesses later in life.

According to Dr Mubeen, breast-feeding also benefits mothers by reducing the risk of breast and ovarian cancers, post-partum weight loss, bleeding and promotes faster physical recovery after childbirth. Additionally, it contributes positively to maternal mental health by lowering the risk of post-partum depression. Citing global health reports, she noted that optimal breastfeeding practices could help prevent up to 98,243 deaths.

Emotional bonding and psychological benefits

Breastfeeding creates a unique skin-to-skin attachment and helps to build strong bonding between mother and child. This closeness fosters emotional security, trust, and attachment, which are essential for a child’s mental and emotional development. It also benefits mothers by reducing stress and strengthening maternal confidence. Unlike bottle feeding, breastfeeding naturally encourages warmth, touch, and communication.

Breastfeeding also protects mothers by reducing the risk of breast and ovarian cancers and helping them recover after childbirth.

Economically, it reduces the cost of infant feeding and lowers healthcare expenses by preventing illness. For communities and nations, promoting breastfeeding leads to healthier children and stronger societies.

Breast feeding versus formula milk

Ironically, today, bottle-feeding is often glamorised on television channels and social media, where celebrities in “white coats” endorse formula brands as if they were medical solutions. This is alarming and raises serious questions: Do international or national health regulators monitor such advertising? How do these promotions influence mothers’ choices about infant feeding?

When I raised these questions with paediatricians to elicit their expert views, many pointed to the International Code of Marketing of Breast-Milk Substitutes, adopted by WHO in 1981.

Dr Mubeen described the promotion of the use of formula milk on any platform is against WHO code of marketing. “Such marketing can discourage breastfeeding and mislead parents”, she asserted. She further emphasised even health professionals are restricted to promote use of formula milk by mothers.

According to Dr Mubeen, health professionals are ethically expected to provide evidence-based guidance and avoid promoting formula unless medically necessary, because aggressive marketing can shape perceptions and push mothers toward formula feeding even when breastfeeding is possible.

Marketing gimmicks

Despite these codes, guidelines and restrictions, promotion of the use of formula milk goes unchecked ranking Pakistan the fourth largest milk producer in the world. Despite spending $30.5 million annually on dairy products, Pakistan imports 15,000 tonnes of formula milk. In 2025 the market share of formula milk reached to $435.50 million.

Aggressive marketing by the infant-formula industry is influencing many mothers’ feeding choices worldwide. Market analyses show that the global formula milk sector is projected to grow steadily, often estimated at around 5–6% annually through 2030. At the same time, global breastfeeding rates remain below public-health goals. According to joint estimates by the WHO and UNICEF, about 48% of infants under six months are exclusively breastfed, while countries have set a target of 60% by 2030.

A cross-sectional study conducted by the National Institute of Health (NIH) examined paediatric, gynaecology and obstetric departments at two hospitals in Pakistan between 2020 to 2021. The study included 484 mothers with children up to three years of age. Of these, 180 mothers exclusively breastfed their children, 80 used formula milk, and 219 combined breastfeeding and formula feeding. Bottle feeding was most common among mothers who had previously introduced formula milk.

As formula milk consists of processed milk, it is devoid of nutrients necessary for baby growth. Moreover, prolong usage of bottled milk can cause multiple infections to the child, resulting alarmingly high health consequences.

According to UNICEF and WHO estimates, pneumonia and diarrhoea together caused roughly 700,000–750,000 deaths among children under five globally in 2019.

Pakistan remains one of the countries facing severe child-health challenges. Around 400,000 children under five die each year from preventable and treatable causes, including pneumonia, diarrhoea, malnutrition, and neonatal complications.

A report in Dawn newspaper quoting ChildLife Foundation Director Dr Irfan Habib states: roughly one in three children presented to their emergency services suffer from diarrhoeal illness. Data from the Foundation’s telemedicine network in more than 300 government hospitals across Pakistan shows that gastroenteritis is among the most common illnesses in children.

Health professionals also highlight that inappropriate or unsafe bottle-feeding practices can worsen infant health risks, especially in areas with poor sanitation or limited access to clean water.

Exclusive formula feeding, when not medically prescribed and prepared unsafely, may contribute to malnutrition, infections, and weakened immunity, which can in turn cause stunted growth.

Although infant formulas are regulated to be nutritionally adequate when properly used, as Dr Mubeen stated, some paediatricians note that formula milk typically contains a higher proportion of casein protein which may be harder for immature kidneys and digestive systems to handle in early infancy.

Similarly, paediatricians, including Dr Wasim Jamalvi, former Sindh chapter president of the Pakistan Paediatrician Association (PPA), have explained that introducing formula milk early can reduce a mother’s milk supply, because breast-milk production depends on regular suckling and demand.

Medical research shows that avoiding breastfeeding is associated with higher risks of certain diseases in mothers, including breast and ovarian cancers, compared with women who breastfeed for longer durations.

Health professionals, including Dr Mubeen, stress that formula milk should be the last option. It is recommended only in rare medical emergencies where breastfeeding is not possible or is medically not advised if a mother’s own milk is unavailable, the preferred alternative is donor breast milk, before considering formula.

Myths about breast milk

According Dr Mubeen, many families hold myths about breastfeeding, such as the belief that breast milk does not help babies gain weight or that breastfed children become physically weak. In our society, a ‘healthy child’ is often wrongly associated with being chubby or overweight. Because of this misconception, families introduce formula milk as a supplement. Over time, formula feeding may replace breastfeeding, which can reduce breast stimulation and lead to a drop in prolactin levels, ultimately decreasing breast milk production.

She specified multiple reasons for reduction in breast milk after delivery, including gestational diabetes mellitus. In this condition mothers may feel less milk production nearly for two to three days. During this time mothers should not instantly go for formula milk rather continue skin contact and sucking of babies. This will continuously stimulate signals to brain to raise milk production. Most of the mothers complain the deficiency of breast milk after delivery.

A second contributing factor to early complementary feeding is the rising rate of caesarian section deliveries. Mothers who undergo C-sections often experience immense pain and limited mobility, making breastfeeding uncomfortable or difficult in the initial days. As a result, some mothers resort to formula milk, sometimes on paediatricians advice, to ensure adequate infant nutrition

Additionally, cross-section studies conducted during Covid-19 pandemic found that many mothers turned to formula milk feeding due to fears of transmitting the virus to their infants.

Corrective measures

Many professionals, including the Executive Director of Sindh Institute of Child Health and Neonatology, Dr Jamal Raza, recommended imposition of heavy taxes on the formula milk industry to protect public health.

Moreover, it is essential to make vibrant policy against unethical advertisements and health professionals who promote formula milk for personal gains and to for the interests of the corporate sector.

It is the responsibility of health authorities and professionals to arrange awareness and training sessions for mothers encouraging them to adopt breastfeeding.

For working mothers Dr Mubeen recommended milk compression where milk can be preserved for nearly four to five hours. Besides, jurisdiction should be inflexible for those who unethically promotes formula milk on social platforms.

Supporting mothers to breastfeed is not only a personal responsibility, but it is a public health priority that ensures healthier children, families, and futures.