What Baby Formula Milk To Use?
When you have made the decision to bottle feed your baby the next, and most important, decision is what formula milk is best for your baby. Choosing the best formula for your baby should be done in consultation with your doctor. You can rest assured that the formula milk manufactured today is the best it ever has been and most infant formulas are designed to be as close to human breast milk as possible. Whatever formula milk you decide to use the most important thing to do is to always follow the manufacturer's instructions.
About baby formula
Infant formula comes in 3 varieties:
- ready-to-use (which is the most expensive)
- concentrated liquid
- powder (which is the cheapest)
When prepared for feeding, according to manufacturers recommendations, these different forms of infant formula are equivalent in nutritional content.
There are two categories of formula - 'Starter' formulas are designed for babies 0 - 6 months and 'Follow-on' formula can be offered to babies older than 6 months.
Apart from the large variety of different brands of infant formulas, found on your supermarket shelves, these is also a range of specialty formulas available for babies with problems associated with prematurity, lactose intolerance, milk allergy, reflux and other more serious conditions.
With the exception of some of the specialty formulas, all infant formulas are made up to provide the same amount of energy (calories) per ounce. As your baby grows she needs more milk, not stronger milk.
There is very little difference between the different brands, so don't just go and buy the most expensive. Regulations on the manufacture of infant formula are very strict in most countries, which means the different brands of formulas are generally very similar in nutritional content. As prices can vary from store to store it pays to shop around.
It is generally a good idea to stick to the one brand of formula however, you may need to change the type of formula you use if the baby shows signs of milk allergy, becomes constipated or has a lactose intolerance. Before changing the formula milk you use always consult your doctor.
Cow's milk formula
This is by far the most widely used. Manufacturers use cows milk as the base product; the protein quality is improved and salt levels are reduced. A range of different fats is added and the milk is supplemented with 13 essential vitamins and 11 essential minerals (including iron and calcium).
Cows milk formulas are classified as 'whey dominant' or 'casein dominant', which describes the main protein type in the formula. Whey dominant formula is easier to digest and is more suitable for babies under 6 months of age.
Although providing the same amount of calories per ounce, casein dominant formula is digested more slowly than whey dominant formula. Many 'follow-on' formulas and so called 'hungry baby' formulas are casein dominant. Brands such as Similac Advance, Enfamil Lipil, and Nestle Good Start Supreme are made with lactose and cow's milk based proteins.
Soy based formula
Soy formulas are designed for use when a baby becomes temporarily unable to digest lactose, for example, after gastroenteritis, and are prescribed if the baby is intolerant of cow’s milk protein. In soy formulas carbohydrate is added as sucrose or corn syrup solids, or a mixture of both. Soy-based formulas are made so that they contain slightly more protein than milk formulas because the body uses vegetable protein less efficiently than animal protein.
Soy-based and modified lactose formulas are suitable when recommended by your doctor. According to the Australian College of Paediatrics’ policy statement on soy protein formulas there’s a tendency to wrongly diagnose food allergy in infants and the indiscriminate use of soy formulas should be avoided. Food intolerance of any kind is a matter for expert dietary diagnosis and advice.
Another possible problem with soy-based formulas is the potential effects of phytoestrogens in soy on hormones, but there needs to be more research on this. The effects of genetically modified soy beans may also be a concern, but again more investigation is needed. Brands include Enfamil ProSobee, Similac Isomil, and Nestle Good Start Supreme Soy.
Goat's milk formula
Goat’s milk is gaining in popularity and some feel it is better for baby and the environment. Using goat’s milk is probably fine, however, goat’s milk does only contain around 10% of the folic acid that is found in cow’s milk. So, if you are planning to use goat’s milk, find a brand that has been fortified with folic acid. On the plus side, goat’s milk formula does contain far higher levels of copper and antioxidant selenium. Some also believe that babies have a lactose intolerance will do better by switching from cow’s to goat’s milk. Whilst it is true that Goats milk does contain lower levels of lactose, if your child is lactose-intolerant then you are probably best switching to soy based formula or a lactose free formula of cow’s milk.
Partially hydrolyzed formula
If a formula fed baby is at risk of developing an allergy, e.g. if either parent or a brother or sister have an allergic condition (such as eczema, asthma or a food allergy) using a partially hydrolyzed formula may help to reduce the risk of a milk allergy developing. Although soy formula was recommended for this purpose in the past, studies have shown soy formula does not reduce the risk of allergies to any great extent.
Partially hydrolyzed formulas are based on cows milk, but the protein molecules in these formulas have been partially broken down into smaller molecules that should be less likely to cause allergies.
Where a baby has already developed an allergy to cows milk, partially hydrolyzed formulas should NOT be used. A specialty formula, where the protein is more completely broken down, may then be necessary. (Specialty formulas for milk allergies are only available on a doctor's prescription.)
Specialty formula
This type of baby formula usually requires a doctor's prescription. It is mainly used for premature babies, those with heart conditions, mal absorption disorders, or an inability to digest fats.
AR (Anti Regurgitation) formula
AR formulas are thickened with carob bean gum or starch, such as rice or cornstarch. Each formula manufacturer may use a different substance to thicken the milk. One brand of AR formula may work better than another for some babies. Brands include, Similac Special Care and Enfamil Premature.
AR formulas are designed to help to reduce spitting-up and regurgitation associated with gastro-esophageal reflux. However, thickened formulas do NOT always help. Some babies will fuss more with thickened formula or may become constipated or spit-up even more.
AR formulas are modified by removing some of the lactose (sugar in milk) to adjust for the extra calories provided by the thickening agents. As a result, the amount of calories in an AR formula remains the same as regular formula (which is not the case when you use a food thickener to thicken formula).
A certain amount of regurgitation or reflux (spitting-up) is normal for healthy babies. If your baby is not distressed by regurgitation or minor spit-ups, it's not essential to use a thickened formula at all. In a healthy, thriving baby minor spit-ups are more of a laundry problem than a health concern. (For severe vomiting consult your baby's doctor.)
Note: AR or thickened formulas are NOT recommended for healthy infants who DON'T spit-up or regurgitate milk.
DRA and ARA Formula
Very recently, new infant formulas have been introduced that are supplemented with DHA and ARA, which are found in breast milk and are thought to help with an baby’s development. DHAs and Aras are nutrients known as fatty acids. Fatty acids are building blocks of various body tissues both before and after birth. In fact, the nonwater matter in the brain is made up of about 60 percent fat. Babies receive both DRA and AHA throught the placenta before birth, and can receive reduced levels in breastmilk.
DHA is the scientific shorthand for docosahexaenoic acid, an abundant fat in the eye and the brain. Recently, medical researchers have recognized the importance of this nutrient and its potential to positively influence brain function and vision development.
ARA or arachidonic acid is found in cells throughout the body, including the brain and retina. It has long been recognized to play a key role in nutrition, supporting the growth of organs and tissues. Together with DHA, it is important for brain, neural and eye development in infants.
Brands of these supplemented formula include Enfamil Lipil, Similac Advance, and Nestle Good Start Supreme DHA & ARA. Talk to your doctor about these and what benefits, if any, they could offer your child.
Follow-on formula
These formulas are used to feed babies over six months old. These formulas usually have a little extra protein. There is no need to use follow-on formula; you're baby will continue to thrive on baby formula for the first 12 months. Remember, as your baby grows it will want more milk, and that's it.