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Is breastfeeding an infant more healthy than using expressed milk? With healthy I mean the relative health of mother and child, and with expressed milk I mean milk extracted from the breasts using breast-pumps.

I assume it is more safe to use breast-pumps, since one can sanitize pumps with more intense chemical agents than one would use on a breast. But then again, how intense would cleaning for a breast even need to be? Or I guess one could also argue that the more times some device is touched, the more it can be contaminated, so then the shortest route, breast to mouth, would be better than breast to pump to bottle to mouth.

Or conversely, pro breastfeeding, would the child have a better chance to "bond" with the mother when being breastfed? This might be psychological territory, though.

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    It depends on the pitch of answer you wish to hear, but this question may find more fertile soil in Parenting (you will certainly stir some strong-opinionated folks there) and in Health.SE. Bonding as you say goes both ways and physical contact generates more oxytocin in both bubba and mommy. In all, breast feeding is preferable when possible, provided personal hygiene is maintained of course. Bubba, when able, is more effective in emptying the breast too, reducing the chance of infection. – AliceD Jul 15 '15 at 1:31
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    Putting the question about how much sense "sanitization" of normal skin-dwelling bacteria makes in the first place, I don't see how you are going to get the milk out of the breasts without "contaminating" it even if you can sterilize pump and container to your heart's content. Are you planning to draw the milk out through needle and syringe? Even that will not save you from gland-dwelling bacteria. So I don't see the objective you are trying to achieve by adding another device in the middle. – user16770 Jul 15 '15 at 6:42
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    I would be more concerned about residual cleaning chemicals than a a little dirt – gillonba Jul 15 '15 at 14:57
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    I haven't evidence for this, but I've heard some people speculate that breastfeeding also helps develop jaw, mouth, and facial muscles more fully than bottlefeeding, because it takes less work to get milk out of a bottle. So, there's another line of inquiry to follow. – user11394 Aug 7 '15 at 17:43
  • As a follow-up to user16770's comment, we'd also have to look at what types of bacteria are typically found on the breast. Many forms of bacteria found on the human body aren't harmful. – user11394 Aug 7 '15 at 17:45
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Hygiene

Several points to address here:

one can sanitize pumps with more intense chemical agents than one would use on a breast

Breasts, nipples of a typical-healthy-relatively-clean mother are perfectly safe for a child. A breast can be "dirty", just as a bottle can be either not cleaned well enough or cleaned very well but with some of the chemistry involved staying there. In general: no difference in hygiene assuming that proper hygiene is maintained.

the more times some device is touched, the more it can be contaminated

properly cleaned device will not be harmful and will not make the milk go bad.

would the child have a better chance to "bond" with the mother when being breastfed?

Mother could bond with the child more I guess. The child... Not necessarily. Notice that a newborn sees little, it feels warmth, touch and smell though, and it is comforting. So assuming that the baby is held in mother's/father's arms there'll be little difference in comfort and bonding for the child.

Quality of milk

An important factor of your considerations should be the quality of milk the baby drinks. Most often the milk from the breastpump goes to a fridge or feezer to be used later on. After that it will still be a very good source of nutrition, however, with time and improper storing, it may lose some of its properties, especially antibodies and fat

Amount of milk

Some pumps and some women may experience a decrease of milk production when using pumps. In that case a woman should try to feed the baby more straight from the breast, thus increasing the milk production.

  • Looks similar to what I was going to say - I recall being told that the enzymes from a suckling infant help to stimulate/prolong milk production, which along with having fewer bottles and equipment to sterilise can only lend favour to breastfeeding directly. Though that may be offset by the fact that breast pumps don't bite! :) – James Snell Jul 15 '15 at 12:54
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    @JamesSnell as far as I know it's not the enzymes, it's the sucking itself. The more a child sucks, the more milk is produced, but a pump sucks in the same way a child does and also influences the amount of milk being produced. My wife didn't notice a decrease in milk production after she started using a pump. – Dariusz Jul 15 '15 at 12:59
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    warmth, touch and smell . little ones bond by smell too. its why us daddies do skin to skin too. as far as mom, i think she has more hormones released latching vs. pumping. id say do both if you can. Latch on breast for bonding, pump to keep supply up. easy for me to say - i don't have to sit and pump. – Rich Homolka Jul 15 '15 at 13:56
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    @Dariusz Pumps do not suck nearly as hard as a child does, generally, and thus do not stimulate as much production nor do they generally get quite as much out. While for most women this isn't an issue, for women who are only barely making enough milk it can be problematic. I remember my wife (who usually made sufficient milk) had a period with our first child where she had a very bad sinus infection and had to take sudafed (which is a milk suppressant); she needed to feed him at lunchtime (rather than pumping) in order to make enough milk. – Joe Jul 15 '15 at 15:12
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Expressed milk is the next best alternative only when breastfeeding is not possible.

When you breastfeed directly, the physical contact with your baby helps your body to create antibodies to germs in his environment, your body creates antibodies in response to cues from the baby's saliva and other secretions.

When breastfeeding directly, your body will produce more milk in response to the baby's demand, replaces the milk your baby removes from the breast; it is not possible with expressing milk.

For expressed milk you need to wash breast pump and bottle parts which involves chemicals - that is not safe for babies. So breast-mouth is better than breast to pump to bottle to mouth.

Breastfeeding directly increases the mother-baby bonding.

Source: http://nativemothering.com/2012/04/are-there-differences-between-breastfeeding-directly-and-bottle-feeding-expressed-milk/

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