Breastmilk Substitutes


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The-Top-Up-TrapOften by suggesting to a mother that she should give her baby formula, we are disempowering her and decreasing her confidence. This can result in frustration and low milk supply.

Breastmilk is all that a baby needs to support normal growth and development for the first 6 months of life. Generally, babies do not need formula, water, sugar water, teas, condensed milk, etc. Rehydration solution (ORS) and syrups (vitamins, minerals, medicines) are acceptable as recommended by a health professional.

Should a baby require supplementation for a medical reason, there are other options prior to offering infant formula.  The order of feeding options are:

  1. Breastfeeding
  2. Expressed Breastmilk
  3. Donor Breastmilk
  4. Infant Formula (Iron-fortified)


Donor Breastmilk

For more information on donor breast-milk in Alberta and the Calgary Mother’s Milk Bank, click here.

There are 2 other milk banks in Canada. There is one BC (BC Women’s Milk Bank) and one in Ontario (Rogers Hixon Ontario Milk Bank).

More information about Milk Banking is available from the Human Milk Banking Association of North America (HMBANA)



Here are some situations when formula may be needed:

  • Infants with certain rare conditions (glactosemia maple syrup urine disease, phenylketonuria)
  • If the mother has HIV
  • If the mother has active Herpes simplex virus (direct contact to lesions should be avoided)
  • If the mother is taking certain medications (radioactive iodine, cytotoxic chemotherapy)
    Most medications are safe. See the Thomas Hales’ latest edition of Medications and Mother’s Milk

Click here to See the WHO’s “Acceptable medical reasons for use of breast-milk substitutes”

Informed consent from parents should be obtained prior to giving a baby infant formula. This includes an explanation of the risks of formula feeding. If parents make the informed decision to provide formula to their infant, ensure that parents know how to prepare and provide formula safely. For more information see the Nutrition Guidelines for Healthy Infants and Young Children


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