Module 18

Breastmilk & Formula Nutrient Comparison Sheet

Understand what's in each, what's unique to breastmilk, and how to optimize either feeding method

This is not a judgment sheet. Fed is baseline. Informed is better. Whether you breastfeed, formula feed, or combo feed, understanding the nutritional profile helps you make targeted choices to support your baby's brain development.

Macronutrient Comparison (per liter)

Nutrient	Mature Breastmilk	Standard Infant Formula	Notes
Energy	~650-700 kcal	~670 kcal	Breastmilk varies by feed and time of day
Protein	~10 g (60% whey, 40% casein)	~14-15 g	Breastmilk protein is more bioavailable; formula needs more to deliver same amino acids
Fat	~35-40 g	~35-36 g	Breastmilk fat varies hugely — higher at end of feed (hindmilk) and in afternoon
DHA	Variable (0.1-1.0% of fat, depends on mother's diet)	~0.2-0.36% of fat (varies by brand)	Mothers eating fatty fish 2-3x/week have 2-4x more DHA in milk
ARA	~0.5% of fat	~0.4-0.7% of fat	Arachidonic acid — important for brain growth
Carbohydrate (lactose)	~70 g	~72-74 g	Lactose feeds beneficial gut bacteria (Bifidobacterium)
HMOs (human milk oligosaccharides)	~5-15 g (200+ varieties)	1-2 types added in some formulas (2'FL, LNnT)	Major breastmilk advantage — feeds gut bacteria, blocks pathogens

Key Micronutrients

Nutrient	Breastmilk	Formula	Supplementation Needed?
Iron	Low (0.3-0.5 mg/L) but 50% absorbed	Fortified (10-12 mg/L) but ~5-10% absorbed	Breastfed babies: may need supplement or iron-rich solids by 4-6 mo
Vitamin D	Very low (10-80 IU/L)	Fortified (400 IU/L)	ALL breastfed babies need 400 IU/day supplement from birth
Vitamin K	Low	Fortified	All newborns should receive vitamin K injection at birth
Zinc	Adequate in early months, declines by 6 mo	Fortified	Breastfed babies need zinc-rich foods (meat) starting at 6 mo
Vitamin B12	Depends on mother's status	Fortified	Vegan/vegetarian mothers MUST supplement B12
Iodine	Depends on mother's intake	Fortified	Nursing mothers need 290 mcg/day (most are deficient)
Choline	~125 mg/L	~80-100 mg/L (varies)	Nursing mothers should supplement choline (550 mg/day)

What's Unique to Breastmilk (Cannot Be Replicated)

200+ Human Milk Oligosaccharides (HMOs)— Feed Bifidobacterium, block pathogen attachment, train the immune system. Formula adds 1-2 types.

Live immune cells— Leukocytes, macrophages, stem cells — breastmilk is alive. Up to 1 million white blood cells per mL in colostrum.

Secretory IgA antibodies— Targeted to pathogens in the mother-baby environment. Updates in real time when mom is exposed to illness.

HAMLET protein— Human alpha-lactalbumin made lethal to tumor cells. Under research for anti-cancer properties.

MicroRNAs— Gene-regulating molecules that survive digestion and influence baby's gene expression and immune development.

Hormones (leptin, ghrelin, adiponectin)— Help regulate baby's appetite and metabolic programming for life.

Circadian variation— Morning milk has cortisol and stimulating amino acids. Evening milk has melatonin and tryptophan. Helps set baby's day-night rhythm.

Optimizing Formula Feeding

1Choose formula with DHA/ARA at 0.3%+ of fat content — and from non-hexane-extracted sources if possible
2Look for formulas with added HMOs (2'FL) — Similac and some European brands include them
3Consider goat milk or European formulas (HiPP, Holle) for gentler protein structure — cow milk protein in US formulas is more processed
4Add a probiotic (Lactobacillus rhamnosus GG or B. infantis) — formula lacks the prebiotic HMOs that feed beneficial gut bacteria
5Paced bottle feeding: hold bottle horizontal, allow baby to control pace, switch sides to mimic breastfeeding pattern
6Don't microwave formula — uneven heating creates hot spots and destroys nutrients. Warm under running water.
7Use filtered water for mixing — municipal water may contain fluoride, chlorine, and disinfection byproducts

Optimizing Breastmilk Quality

1Eat fatty fish 2-3x/week (salmon, sardines) or supplement 500+ mg DHA — directly increases milk DHA
2Take 550 mg/day choline — most nursing mothers are deficient, and it directly impacts milk choline levels
3Supplement 6,400 IU vitamin D to raise milk D levels (alternative to supplementing baby directly, per Hollis 2015)
4Continue prenatal vitamin or postnatal multivitamin — nutrients deplete during lactation
5Eat enough calories (roughly 500 extra per day) — severe dieting reduces milk supply and nutrient content
6Stay hydrated but don't force fluids — drink to thirst. Overhydrating doesn't increase supply.
7Minimize alcohol — if you drink, wait 2+ hours per drink before nursing. No need to pump and dump if timing is right.

Combo feeding (breast + formula) captures many breastmilk benefits. Even 1-2 breastfeeds per day provides significant immune protection and HMO exposure. Any amount counts.