Are you a new parent? Overwhelmed by all formula options? Planning to breastfeed but now need formula?
I get it, there are a lot of things to think about when deciding which formula is best for your little one. It’s difficult to even know where to start!
As a pediatric dietitian I have learned the ins and outs of infant formulas. Let me decode the infant formula choices for you.
This article explains the types of infant formulas, how they are alike, and how they differ. This guide will help you learn about all the Infant formulas so you can decide which one is right for your baby.
Introduction
Breast milk, also known as human milk, holds the top spot for feeding our little ones. It’s so great all baby formulas aim to be just like it.
In reality though, there are many situations where human milk is not an option. Stress, inadequate supply, difficulty with feeding, etc can all limit the availability of human milk.
Luckily, we have many safe and healthy formula options for babies, either as a supplement to human milk or instead of human milk.
Key similarities of baby formulas
Nutritionally complete for a growing baby
All baby formula sold in the United States must meet specific nutrition requirements to support healthy growth.
To provide complete nutrition for babies, all baby formulas contain several vital components:
- Proteins
- Fats
- Carbohydrates
- Vitamins
- Minerals
Nutrients like iron and calcium must be within a certain range to support growthing in babies.
Meet safety standards
The Food and Drug Administration (FDA) oversees the approval of baby formulas to ensure they meet nutrient requirements and are manufactured in a safe way.
Each formula must have above a minimum, and below a maximum amount of protein, carbohydrates, fats, vitamins and minerals.
Key differences of baby formulas
Protein Source
A variety of protein sources are used in infant formulas. The three most common proteins used in baby formula are cow’s milk, goat’s milk, and soy.
Goat and cow’s milk protein contain two protein types: whey and casein. Whey protein is digested more quickly than casein protein. Both types are found in human milk and baby formulas.
In some formulas the protein is modified and broken down to be more easily digested by babies with sensitive tummies or babies with food allergies. Formulas with broken down proteins are called gentle, hypoallergenic, and amino acid formulas.
Lactose Content
Lactose is a main energy source in human milk. Babies need an energy source like lactose as part of their formula to growth.
The amount of lactose is different from one formula to the next. Low lactose or lactose free formulas use other energy sources in place of lactose like corn syrup, maltodextrin, potato starch, rice starch, or just plain sugar.
DHA and ARA
DHA and ARA are two kinds of fats called long-chain polyunsaturated fats (PUFA). These fats are an essential part of the development of a baby’s eyes and brain found in human milk.
The studies done so far don’t show a clear benefit of adding DHA and ARA to Infant formula for healthy full term babies. However, studies do show providing formula with DHA and ARA can increase the blood levels of these fats.
DHA and ARA are not required nutrients in baby formulas in the United States. They are required in European baby formulas. Many baby formulas include DHA and ARA.
Prebiotics
Prebiotics feed beneficial bacteria in the gut that help with digestion, immune function, and nutrient absorption. Babies are born with no bacteria in their gut. Over the first few years of life they build up their gut microbiome through what they drink, eat, and come in contact with.
Human milk contains many different prebiotics called human milk oligosaccharides (HMO) which help babies develop a healthy gut.
Some formulas include prebiotics to feed and increase the healthy bacteria in a baby’s gut like human milk.
Probiotics
Probiotics are bacteria that provide health benefits. They are often called “good” or “healthy” bacteria and there are many different kinds. Each one has a unique way it can impact or improve health. We are still learning how they impact health and do not understand them well. Probiotics are found in human milk and some formulas.
Types of baby formulas
Routine baby formulas or Standard baby formula
Routine or standard baby formulas are designed for healthy, full-term babies. These are sold at stores with the name including the word “Infant,” “Advance,” or “Total Care”. These formulas are suitable for most babies.
Currently, cow’s milk is the base milk used for most infant formulas. The cow’s milk is modified with other nutrients added to be suitable for babies.
Goat’s milk based baby formula
Another option for routine or standard infant formula is goat’s milk formula, which uses goat’s milk instead of cow’s milk as the base of the formula and protein source. Like cow’s milk, goat’s milk is modified to make it suitable for babies.
Although goat’s milk-based formula is a newer option available in the US, it has been available in Europe for over 10 years. Evidence shows some babies with sensitive tummies may benefit from goat’s milk formula.
Organic baby formula
Organic formula is a standard formula made from cow’s milk. “Organic” means it has met the requirements for organic certification, including being non-GMO and containing at least 95% certified organic ingredients.
Being organic does not change or improve the nutritional quality of the formula.
One drawback is these formulas are often more expensive than other standard baby formulas. Also, it is important to note that many non-organic baby formulas are made with non-GMO ingredients.
Plant-based baby formula (aka Lactose free baby formula or Soy)
Plant-based baby formulas are made from soy. These soy-based formulas are lactose-free and widely available.
Lactose-free formulas are essential for infants unable to digest lactose due to medical conditions like galactosemia. However, these medical conditions are quite rare. This differs from lactose intolerance, which is also rare during infancy.
Scientific studies have shown lactose-free formulas don’t have an advantage over routine dairy formulas for colic, growth, or development.
Soy formula is often marketed as an alternative to cow’s milk-based formulas. Sometimes these formulas are used for babies with a cow milk protein allergy. However, some babies with a cow’s milk protein allergy are also allergic to soy protein.
Sensitive baby formula
Sensitive formulas are made with lower lactose to help babies with lactose sensitivity. They will include the word “Sensitive” in the name.
However, it is quite rare a baby is not able to digest lactose. Lactose is naturally found in human milk, and most healthy, full-term babies can digest it.
The American Academy of Pediatrics states that these lower-lactose formulas have no clinical advantage over standard formulas for healthy, full-term babies.
Gentle baby formula
You can identify these formulas by names containing “Gentle” or “Comfort.”
They are made for babies with tummies that need a little help with digestion. The protein is broken down into smaller pieces, making it easier to digest so the baby’s tummy has less work to do. The scientific term for this is “partially hydrolyzed” proteins.
Many of these formulas are also lower in lactose than standard infant formula.
Specialty formulas
Specialty formulas on the market are designed for specific medical needs.
These formulas should be used with medical supervision, even if they can be purchased over the counter.
Your medical provider can help identify the best option for your baby and may assist with obtaining the formula.
Spit up baby formula
Spit-up formulas are specifically designed for babies with severe spit-up issues. Evidence supports they are effective in reducing the number of daily spit-ups.
These formulas are made thicker by adding a starch, such as rice, to prevent the formula from coming back up as vomit or spit-up.
Adding thickeners to infant formula increases the calorie content, which can lead to overfeeding. Spit-up formulas are specially designed so they are not higher in calories when thickened and can help prevent overfeeding babies.
Hypoallergenic baby formula
Often referred to in the US as hypoallergenic or extensively hydrolyzed formula. This formula is designed for babies with cow’s milk protein allergy.
The cow’s milk protein in the formula is broken down into even smaller pieces than in partially hydrolyzed (or gentle) formulas, which reduces the likelihood of an allergic reaction.
You may wonder why cow’s milk protein would be given to a baby with an allergy? The process of hydrolyzing the cow’s milk proteins breaks them down into such small pieces that many babies’ immune systems do not recognize them as cow milk protein anymore.
The American Academy of Pediatrics recommends hypoallergenic formula for infants with cow’s milk protein allergy.
Amino acid based baby formula
Also referred to as elemental formula, this type of formula’s protein comes from individual amino acids, or the basic building blocks of proteins.
Because it does not contain intact proteins or protein pieces, most babies can tolerate this formula well. The American Academy of Pediatrics recommends amino acid formula for infants with cow, soy, and goat milk protein allergies.
This formula typically comes with a higher price tag and is less palatable compared to other formulas.
The image below shows the difference in protein sizes for the various types of baby formulas.
Preterm baby formulas
Designed for babies born early, or before 37 weeks gestational age, preterm baby formulas are formulated to meet the unique nutritional needs of these infants.
Preterm babies often have different requirements for growth compared to full-term babies, and these specialized formulas aim to provide the necessary nutrients to support their development.
In the end…
There are many options when it comes to feeding your baby.
Always discuss with a medical provider before making changes to what you are feeding your baby. This is true even for formulas you can get over the counter.
All infant formulas sold in the United States provide the essential nutrients for a baby’s growth and development. There are regulations in place to keep baby’s safe.
Infant formulas vary in the protein source, amount of lactose, and addition of some additional nutrients like DHA, ARA, prebiotics, and probiotics.
When choosing a formula there are a variety of options based on your baby’s individual needs. Most full term babies do well on a routine formula made from either cow’s milk or goat’s milk.
For babies who do not do well with routine formula, other options exist including gentle, sensitive, and lactose free formulas
And for babies with a medical condition like a milk protein allergy or reflux, specialty formulas are available. If you suspect your baby may need these formulas talk with your medical provider. They can guide you and often have access to free samples or coupons.