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Ms. Gartner makes important points. The American Academy of Pediatrics (AAP) states that "exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first six months of life . . ." and that "supplements (water, glucose water, formula, and other fluids) should not be given to breastfeeding newborn infants unless ordered by a physician when a medical indication exists." 1 In my article I used the Centers for Disease Control and Prevention's (CDC's) previous definition of exclusive breastfeeding 2; the more recent AAP recommendation was issued this year. (Beginning in January 2004, the CDC's definition of exclusive breastfeeding explicitly rules out water.)


Ms. Gartner is correct: no extra food or equipment are required for breastfeeding. But even when you factor in the potential costs of food for optimal health and breast pump equipment, breastfeeding is still less expensive than formula feeding.




1. Gartner LM, et al. American Academy of Pediatrics Section on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 2005;115(2):496-506. [Context Link]


2. Centers for Disease Control and Prevention. Breastfeeding practices: results from the 2003 National Immunization Survey. 2004. [Context Link]