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Do Formula-Fed Babies Get More Congestion?

Do Formula-Fed Babies Get More Congestion?

It’s tough to hear your baby stuffed-up and sniffling. And unlike adults, babies can’t simply blow their nose or cough out mucus. 

It’s natural to wonder whether your decision to formula feed might be causing congestion, but don’t worry – it’s not. There is no evidence linking formula to congestion at all, so you can ditch the guilt. 

It is true that breastfed babies are less likely to suffer from upper respiratory infections than formula fed babies, but this is often the result of regurgitated milk or excess saliva. Breastfed babies can, and do, get congestion just like formula fed babies. 

If you’d like some reassurance, take a look at parenting groups on social media – you’ll find plenty of breastfeeding, formula feeding and mix-feeding moms asking for help with their little one’s congestion.

What about ear infections? Are they caused by formula?

No, ear infections are not caused by formula, though there is some evidence that bottle feeding (whether expressed breast milk or formula) can make ear infections more likely.  But the good news is, you can take steps to prevent it. 

Bottle feeding can cause congestion where babies are fed lying down. As milk from the bottle pools in the mouth the eustachian tube, which connects the throat to the ear, can become filled with milk too. This can block and irritate the tube, causing ear infections. 

By contrast, the breastfeeding position is naturally more upright, and breastfed babies can’t be left with a bottle propped up for them, as some parents choose to do. 

To prevent ear infections, always mimic the natural breastfeeding position as closely as you can when bottle feeding and never leave them with a propped up bottle. Have your baby in your arms, making sure they’re as upright as possible, and feed them slowly. That way, bottle feeding is as close to breastfeeding as it can be, and you’ll dramatically cut the risk of infection.

My baby is congested – what should I do?

There are a few simple things you can do to help ease congestion. Saline drops and nasal aspirators can provide some fast relief and are easy to use away from home. 

Overnight and for naps, some parents find putting a humidifier in their baby’s room is helpful, as it adds moisture to the air and helps clear airways (just like steaming your face over a bowl of hot water can). You can also try raising one end of your crib to prop your baby’s head up without using pillows (which are a suffocation risk). If your crib isn’t adjustable, a pile of sturdy books under the top two legs will do the trick.

As always, see your pediatrician if you have any concerns. Watch for signs of fever, wheezing and vomiting. And be especially vigilant for signs that your baby is having serious trouble breathing. These can include making grunting noises, flared nostrils and their skin pulling in around the ribs or collarbone as they breathe – you’ll need urgent medical help if you see any of these. 

Congestion can be caused by common colds or bronchiolitis, or possibly an allergy or intolerance. Around 2-3% of babies are thought to be allergic or intolerant to cow’s milk protein – but it’s more common in formula fed than breastfed babies. As well as congestion, they might have rashes, swelling or tummy pain. It’s hard to diagnose cow’s milk protein allergy (CMPA) or intolerance (CMPI) as the symptoms are similar to other conditions, such as celiac disease. If you suspect it, see your doctor – they might suggest cutting out dairy products or a blood test or skin prick test. 

If your baby is found to have an allergy or intolerance, they’ll need a specialist formula. If you’re breastfeeding a cow’s milk allergic baby, you’ll need to stop eating dairy products yourself, to avoid passing them on through your milk. The majority of babies grow out of cow’s milk allergy by the time they turn 1.


Goat’s milk and hypoallergenic cow’s milk formulas are available, but check with your pediatrician before switching.

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