Formula Feeding in Infancy: Toddlers’ Digestive System

Research Literature Support

The current project is an evidence-based research paper that deals with the possible effects of formula feeding in infancy on toddlers’ digestive system. Before discussing the proposed methodology for the study, it is important to review the available literature that may support the research. It can be suggested that researchers’ views on the topic of breastfeeding versus formula have been mixed. For example, Belfield and Kelly (2012), as well as Brown and Lee (2012), concluded that breast milk helped children become protected against obesity and mental illnesses. Also, Salone, Vann, and Dee (2013) suggested that breastfeeding should be exclusive for at least the first six months of life as it promoted better health outcomes. Stuebe (2009) found that not being breastfed increased the chances of childhood mortality and health issues such as diabetes or leukemia. Asgarshirazi, Shariat, Nayeri, Dalili, and Abdollahi (2017) found that infants fed with breast milk showed higher levels of protection against inflammation, which pointed to bodies’ immune maturity. According to Lok et al. (2017), infants with low birth weight were more likely to reach a healthy weight when drinking breast milk. For preterm infants, breast milk feeding was also beneficial in increasing body weight and preventing the incidence of complications such as necrotizing enterocolitis (Li, Yan, Yang, & Han, 2017).

Martin, Ling, and Blackburn (2016) had a neutral attitude towards formula as it was the best attempt toward mimicking the composition of breast milk as closely as possible; it is a good substitution since breastfeeding is not always available. Formula feeding was shown to have a positive effect on preterm low birth weight infants who could not have breast milk (Hay & Hendrickson, 2017). No differences between the impact of formulas and breast milk were found by Osborn, Sinn, and Jones (2017), who investigated the effect of the two feeding methods on preventing allergies among infants. Add-on formulas have been suggested by Maldonado et al. (2012) for reducing cases of community-acquired gastrointestinal and respiratory infections.

Support for further research on comparing the impact of breast milk versus formula was provided by Ryan and Hay (2016) who suggested that the two methods had to be investigated deeper as parents may take different approaches to feed their children. Also, the need for future research on formula and breast milk feeding is associated with the differences in infants’ lipid responses to either type of nutrition and therefore the gain of healthy weight (Teller, Schoen, van de Heijning, van der Beek, & Sauer, 2017). Moreover, the use of formula should be investigated further with regards to long-term effects among healthy infants of standard risks since the majority of studies reviewed its impact on high-risk infants, whose nutritional needs usually align with the use of breast milk (Fleischer, Venter, & Vandenplas, 2016).

To conclude, the review of supporting literature showed that further research on the effects of formula use or breastfeeding among infants is needed, especially in connection to nutritional outcomes and digestive functions of standard risk children. The research articles included in the brief literature review can also become valuable contributions to current research regarding the further discussion of findings, relevance to nursing practice, and implications for future research.

Research Approach/Design

The current research will focus on quantitative data since such data can provide reliable and objective findings, restructure a complex problem to a specific number of variables that are the most important, as well as look at relationships between the established variables for discovering correlations. In this study, associations between infants’ digestive function and the use of either breast or formula feeding will be investigated. The quasi-experimental research was chosen as the appropriate design based on the rationale that it is a useful method for finding the causal effects of an intervention on a selected population. The quasi-experimental design is described as a method that has some features of experimental designs and randomized control trials; however, such a design provides a unique opportunity for researchers to control the assignment of conditions, interventions, and sampling techniques. It is also important to mention that quasi-experimental studies usually imply a manipulation of an independent variable before measuring a dependent, which gives a researcher more control over the study, thus eliminating issues with directionality.

Advantages of the selected research design include the ease of setting up research, the ability to conduct any necessary manipulations, the minimization of ecological validity threats, the efficiency in conducting longitudinal research, and the ability to perform follow-up in environments different to those in which the initial study was conducted. On the other hand, there are some disadvantages to the chosen study design; for instance, quasi-experimental research increases the contamination of findings by variables that can confound each other. Moreover, the design can introduce internal validity threats, make it difficult to determine causal relationships between studied variables, as well as produce evidence of a weaker quality since the aspect of randomness is absent.

Sampling Method

The target population for the research will include infants and toddlers whose primary sources of feeding include breast milk and/or formula. Non-probability sampling will be used since the study is quasi-experimental and will need greater control on the part of the researcher. Convenience sampling is the preferred method in this quasi-experimental research because it will provide the researcher with the convenience of selecting accessible participants that will fit the purpose and the aim of the study. It is expected that 200 participants will be included in the sample; the researcher is planning to approach mothers with infants at healthcare facilities and public places. They will be provided with a leaflet with general information about the study and will be asked to contact the researcher if they would become interested in participating.

Advantages of convenience sampling include such benefits to the current research such as expedited data collection, the ease of research for the scientist, ready availability of subjects, and cost-effectiveness. This means that the researcher will not spend too much time on data collection, will be able to move from one stage of research to another without disruptions, will not have to spend large distances to reach participants, as well as will reduce costs associated with research. A key disadvantage of convenience sampling is associated with bias. Study participants will be protected from personal information breaches with the help of coding (using numbers instead of names), consent letters to confirm their participation, and the supervision of healthcare specialists (nurses and mental health professionals) to guide interventions and support mothers and their infants. Additional security methods (both digital and physical) will be used when it comes to the storage of information after the research is completed.


Asgarshirazi, M., Shariat, M., Nayeri, F., Dalili, H., & Abdollahi, A. (2017). Comparison of fecal calprotectin in exclusively breastfed and formula or mixed fed infants in the first six months of life. Acta Medica Iranica, 55(1), 53-58.

Belfield, C., & Kelly, I. (2012). The benefits of breast feeding across the early years of childhood. Journal of Human Capital, 6(3), 251-277.

Brown, A., & Lee, M. (2012). Breastfeeding during the first year promotes satiety responsiveness in children aged 18-24 months. Pediatric Obesity, 7(5), 382-390.

Fleischer, D., Venter, C., & Vandernplas, Y. (2016). Hydrolyzed formula for every infant? Nestle Nutrition Institute Workshop Series, 86, 51-65.

Hay, W., & Hendrickson, K. (2017). Preterm formula use in the preterm very low birth weight infant. Seminars in Fetal and Neonatal Medicine, 22(1), 15-22.

Li, Y., Yan, C., Yang, L., & Han, Z. (2017). Effect of breastfeeding versus formula milk feeding on preterm infants in the neonatal intensive care unit. Chinese Journal of Contemporary Pediatrics, 19(5), 572-575.

Lok, K., Chau, P., Fan, H., Chan, K., Chan, B., Fung, G., & Tarrant, M. (2017). Increase in weight in low birth weight and very low birth weight infants fed fortified breast milk versus formula milk: A retrospective cohort study. Nutrients, 9(5), 20-29.

Maldonado, J., Cañabate, F., Sempere, L., Vela, F., Sánchez, A., Narbona, E., …Lara-Villoslada, F. (2012). Human milk probiotic lactobacillus Fermentum Cect5716 reduces the incidence of gastrointestinal and upper respiratory tract infections in infants. Journal of Pediatric Gastroenterology and Nutrition, 54(1), 55-61.

Martin, C. R., Ling, P.-R., & Blackburn, G. L. (2016). Review of infant feeding: Key features of breast milk and infant formula. Nutrients, 8(5), 279.

Osborn, D., Sinn, J., & Jones, L. (2017). Infant formulas containing hydrolyzed protein for prevention of allergic disease and food allergy. Cochrane Database Systematic Reviews, 3, 1-7.

Ryan, A., & Hay, W. (2016). Challenges of infant nutrition research: A commentary. Nutrition Journal, 15(42), 1-8.

Salone, L., Vann, W., & Dee, D. (2013). Breastfeeding: An overview of oral and general health benefits. The Journal of the American Dental Association, 144(2), 143-151.

Stuebe, A. (2009). The risks of not breastfeeding for mothers and infants. Reviews in Obstetrics and Gynecology, 2(4), 222-231.

Teller, I., Schoen, S., van de Heijning, B., van der Beek, E., & Sauer, P. (2017). Differences in postprandial lipid response to breast- or formula-feeding in 8-week-old infants. Journal of Pediatric Gastroenterology and Nutrition, 64(4), 616-623.