Is Breast Still Best From a Bottle

* Abbreviation: CHILD — : Canadian Healthy Infant Longitudinal Development “What is the healthiest way to feed our baby?” Many new parents ask their pediatricians this question. Although “breastfeeding” has been the clear answer for decades, the importance of exclusive breastfeeding as the primary driver of health benefits for infants has emerged more recently.1,2 The strongest evidence for exclusive breastfeeding is in the prevention of common infectious diseases and sudden infant death syndrome.1–3 That exclusive breastfeeding is associated with healthier early weight gain trajectories has been more difficult to demonstrate, but authors of recent studies have begun to build some early evidence in this area.2,4 Because exclusive breastfeeding was found to be the key ingredient for positive child health impacts, new questions arose. If a newborn is transiently given supplemental formula for a few days in early life but then reverts to exclusive breastfeeding, does the same degree of health benefits hold? Is there a difference in health outcomes if human milk is fed directly from the breast or if it is expressed and fed via a bottle? When bottled human milk is used, does it matter if it is used as fresh milk or reheated after refrigeration or freezing? Does the … Address correspondence to Alison Volpe Holmes, MD, MPH, Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Rubin 525, 1 Medical Center Dr, Lebanon, NH 03756. E-mail: alison.v.holmes{at}hitchcock.org