Infant Nutrition: Choosing a Formula
Selecting the correct formula for an infant can seem like a daunting task, but it really should not be. There are so many choices on the shelves that it can be overwhelming, particularly if you have never used formula before. However, while most babies grow and thrive on basic infant formula, there are certainly cases in which the more specialized types of formula are necessary.
I will not be discussing brands of formula because I honestly do not have a preference amongst them and would not want to come across as biased. There are subtle differences between brands of formula, and some infants appear to do better on one versus another, but my experience does not allow me to make any broad statements in favor of any particular brand.
Cows milk-based
This is the most basic and the most commonly used type of formula in the United States. Lactose is the primary carbohydrate source, and for most formulas the concentration is equal to that found in breastmilk. Vegetable oils and other fats that are easily digested by infants allow for improved growth as well. These formulas are also iron-fortified, which has drastically reduced the rates of iron-deficiency anemia in infants.
“Sensitive”
When infants do not tolerate the basic cow’s milk-based formulas, they sometimes improve on a modified version. These include labels like “sensitive” or “gentle” or “predigested” and typically refer to proteins that have already been partially or extensively broken down to allow for easier digestion and absorption.
Hypoallergenic
There are times when infants cannot tolerate cow milk-based formulas at all, sometimes due to an allergy to the milk protein. This can cause extreme abdominal discomfort, even blood in the feces. These infants require a hypoallergenic formula to ease the process of digestion and allow the gut lining to heal, while still providing proper nutrition.
*A note on corn syrup solids, a component of many hypoallergenic formulas – it is important to know that this is NOT the same as high-fructose corn syrup. This is a common misconception. Corn syrup solids are a hypoallergenic carbohydrate source that is used to replace lactose. These corn syrup solids are broken down into glucose during digestion.
Other alternatives to cows milk
Alternative formulas for lactose-intolerant infants include soy or plant-based formulas. There is also growing research regarding goat milk-based formulas but these are not currently widely used. Please note: goat milk-based formula is not the same thing as goat milk, just like cow’s milk-based formula is not the same as cow’s milk. It is not recommended to give goat milk OR cow’s milk to infants under one year of age.
Safety concerns
While the proper use of formula is safe for infants, there are some safety concerns that we need to address.
- mixing concerns – it is vitally important that formula be mixed properly. Always follow the directions on the can for mixing. Never dilute formula to make it last longer, and do not add water to liquid, ready-to-feed formulas. Infants can become very sick if the formula is diluted too much.
- homemade formula – there are recipes online for making your own formula, and while this may be tempting because they claim to be healthier and cheaper than store-bought formulas, they can be dangerous. These may not meet your infant’s complete nutritional needs and the ingredients may not be safe for infants under a year. Breastmilk or store-bought formulas that meet FDA standards are the only recommended sources for infant who are under a year.
- foreign formulas – it is not currently recommended to use formula imported from other countries. These have not been reviewed or approved by FDA for safe use in infants. They are also not always stored or shipped correctly. There is no scientific evidence that these formulas are more beneficial for infants.
- how long is it good for – prepared formula should be used within the 2 hours of mixing. It can be stored in the refrigerator for up to 24 hours. Dispose of all formula that has been at room temperature for more than 2 hours or in the refrigerator for more than 24 hours.
Final thoughts
Feeding an infant formula is a perfect solution for those who are unable or decide not to breastfeed. Formula is a source of complete nutrition and allows infants to grow and develop at a normal rate. However, there are multiple options when it comes to choosing formulas, and not every baby will tolerate every formula. It may take time to determine which choice is best for your baby.
It is not recommended to change formulas frequently. Work with your infant’s pediatrician to determine which formula may be needed if a traditional infant formula is not working for your child. It can take several days on a new formula to see if it makes a difference in symptoms.
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